In this article the author will examine the important role that the appraisal system, or performance review, plays in ensuring and improving quality care. As a manager it is your responsibility to support and develop your staff. Through appraisal you can identify good practice and support the achievement of organisational goals. It is also your opportunity to sit down with your staff on a one to one and discuss short falls and problems in performance. This article will start by highlighting the benefits and importance of appraisals, before examining why they have also generated such bad press in the past with both managers and staff? It will then identify the role and purpose that appraisal brings when performed correctly. Why difficulties may arise in performing appraisals will be highlighted. The importance of training for both managers and staff, in the appraisal process will be discussed as a key element to success.