Has one of our teams, services or individual members of staff made a real difference to your healthcare?

Or have they listened to your experience and made things better for you and other people as a result?

Why not say thank you by nominating them for an award?

We are inviting patients, service users andcarers to nominate members of staff who they feel have shown exceptional dedication in caring for either themselves or someone they know, or who have listened to what people have said and improved our services as a result.

The winners will be announced at our Celebrating Excellence 2016 Awards Ceremony on the evening of 5 May 2017,and if you nominate a finalist you will be invited to attend.

To nominate, complete and return this form or make an online nomination at

Closing date for nominations is5pm on Wednesday15 February 2017.

Celebrating Excellence 2016

The Celebrating Excellence 2016 Awards aim to celebrate the hard work and dedication of staff working for Leicestershire Partnership NHS Trust.

The following Celebrating Excellence Awards are open for nominations from patients, service users and carers:

Innovation in Patient/Service User Experience Award
The Team of the Year Award
Delivering Exceptional Care Award
Volunteer of the Year Award
Young talent of the Year

If you would like to nominate a member of staff or team for one of these awards, please complete the details below:

Nomination Form

Your details

Last name:
First name:
Home telephone:
Mobile telephone:
Email:
Address:

Details of the individual or team you are nominating

Name of individual or team:
Job title:
For example, ‘district nurse’ or ‘physiotherapy team’.
Name of contact for team:
If you are nominating a team please provide a contact name.
Place of work:
For example, ‘Bradgate Unit’. If not known please state in which area they work. For example, ‘Oadby’.

Award title (see above): ______

Tell us in a maximum of 250 wordswhy you believe this individual or team deserves this award. Please describe the difference they have made to you, someone you know, or others who use our services. Please continue on another sheet if necessary.

Nominations must be received no later than Wednesday 15 February 2017. Regrettably, any received later cannot be included.

We can only accept nominations for staff who work for Leicestershire Partnership NHS Trust.

The information you supply will be treated in confidence. It will be seen by the judging panel and awards’ organising team and will only be shared more widely with your consent.

All nominations will be acknowledged. If you have not received an acknowledgment within a week of submitting your nomination, please contact Laura Higgins on 0116 295 0919.

All nominations will be reviewed by a panel of judges, details of which can be obtained by calling 0116 295 0924.

The winners will be announced at the Celebrating Excellence 2016 Awards Ceremony in the evening of 5 May 2017.

You will be notified whether or not the individual or team you nominate is shortlisted by Wednesday15 March 2017.

If the individual or team you nominate is shortlisted, you will be invited to attend the awards ceremony in May 2017.

Returning this form

By email to:

By post to:

Kamy Basra, Head of Communications

Leicestershire Partnership NHS Trust

Riverside House

Bridge Park Plaza

Bridge Park Road

Thurmaston LE4 8PQ

Enquiries about the awards:

Enquiries should be directed to:

T: 0116 295 0924

E:

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