PS FORM 5

THE REPUBLIC OF UGANDA

STAFF PERFORMANCE APPRAISAL FORM FOR THE PUBLIC SERVICE

Uganda Government Standing Orders Section A-e

Preamble
Staff Performance Appraisal is part of the Performance Management System for the Public Service of Uganda. It is
used as a management tool for establishing the extent to which set targets within overall goals of the organization
are achieved. Through staff performance appraisal, performance gaps and development needs of an individual
employee are identified. The appraisal process offers an opportunity to the Appraisee and Appraiser to dialogue and
obtain a feedback on performance. This therefore, calls for a participatory approach to the appraisal process and
consistence in the use of guidelines by all Public Officers in filling the form.

The Appraiser and Appraisee are therefore, advised to read the detailed guidelines before filling this form.1

DD MM YY DD MM YY
Period of Assessment: From To

SECTION A: PERSONAL INFORMATION (To be filled by the Appraisee)

Name of the Appraisee …………………………………………………...……………………………………...……

DD MM YY
Date of Birth

Job Title/Rank…………………………..…………………. Salary scale ………..........….….…….…………..…….

DD MM YY
Date of present appointment

Terms of employment (Probation, Permanent, Contract)…………..…………………………………………………

Name of the Appraiser ………………………………………………...…………………………………….......……

Job Title/Rank…………………………..………………………Salaryscale ………….….…….….………….….….

Ministry/ Department/ Local Government/Institution ……………………...……………….…….....………….……

Department………………….………………………………Division…….....……….………..………….………….

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 SECTION B: ASSESSMENT OF THE LEVEL OF ACHIEVEMENT

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This section should be filled by both the Appraiser and the Appraisee. At the beginning of each assessment period, the Appraiser and Appraisee will agree on the key outputs for the
assessment period. The means by which performance shall be measured (Performance Indicators) and the minimum level of performance (performance targets) for each output shall
be agreed upon. If in the course of the assessment period, other activities are assigned to the Appraisee, the outputs related to the new activities should be agreed upon and included
immediately or at least before the end of the assessment period. It is recommended that the maximum number of outputs for each assessment period should not exceed 10.

At the end of the assessment period, an appraisal meeting should be conducted by the Appraiser. The Appraisee completes part B (1), before the appraisal meeting, by indicating the
key outputs, performance indicators and targets agreed upon in the performance plan at the beginning of the assessment period. The Appraiser should complete part B (2), after the
appraisal meeting. The assessment should reflect the jointly agreed position.

The assessment of the Individual outputs shall be reflected as a performance level under section B(2), this will be supported by relevant comments on performance under the same
section. The performance levels shall be described as Excellent, Very Good, Good, Fair and Poor. In order to quantify the assessment the performance levels shall be awarded scores
namely; 5 for excellent, 4 for Very Good, 3 for Good, 2 for fair and 1 for Poor. Right after the table below is a detailed description of the performance levels.

B(1) B(2)
Agreed Key Outputs, Performance Indicators and Targets Agreed Assessment of Performance between the Appraiser
and the Appraisee
Key Outputs Performance Indicators Performance targets (An agreed minimum Performance Level Comments on Performance
(How will results be measured) level of performance)
Definition of the Performance Levels

Excellent (5): The Appraisee has exceeded the agreed targets and has consistently produced results of excellent
quality and demonstrated a high level of productivity and timeliness. The Appraisee is a model
of excellence in both the results achieved and the means by which they are achieved.

Very good (4): The Appraisee achieved all the agreed outputs in line with the agreed targets. The Appraisee
consistently meets expectations for the outputs achieved and the means by which they are
achieved.

Good (3): The Appraisee achieved most, but not all the agreed outputs in line with the agreed targets, and
there is no supporting rationale for not meeting the other commitments.

Fair (2): The Appraisee has achieved minimal outputs in line with the agreed targets and without a
supporting rationale for inability to meet the commitments.

Poor (1): The Appraisee has not achieved most of the agreed targets and without supporting rationale for
not achieving them.

Overall Assessment of Performance

Overall assessment of performance should be derived by adding the scores at each performance level and the total
divided by the total number of outputs. The average of the scores obtained shall be the overall assessment.

Overall Performance Level Excellent Very Good Good Fair Poor

5 4 3 2 1
Tick the relevant box

SECTION C: ASSESSMENT OF CORE COMPETENCIES

This section should be filled by the Appraiser after joint discussions between the Appraiser and Appraisee. The
assessment will help establish any areas where some training or development is necessary. The Appraisee should
be rated only in areas, which are relevant to his/her job. The maximum points per competence are 5, where 5 is for
Excellent, 4 - Very Good, 3 - Good, 2 - Fair, 1 – Poor, N/A - Not Applicable. The Appraiser should give work related
examples under comments, to justify their rating.

COMPETENCE ASSESSMENT COMMENTS

Performance level attained
(Please tick)

5 4 3 2 1 N/A

Professional knowledge/skills
Draws on own experience, knowledge and expertise to
demonstrate good judgment; relates professional knowledge
to work.
Planning, organizing and coordinating
Prioritizes own work, develops and implements plans;
rationally allocates resources, builds group capacity for
effective planning and executing of work. Has ability to
meet deadlines.

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Leadership
Keeps people informed; models and encourages
personal accountability; uses power and authority
fairly; demonstrates credible leadership, champions new
initiatives; reinforces and communicates a compelling
vision for change.

Decision Making
Makes logical analysis of relevant information and factors;
develops appropriate solutions and takes action, generates
ideas that provide new insight; provides reasons for
decision or actions, is objective.

Team work
Works cooperatively and collaboratively; builds strong
teams; shares information and develops processes to
improve the efficiency of the Team.

Initiative
Shows persistence by addressing current problems;
acts proactively, plans for the future and implements
comprehensive plans.
Is open to new ideas; curious about and actively explores
new possibilities; identifies how to create more value for
customers; takes action on innovative ideas and champions
innovation.

Communication
Actively listens and speaks respectfully; seeks to send
clear oral and written messages; understands the impact of
messages on others.
Result Orientation
Takes up duty willingly and produces results.

Integrity
Communicates values to others, monitors own actions for
consistency with values and beliefs, takes pride in being
trust worthy; is open and honest and provides quality
services without need for inducements.

Human Resource Management

Works effectively with people to achieve organizational
goals. Motivates the supervisees, focuses on the knowledge,
skills and attitudes and the general work environment that
affects their efficiency and effectiveness. Trains, mentors,
coaches, inspires, motivates the supervisees, delegates
effectively and are able to build a strong working team.
Financial Management
Knows the basic financial policies and procedures; familiar
with the overall financial management processes.
Management of other resources (equipment & facilities)
Effectively and efficiently uses resources to accomplish
tasks.
Time Management
Always in time and accomplishes tasks in time required and
maximizes the use of time to achieve set targets.

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 Customer care
Responds well and attends to clients. Reflects a good
image for the Public service.
Loyalty
Complies with lawful instructions of Supervisor and is able
to provide on going support to Supervisors.

Any other relevant Competence

SECTION D: ACTION PLAN TO IMPROVE PERFORMANCE

The Action Plan shall be jointly agreed during the performance appraisal meeting, taking into consideration the
Appraisee’s required job competences and the identified performance gaps.

The action plan to improve performance may include; Training, Coaching, mentoring, attachment, job rotation,
counseling and or provision of other facilities and resources.

Where the plan (s) involves formal training of the Appraisee, the record should be forwarded to the Training
Committee.

Performance Gap Agreed Action Time frame

SECTION E: COMMENTS, RECOMMENDATIONS (IF ANY) AND SIGNATURES

This section is to be completed by the Appraisee, Appraiser and the counter signing Officers. It is a confirmation
that the appraisal meeting took place and that there was agreement or if there was disagreement, it was resolved. It
is also confirmation that the action plan to improve performance was discussed and agreed upon. The Appraisee /
Appraiser / countersigning officer should use this section to comment about the job, career and any other relevant
information.

COMMENTS OF THE APPRAISEE

………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………

…………………………………………..………………………………………………………………….…………
DD MM YY
Signature …………………………………………….

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COMMENTS OF THE APPRAISER

………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………

……………………………………………………………………………………………...…………………………

DD MM YY
Signature …………………………………………….

COMMENTS OF THE COUNTERSIGNING OFFICER/SUPERVISOR OF APPRAISER

………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………

……………………………………………………………………………..……………..…………………………

…………………….......................................................................................................................................................

Name of Countersigning Officer …………………..……………………………………......……………..…...……..

Job Title ………..………………………………………………………….……………...……………………..……

DD MM YY
Signature …………………………………………….

COMMENTS OF THE RESPONSIBLE OFFICER

………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………

……………………………………………………………………………………......…………………………….…

Name ……………………………………………………….………………………....……………….………….......

Job Title …………………………………………………………………………….....………………………..… …

DD MM YY
Signature …………………………………………….