Healthcarechampions - 2016 nomination form

HEALTHCARE CHAMPIONS AWARDS 2016
Nominate your Healthcare Champion 2016 and help us share good
practice in treating rheumatoid arthritis and juvenile idiopathic arthritis.
Many people across the UK with RA and JIA are receiving excellent care and support in coping with their
disease. The dedication and professionalism of the healthcare professionals working in this field play a vital
role in getting the best outcomes for patients.
NRAS will be holding its 5th Healthcare Champion Awards in Westminster to celebrate the excellent work
that healthcare professionals are doing across the UK and highlight such good practice to an audience
including parliamentarians, commissioners, clinicians, health care professionals and key decision makers.
We need your help to find those healthcare professionals who are really championing the cause of RA and
JIA patients and who maintain an excellent service despite the challenging financial environment,
resource pressures and time restraints imposed on them.
Nominate your healthcare professional star today. You can nominate anyone or a team that you believe
really deserves that acknowledgement.






Consultant Rheumatologist
Paediatric Rheumatologist
GP or GP Surgery or Practice nurse
Pharmacist
Podiatrist
Occupational therapist





Paediatric or Rheumatology specialist
nurse
Physiotherapist
Orthopaedic Surgeon
Whole rheumatology team
Whole paediatric team
The closing date for nominations is Friday 12th August 2016. From your nominations, individuals and
teams who have undertaken outstanding work to support rheumatoid and juvenile arthritis patients will
be identified. We will then invite the ten top Healthcare Champions in the UK, and those of you who
successfully nominate them, to attend a high profile awards ceremony in November 2016.
Please email all entries to [email protected] or post to Healthcare Champions, NRAS, Ground
Floor, 4 The Switchback, Gardner Road, Maidenhead, SL6 7RJ.
To request a postal version of this form, or if you have any If you have queries regarding the event,
please email [email protected] or call Emma in the Membership team on 0845 458 3969.
1
HEALTHCARE CHAMPION AWARDS 2016
A Healthcare champion is a health professional who provides you with a rheumatology
service that really meets your needs, treats you holistically, i.e. as an individual with
individual needs and preferences, involves you in decisions about your care and goes
that extra mile to listen, to care and to educate you about your disease, your options
and the next steps in your care pathway, and is also someone who will fight for you if
necessary if you need treatment for which funding has become difficult.
YOUR NAME: ______________________________________________________________
YOUR ADDRESS: ___________________________________________________________
DAYTIME CONTACT NUMBER: ____________________________________
EMAIL ADDRESS: _______________________________________________
I WOULD LIKE TO NOMINATE: (name of the healthcare professional or team)
_________________________________________________________________________
IN 400 WORDS PLEASE STATE YOUR REASONS FOR NOMINATING THIS PERSON:

HOW ARE YOU/YOUR CHILD TREATED WHEN YOU ATTEND APPOINTMENTS? HOW
ARE YOU/THEY MADE TO FEEL? (100 WORDS)

WHAT MAKES THE CARE RECEIVED FROM THIS PERSON OR TEAM SPECIAL? GIVE
EXAMPLES (100 WORDS)
2

WHAT SUPPORT OR HELP DO YOU, OR YOUR CHILD, RECEIVE AND HOW RESPONSIVE
ARE THEY WHEN YOU OR YOUR CHILD ARE EXPERIENCING DIFFICULTIES OR A FLARE
FOR EXAMPLE? (100 WORDS)

ANYTHING ELSE YOU CAN ADD TO DEMONSTRATE THAT YOUR NOMINATED
HEALTHCARE PROFESSIONAL OR TEAM IS REALLY DESERVING OF CHAMPION
STATUS! GIVE EXAMPLES. (100 WORDS)
THE PERSON / THE TEAM I HAVE NOMINATED WORKS AT: (e.g. hospital/clinic/practice)
_________________________________________________________________________
THEIR JOB TITLE: (e.g. consultant/paediatric nurse or give the name of the team leader if
you are nominating a whole rheumatology team)
_________________________________________________________________________
THEIR DEPARTMENT: _______________________________________________________
THEIR ADDRESS:____________________________________________________________
I agree that NRAS can inform the person/team named above that I have nominated them
and why, and I also agree to participate in any associated publicity.
Signature………………………………………………………………………………………………….
PLEASE COMPLETE AND RETURN THIS FORM TO:
Healthcare Champions, NRAS, Ground Floor, 4 The Switchback, Gardner Road, Maidenhead,
SL6 7RJ or email Emma at [email protected]
3