Throughout the PDR process managers should be alert to staff struggling with performance due to an LLN skills gap.

There is an increasing volume of research which shows the impact of insufficient LLN skills, including difficulties with:

• Team working
• Patient handling skills
• Technical and practical skills
• Oral communication
• Problem solving skills
• Written communication
• ICT skills
• Health and safety

Often staff with LLN skills gaps lack confidence and so become inflexible and averse to change.

This in turn can affect confidence and motivation, leading to them becoming more prone to errors and sickness absence.

So a member of staff who makes lots of mistakes or frequently avoids certain activities may not be careless or being deliberately awkward. They may not have the skills to cope with the particular situation.

Implications for staff

Possible symptoms of low LLN skills can include:

• Misreading of documents
• Incorrect dosages supplied
• Absenteeism, which may be general or may follow a pattern which avoids certain days or times
• Reluctance to attend training or meetings
• Avoidance of taking messages
• Incorrect recording of messages

• Having difficulties with three digit numbers and percentages leading to incorrect mathematical estimates (affecting, for example, nurses and cleaners) and the inability to undertake essential calculations correctly.

• Struggling with spelling when completing forms or reports leading to the writing of incorrect, incomplete or scruffy handover notes.

• Ignoring important documentation leading to a lack of understanding and compliance with health and safety notices

• Signs of possible LLN difficulties
• Real life examples