Nomination Form

The highly prestigious Proud to Care Awards are intended to recognise and celebrate the achievements of nurses, health visitors, midwives and care staff who have gone over and above the call of duty in delivering the 6Cs – Care, Compassion, Competence, Communication, Courage and Commitment.

To join this fabulous celebration of nursing in Surrey and Sussex you are warmly invited to nominate a nursing/care-giving team or an individual nurse, student nurse, health visitor, midwife or care-giver.

Nominations are welcomed from individuals, teams, members of the public, patients, carers and service users.

Nominations will be judged against the award criteria stated below and overleaf by Nurse Leaders from across Surrey and Sussex.

Shortlisted individuals and teams will be invited to attend the Proud to Care Awards Ceremony on the evening of Friday 28 March 2014 at the Copthorne Hotel Effingham Gatwick.

tHE Awards Criteria

Care Award Criteria

An individual or team:

  • who consistently delivers evidence-based, high quality care for a patient or patient group which explicitly demonstrates impact on improved outcomes;
  • able to adapt a care pathway appropriately and safely in order to tailor the service to the needs of the patient to improve the care and experience;
  • who has inspired other care givers by their professionalism and accountability to care differently and improve patient experience.

Compassion Award Criteria

An individual or team:

  • whoconsistently deliverscompassionate care through relationships based on empathy, respect and dignity.

Competence Award Criteria

An individual or team:

  • who consistently demonstrates ability to understand an individual’s health and social care needs;
  • who uses expertise, clinical and technical knowledge to deliver effective care and treatment based on research and evidence.

Communication Award Criteria

An individual or team:

  • who can demonstrate how good communication has made ‘no decision about me without me’ a reality;
  • whose excellent communication skills have benefited staff and improved public confidence in our care;
  • who listens to feedback and complaints and uses this to develop transparency and improvements to care and or services.

Courage Award Criteria

An individual or team:

  • who has been courageous in speaking up about concerns or has enabled others to do the right thing for the people we care for;
  • who has demonstrated personal strength and vision to innovate and embrace new ways of working;
  • who has developed a recruitment process which recruits staff with the right culture and values for the care setting.

Commitment Award Criteria

An individual or team:

  • whohas demonstrated an on-going commitment to improve the care and experience of patients;
  • who has shown commitment to all those they work with, regardless of role;
  • who has supported positive staff experience, demonstrated equality, and is committed to clinical supervision and support in care settings.

The Public Choice Award Criteria

An individual or team:

  • who has gone above and beyond the duty of care, demonstrating compassion, competence, excellent communication, courage and commitment, to ensure care is the best it can be;
  • who has worked with people, carers, families and staff to enhance the experience of care.

Please complete and return pages 3 & 4.

Award Category

Please tick the category box you think your nominee/s should be entered for:

Contact details of Individual/Team Nominated for Award

Name of individual or Team Leader:
Job title/Name of Team:
Organisation name:
Ward/Section/Department:
Contact address:
Tel. no.: / Email:
Does this person/team know you have nominated them? Y/N

Your details

Your name:
Job title (if appropriate):
Contact address:
Tel. no.: / Email:


Your reason for nominating this person (in no more than 400 words)

This is your opportunity to tell us as much as you can about the person or team you are nominating. What makes them worthy of an award, and what is it that makes them stand out from the crowd? The more information and examples you can give us, the better.

This form can be downloaded from the NHS England (Surrey & Sussex) website at

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