If press reports are to be believed it will not be long before information about the performance of individual surgeons of all specialties is in the public domain. I am sure the royal colleges are preparing members for this major change of culture and practice and the rest of us need to be thinking hard about it, too, says Ken Jarrold

As managers, members of the public, patients and relatives/friends/carers, we are likely to welcome this development and the prospect of openness and a focus on quality and high standards. However, we also need to think about what it will be like for the surgeons and their colleagues, family and friends. For some there will be confidence about the outcome and a sense of recognition that is well deserved. For others there will be apprehension and fear.

Employers need to be preparing individuals, teams and organisations for the impact of publicly available data on performance. It will be a difficult time and if we want it to work we need to put ourselves in the surgeons' shoes and understand how it will feel. It is a time for empathy and care as well as for gladness about a more open NHS.

It is unlikely that individual appraisal forms will be published - and perhaps that is just as well. There might be awkward questions to answer about the system and its robustness as well as about individual performance.

It is not surprising if appraisal has taken a back seat in these difficult times when everything has been dominated by restoring financial balance and structural change. Now that some calm and sense is returning it would be great if appraisal was given some attention. We all need feedback.

Some personality types (including me) need feedback as much as we need air to breathe. The best form of feedback is positive feedback. However, the next best thing is negative comment, provided that it is delivered constructively. The worst thing, by a wide margin, is no feedback.

How many really constructive appraisals have you had in your career? I had seven in 36 years, and that may have been lucky. The lack of decent appraisals stems from three main factors.

First is the failure to take the process seriously and give it priority. Second is the lack of training. There is a real skill deficit here. I was fortunate to sit at the feet of the wonderful leadership expert Beverly Alimo-Metcalfe at a very early stage in my career and I will always be grateful for the learning.

Third, many of us are just not very good at it. We don't learn to listen to the person being appraised. We don't exercise empathy - we don't put ourselves in the other person's shoes. Above all we are simply not capable of giving negative feedback constructively. Even some of the most senior people prefer the easy option of bland and unhelpful comment.

If we are expecting surgeons to accept publication of individual results the rest of us should at least make sure that we let those responsible to us know how they are doing. We all need to give and receive feedback to fulfil our potential for serving patients, the public and each other better.