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The scheme of clinical excellence awards was introduced at the inception of the NHS in 1948.

It has undergone a series of changes in order to make it more transparent and accessible to all eligible consultants. Employer Based Local Awards were introduced with the implementation of the new consultant contracts in 2003. This paper explains the process of National Awards 9 to 12 (bronze, silver, gold and platinum) in England and Wales. Scotland and Northern Ireland have similar but different arrangements. Full publication of annual reports and guidance for 2010 awards can be found on the ACCEA website www.dh.gov.uk/ ab/ACCEA/Committees/index.htm.

This article is based on the guidance issued for the 2009 round. New guidance is due this month and may contain different notes. Members are advised to use the new guidance especially if there appears to be any substantial changes.

The Process
The following chart describes the process for National Awards. It is important to recognise that nominations can be made to the ACCEA through a variety of “nominating bodies” as well as by the individual himself. All applications should have the employer’s citation and the signature of the Chief Executive. Application forms should be submitted on line before the closing date as late applications will not be accepted. In this context, one should note that the closing date will differ from one nominating body to the other. Members should refer to the notifications by the BGS and their respective Royal Colleges for their closing dates. It is generally accepted that consultants will have spent at least ten years in the post before receiving a bronze award. Also, it would be unlikely that a consultant would be able to demonstrate a “step change” within 5 years of the last award. All achievements should be dated so that comparisons between applicants may be made more easily.

The application form
Applications have several sections. Each section should be completed in full. It is not uncommon to find applications without such details as the date of birth, e-mail i.d., phone numbers, or previous consultant appointments held, etc.

Personal Statement
Personal statement is an opportunity for the applicant to outline the reasons for his application to be considered by ACCEA and summarise his achievements in each of the domains that follow. It should draw attention to the significant and most important achievements to justify the award. There are no marks allocated to this section and statements by all successful applicants will be published on the ACCEA website.

Domain One – Delivering a High Quality Service
This section relates generally to one’s clinical work. It should include workload details, outcome details, benchmarked comparisons of outcomes and results, demonstration of high quality through audits, patient satisfaction surveys, waiting list management, influence on admissions and discharges, quality awards and accolades and national influence through examples of high quality service. Most Trusts have individualised data on workload and outcomes that should help. Examples of good multi-disciplinary practice and results of 360 degree appraisals are particularly well noticed.

Domain Two – Developing a High Quality Service
This section is about innovations and developments that have improved one’s service. It should include completed audit cycles and research that have led to improvements in the service, new ways of meeting targets, new ways of meeting gaps in the service, adjustments and adaptations in one’s working patterns to meet increasing demand, and application of new technology. Generally, any new designs and developments that are an example for other colleagues nationally are well received.

Domain Three – Managing a High Quality Service
This section refers to one’s involvement in the management of the Trust, Society or the College. Management roles may vary from managing one’s firm to being a Medical Director. It is about demonstrating clinical leadership. It should not be a list of all the many committees the applicant attends. It should contain examples of changes and influence that has been brought about by being on committees. Managing risk and one’s role in clinical governance are also important.

Domain Four – Audit and Research Publications
Most consultants may find this section difficult as they may feel that they are competing with academics with a long list of publications. In fact a full-time consultant in a busy job showing fewer publications scores just as well. Chairing Conferences, giving invited lectures, published audit work, presentations at national and international meetings, undertaking book reviews, writing chapters in books are all academic work worthy of inclusion in this section. All publications should be referenced appropriately.

Domain Five – Teaching and Training
Most consultants are involved in teaching undergraduate medical, nursing and other students both at ward level and in the lecture rooms. Examples of good teaching methods, student evaluations and commendations by the Dean, involvement in the medical school committees and in teaching organisation in the Trust should be included.
Training doctors is an integral part of one’s work. Being programme directors and chairs of training committees should provide an opportunity to outline achievements in Training. Organising post-graduate courses and international and national meetings should also be mentioned.

Citations
Generally, citations should be from Societies and Colleges in addition to the employer. Citations from “friends and family” are not considered favourably. It is important for the Societies and Colleges to make sure that the same citation is not used by several bodies.

Clearly, applying for an award is not simply about completing the form. The application form is only a reflection of one’s contribution to the NHS and to deserve an award it should be “over and above” that meeting the contractual requirements. It is a competitive scheme designed to reward clinical excellence and recognise high level performance in all domains. It is neither a “overtime payment” nor a hand shake before retirement. Whilst it rewards achievements thus far, it is also an incentive for better performance. The regional Committees and the ACCEA do not judge the reputation of individuals but only score on the contents of the application forms. Better the application, greater are the chances of an award.

B S Dwarak Sastry
Consultant Physician in Geriatric Medicine
Cardiff and Vale NHS Trust
Medical Vice-Chair, Wales Regional CEAC

BGS Newsletter, July 2009
Issue 22 ISSN 1748-6343 22