2016 Annual Awards - Making a Difference Award

This form is to be returned to Pat Winter at Room 30.26, Old Trust HQ, University Hospital North Durham, Durham DH1 5TW in paper form or electronically to no later than 13th January 2017. Applications received after this date will not be processed. If you require any assistance with the completion of this form, please do not hesitate to contact Pat Winter.

Making a Difference Award 2016

This award will be made to an individual or team who have challenged the traditional provision of services and have clearly demonstrated the delivery of a first class service which embraces the values of the organisation.
The judging panel will be looking for nominations which supply evidence which may include embracing diversity issues, changing the way they work in order to improve patient safety, developing the workforce or service through using resources innovatively or by demonstrating excellent customer service.
When writing your nomination think about how your colleague or colleagues have embraced the Trusts values:
  • Working together for patients
  • Respect and Dignity
  • Commitment to quality of care
  • Compassion
  • Improving lives
  • Everyone counts

Please supply a full description of who and why you are nomination this individual, team or service in this category (you should consider in your nomination how this supports the Trust’s vision ‘Right First Time, Every Time’ and the six Trust Values):
The judging panel will use the above information when judging the categories therefore please include as much relevant information, supporting evidence, pictures and/or supporting articles as possible

Making a DifferenceAward continued ………….

If you are nominating a “Team” could you also please provide the requested information for each of the Team members up to a maximum of 12?

Team / Service Name:
Name/s of individuals in Team / Job Title / Team, Ward or Department / Hospital Site or Community Base / Contact Tel. No./ E-mail

Nominator: It is essential that you provide your details below as we will write to you with regard to your nominations.

Name / Job Title / Team, Ward or Department / Hospital Site or Community Base / Contact Tel. No./ E-mail

Making a Difference Award continued ………….

For individual nominations could you please provide the following information below?

Name:
Job Title:
Team/Ward or Department:
Hospital Site or Community Base:
E-mail Address
Additional section for more Information:

Nominator: It is essential that you provide your details below as we will write to you with regard to your nominations.

Name / Job Title / Team, Ward or Department / Hospital Site or Community Base / Contact Tel. No./ E-mail

** Please use as many additional sheets as necessary