Team and Individual Recognition Awards 2013 – Nomination Form

In addition to the 8 NHS Isle of Wight 2013 Awards, applications are now invited for the Team and Individual Recognition Awards to be presented at the Awards Evening on Tuesday 19th November 2013.

Criteria

The awards will be made to the staff member or team who have gone the extra mile to improve patient care, or experience or support colleagues or staff in some way. The reasons for nominations should include what makes this person or team special and why they deserve the award. It could be that they have never had a day off sick, always go the extra mile, prepared to help out when times get tough or that they have excelled in their job in some way or another – they have clearly demonstrated some or all of the positive principles mentioned in our ‘Lets Show We Care’ initiative (www.iow.nhs.uk/wecare).

1. Please give the name(s) of the individual(s)/team you are nominating:

Name(s): ______

2. Please tick the award you are nominating them for:

r Vectis Award

for excellence by a Doctor or Doctors

r  Osborne Award

for excellence by a non clinical Band 5 and above

r  Carisbrooke Award

for excellence by a non clinical band 4 and below

r  Solent Award

presented to the most outstanding team (non-clinical or mixture of both)

r  Medina Award

for allied healthcare professionals for excellence & innovation in practice

r Island Award

for outstanding achievement by a nurse or midwife

r Wight Award

for outstanding achievement by a volunteer or group of volunteers

NB. The awards for ‘Clinical Educator of the Year’ and the ‘Sandy Reed Rosebowl Award’ for significant success as part of an NVQ programme are made on a different basis which is not open for nominations.
3. Your details:

Forename:
Surname:
Address:
Office Phone:
Mobile Phone:
E-mail address

4. Reason for Nomination:

SUMMARY (Max 100 words)
Please provide a brief overview of the reasons for your nomination

Completed nomination forms should be returned to Theresa Gallard, Top Floor, General Management offices, St. Mary’s Hospital, Newport, PO30 5TG (or by email to ) by Wednesday 9th October 2013.