How to Handle Underperformance Without Losing Top Talent
Every health manager faces it at some point: a team member who is not meeting expectations. How you respond matters well beyond that one person. Your high performers are watching closely. If underperformance goes unaddressed, they carry extra load and start to wonder if the standard is really the standard. If it is handled poorly, trust erodes. Handled well, it strengthens your culture and your retention.
Act early and stay curious
The biggest mistake is waiting. Small concerns become big problems when they are left alone. Start with a private, supportive conversation as soon as you notice a pattern. Ask open questions before drawing conclusions. Is it a skills gap, workload, a personal challenge, unclear expectations or a poor fit? The cause shapes the solution.
Be specific and clear
Vague feedback such as "you need to step up" helps nobody. Describe what you have observed, explain the impact on patients, colleagues or the team, and be clear about what good looks like. Agree on measurable goals and a realistic timeframe. Document the conversation and follow up in writing, in line with New Zealand employment obligations and good faith requirements.
Support before you escalate
Offer training, mentoring, adjusted rosters or regular check-ins where appropriate. Many people respond well when they feel supported rather than judged. If improvement does not follow, a formal process may be needed, and it should be fair, transparent and consistent. Seek HR or legal advice when in doubt.
Protect your top performers
High performers leave when they feel they are carrying others or that standards are uneven. Keep them informed where appropriate, without breaching confidentiality. Recognise their contribution, share the workload fairly and make sure they have opportunities to grow. A strong team member who sees their manager act fairly and decisively is far more likely to stay.
Manager self-check
- Have I raised my concern directly and early?
- Are expectations written down and clear?
- Have I asked what support the person needs?
- Is there a follow-up date in the diary?
- Have I checked in with the rest of the team?
- Is my approach consistent with how I treat others?
Handling underperformance is never easy, but avoiding it costs more. Clear expectations, genuine support and consistent follow-through protect patient care, your culture and the people you most want to keep.
Need help building or retaining a high-performing permanent health team in New Zealand? Talk to RWR Health at www.rwrhealth.co.nz.






