Nomination Form
People’s Choice Award for outstanding care
and compassion
Each nomination must be entered on a separate form.
Please provide as much detail as you can.
The closing date for nominations is Monday 6 March 2017.
Nominations received after this date will not be accepted.
Send your completed form to:
[email protected]
About You…
Your details will only be used in relation to this nomination and will not be
passed to anyone else without your permission.
Your name:
Your address:
Your telephone number:
Mobile:
Your email address:
Your Nomination…
Name of individual or team you want to nominate:
Department:
Location / Trust Facility:
Address:
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Why is the individual or team being nominated?
Your statement should be a minimum of 250 words and a maximum of 750
words. No additional information will be considered. Please ensure your
submission meets the criteria and avoid use of abbreviations. (Continue on
a separate page if necessary)
People’s Choice Award for outstanding care and compassion
Our People’s Choice Award aims to recognise an individual or team whose commitment,
care and compassion ensures that exceptional care is delivered to our service users. We
know that we have so many extraordinary members of staff who, despite working under
enormous pressure, deliver excellent care day in day out and are consistently finding ways to
improve services for our patients / clients and their families.
This award gives local people the chance to acknowledge our staff and, in particular, those
special individuals who go the extra mile in the course of their work to provide exceptional
high quality health or social care and great user experience. So, whether it’s a nurse, doctor,
receptionist, domestic, therapist, porter, member of catering staff, secretary or someone else,
if you have been impressed by the care, treatment or service you have received and feel they
deserve to be recognised, we would love to hear from you.
If you are a staff member and this nomination is as a result of the care, treatment or
experience you had as a service user or relative please ensure that this is documented in
your nomination.
The judges will be particularly looking for evidence of the individual or team:
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Putting the safety, needs and welfare of service users first
Ensuring service users feel valued and cared for
Treating service users with respect, dignity and compassion
Going above and beyond the call of duty
Please indicate the word count for this nomination (max 750 words). Word count is: ______
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