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The Job description agreed with the new employee,should be the basis of the Contract of Employment and  determine the objectives to be achieved in particular areas of work for each period of  6 months to 1 year.
Once these can be agreed then, as an Independent Performance Review (IPR) they become the method of appraisal of performance, the key to further training and a possible basis for additional reward-bonus, promotion.
The concept of Regular Appraisal and helping people to perform better requires a more involved management style and  agreement for management too to be evaluated.
Staff may leave for a mixture of personal and professional reasons.Some staff turnover is healthy and desirable. Any health organisation is also a Training Organisation for all of its staff. There may be redundancies and sometimes dismissals.
It is essential to have this information easily to hand and to constantly review the changing face of the workforce, its capacity to perform, where there are shortages.
 An exit interview with staff leaving can help show up staff problems early.