Assessors’ guide: 2022 awards round

About this guide

This guide is to inform scorers of national Clinical Excellence Award (CEA) applications of the workings of the scheme and the scoring process. It covers the 2022 national Clinical Impact Awards (NCIAs) competition in England and Wales and tells you:

• how the award scheme works
• who is eligible to apply
• how the new application and assessment processes work
• how to score an individual application

Read this guide before before you start scoring your allocated applications. Part 1 and Part 2 provide an overview of the scheme and its principles and processes, while Part 3, Part 4 and Part 5 explain how things work in more detail.

We’ve created a useful quick guide to the scheme (primarily designed for applicants) that summarises how the new 2022 scheme is designed to work – see all guides on the application guidance page. New assessors may also find it useful to read the applicants’ and nominators’ guides.

All applications need to be submitted by 5pm on 22 June 2022. Any applications received after this will not be considered. Scoring will take place between June and September 2022 – we will let you know the exact dates and the date of your regional subcommittee meeting in due course.

You should find everything you need to help you on our home page – if you have any questions that are not covered, contact us at accia@dhsc.gov.uk.

Changes to the application and scoring processes

Following the 2021 consultation on reform of the national Clinical Excellence Awards, the Department of Health and Social Care (DHSC) and Welsh government have agreed the following changes will be implemented in a revised scheme as the national Clinical Impact Awards. Review the full consultation response for further detail on the reforms.

Summary of the changes

Increase the number of available awards

Once the transition process for existing national Clinical Excellence Award (NCIA) holders has been completed over the 5 year transitional period, there will be up to 600 awards granted annually in England. National awards and local awards are also planned to be held concurrently – this is being reviewed throughout the transition period.

Rebrand the scheme

The awards have been rebranded as the national Clinical Impact Awards to reflect to applicants and scorers that the primary focus of the awards is the output of activities, rather than undertaking activities in the absence of describing their impact and results.

Restructure the award levels

 In England, the scheme now operates as a 3-level award system: 

• national 1 (lowest)
• national 2
• national 3 (highest)

Refresh the assessment domains

The assessment domains have been revised to combine both ‘delivering and developing service’ into a single new domain (domain 1). Three domains (domains 2, 3 and 4) have been renumbered and their emphases amended, and a new fifth domain has been introduced to allow applicants to include evidence of national impact from other unpaid activities, or where they have delivered impact over and above expectations.

Simplify the application process

A single-level application process has been introduced so applicants no longer apply for an award at a specific level. This enables applicants to gain higher level awards on first application based on the score they attain.

Remove pro-rated awards

Those working less than full time (LTFT) will no longer have their post-2022 award payments pro-rated.

Remove the renewals process

The renewals process has been removed. NCIAs will be held for a total of 5 years, at which point applicants need to reapply.

Remove the pensionability of awards

NCIAs are no longer pensionable or consolidated.  

Simplify the process for employers

Employers only need to indicate their support or their lack of support for an application and provide a citation for each applicant. Employer scoring and ranking are no longer required. Further information about employer citations is included below in Part 5.

Differences for those based in Wales

How we’ve streamlined our application process

We’ve removed the additional forms for evidence and increased the character limit on the main form to 2,000 characters for all domains. Applicants only need to submit one form for scoring. We’ve adapted the references section in the new ‘domain 3: innovation and research’ to remove any character limit.

We’ve reduced the list of accredited national nominating bodies and specialist societies to reduce duplication within and across specialties. All accredited ranking organisations will now be known as national nominating organisations (NNOs), amending and rebalancing the number of ranking places available to each specialty, in proportion to the number of eligible consultants. Each applicant can now only have one ranking and citation from one relevant NNO.

We’ve removed the option to seek third-party citations. Citations are only possible from the list of NNOs for those applicants ranked by them in their prioritisation exercises.

We will evaluate the number of applications to be scored in each region and continue to adjust scoring groups and numbers across regions to balance the workload and optimise committee diversity. This will ensure enough scorers are available to assess each application.

Regional sub-committee scoring will continue, with each region being given an indicative number of awards at each level (N1/N2/N3) to retain the equity of regional opportunity for success. This continues to be based on the number of awards available nationally and the number of applications received. Applications tied at the cut off for the lower limit of N1, or tied between N1 and N2, will be rescored by the National Reserve Sub-committee (NRES), as will any applications identified through national governance review. Further details are set out below in Part 4 of this guide.

To decide which applicants gain an N3 award, each region’s highest scoring applicants constituting twice their N3 indicative number will be pooled nationally and rescored by the N3 Committee to determine those most deserving of the highest-level national award. Those who are unsuccessful at N3 will be recommended for an N2 award.

Transitional arrangements

In 2018, the government approved schedule 30 of the 2003 consultant contract which was negotiated and agreed between NHS Employers and the British Medical Association (BMA). This provides transitional pay protection where a new national scheme has lower award values. This protection is costly – peaking at over £30 million in 2025 to 2026. As the NCIA scheme must stay within the agreed budget, pay protection has an impact on the funding available for new awards in the transitional period. Details of pay protection arrangements for existing national CEA holders applying for and successfully gaining their first NCIA can be found in schedule 30.

We have advised applicants to review this carefully and discuss their personal circumstances with their employer if they have any questions. Any questions relating to awards that employers cannot answer can be put to the Advisory Committee on Clinical Impact Awards (ACCIA).

The cost of pay protection means we have altered some elements of the scheme for the transitional period. These elements will be reviewed periodically, and any necessary adjustments will be made each year. For example, local awards and national awards cannot be held at the same time at the moment, and the numbers of NCIAs made available at each level may vary during the transition period.

Part 1: introduction

About ACCIA and the Clinical Impact Awards scheme

ACCIA runs the national Clinical Impact Awards scheme for the Department of Health and Social Care (DHSC) in England.

Health ministers agree a limited number of new awards each year, so the selection process is very competitive.

A consultant can apply for a new award at any time after completing a full year in an eligible role. If a consultant already holds a national Clinical Excellence Award, transitional arrangements apply between the old and new schemes. To be considered, the applicant will need to show that what has been delivered has had an impact at a national level, and over and above the expectations defined in their job plan in developing and delivering a high quality service.

There will also be a need to demonstrate a commitment to, and nationally relevant impact on improving the NHS through:

• leadership
• education
• training
• people development
• innovation and research

There is also an opportunity to provide evidence of national impact in areas that are not captured in the 4 domains, particularly if it relates to published NHS or other relevant health objectives. In all of the domains, applicants should consider providing evidence of national impact relating to equality, diversity and inclusion.

There is one online application form for all awards, so every applicant can highlight their contributions in the same way.

Based on the strength of applications, our regional sub-committees, N3 committee and our main committee will recommend applicants for national awards to health ministers for them to approve.

How national awards relate to local awards

The aim for the NCIA scheme is to allow local and national awards to be held concurrently, but due to the costs of transitional pay protection explained above this is not possible straightaway. In 2022, they will not be held at the same time – this will be reviewed on an ongoing basis. More information about local awards can be viewed on the NHS Employers website.

National awards are awarded by ACCIA. They recognise the national impact of work undertaken over and above contractual or other paid activities in the NHS (in England and Wales). They specifically recognise the dissemination and implementation of that work and its impact on the wider NHS and on public health. There is no requirement to hold any local award to be eligible to apply for a national award.

There are 3 levels of national awards in England:

• national level 1 (N1)
• national level 2 (N2)
• national level 3 (N3)

N3 is the highest award.

What the national scheme rewards

The scheme rewards consultants or academic GPs who deliver national impact above the expectations of their job role or other paid work. Applicants need to give evidence of impact across the following 5 domains: 

1. Delivering and developing a high-quality service
2. Leadership
3. Education, training and people development
4. Innovation and research
5. Other areas of national impact, with specific reference to NHS priorities where relevant

These 5 domains are explained below in Part 4 and Part 5 of this guide.

We do not give awards for standalone overseas work. Work in other countries is not directly relevant for an award so we cannot consider it on its own, but if an applicant can show evidence that overseas work has helped the NHS and the health of the public directly, or has had a direct reputational benefit for the NHS overseas, it may be supported.

How we assess applications

We run the scheme fairly and openly offering every applicant an equal opportunity, and we consider all applications on merit. We include our analysis of each year’s competition in our annual report.  

We assess all applications against the same criteria which you can find below in Part 4 of this guide. 

Our sub-committees are regional groups that assess applications for national awards for most applicants in their area. Based on application workload, and to provide balance and a degree of external scrutiny across these committees, we reallocate some sub-committee members to score in other regions (see Part 4 for more information).

There are 13 regional ACCIA sub-committees in England:

• Cheshire and Mersey
• East of England
• East Midlands
• London North East
• London North West
• London South
• North East
• North West
• South
• South East
• South West
• West Midlands
• Yorkshire and Humber

There are separate sub-committees for:

• DHSC and arm’s length bodies (ALBs)
• assessing the highest-scoring regional applicants for N3 awards – NRES

The sub-committees consider all applications in their area except for those from public health consultants and academic GPs contracted by the UK Health Security Agency and NHS England. These are assessed by the DHSC or arm’s length body (ALB) sub-committee where they can be benchmarked more easily. Each regional sub-committee is allocated an indicative number of awards at each level. This is based on the number of national awards available proportionately distributed based on the number of applications received that year in each region. This means there is an equal chance of achieving an NCIA in any region.

Sub-committee members come from a range of backgrounds with experience and expertise in many different areas. They assess and score applications independently. All the individual scores for an application are averaged and then ranked against the other applications in that region. The top scoring applications in each region are provisionally allocated an NCIA. To ensure the highest-level awards are granted to those making the greatest national impact, a separate N3 sub-committee will rescore all those from each region falling within the N3 indicative allocation, plus the same number of applicants scoring highest in the N2 allocation. This rescoring provides a national benchmarking for determining who receives an N3 award.

Each sub-committee is typically made up of:

• medical and dental professionals – 50%
• non-medical professionals and lay members – 25%
• employers – 25%

Each sub-committee is normally divided into scoring groups to manage the workload. We ensure there is equivalent diversity of scorers across these groups. These groups score a randomly selected group of applications to minimise any unconscious bias affecting the scoring.

Each group scores applications consistently against the guidance. We expect there to be up to 600 new NCIAs available each year in England – subject to ministerial agreement and funding impacts during the transitional period. Our ambition is to award 330 x N1, 200 x N2 and 70 x N3 awards each year at a value of £20,000, £30,000 and £40,000 respectively.

When an application for an award is successful, the NCIA will last 5 years backdated to 1 April 2022.

After regional sub-committee scoring has closed and the ranked list has been produced, our chair and medical director review all the provisionally successful N1 and N2 applications that are not being considered for an N3 award. After their review, applications where questions arise or clarification may be helpful are discussed at the regional sub-committee meetings as part of our quality and governance review.

Applications that are tied at the cut-off point for N1 or between N1 and N2 awards are automatically referred for rescoring by NRES.

Applications where questions have not been resolved are also referred to NRES for rescoring. NRES is made up of the chairs and medical vice-chairs of the regional sub-committees and other experienced scorers from the regions. As a panel of our most experienced scorers, NRES acts as a quality assurance mechanism. Our chair and medical director recommend applications for awards to our main committee based on the sub-committee and NRES scores.

Following scrutiny from our main committee, English recommendations go to DHSC ministers.

If an award is approved, we will let the applicant and their employer know. Unsuccessful applicants will be informed at the same time.

Local awards and commitment awards

ACCIA does not have any say in local awards in England or commitment awards in Wales.

Running an open, transparent scheme

More information about ACCIA and the NCIA scheme can be found on the ACCIA home page, including:

• a list of all national award holders
• personal statements from people who have received a new award
• the members of our main committee and our sub-committees
• a list of national nominating organisations
• a guide for applicants – with a supporting ‘quick guide’
• a guide for assessors on how to assess and score applications
• a guide for nominators for national nominating organisations
• annual reports about each awards round
• summaries of the minutes for the main committee’s meetings

Disability

In line with the Equality Act 2010, employers must consider making reasonable adjustments for employees with disabilities. These are changes to things such as equipment or processes to make sure people with disabilities can do their job.

If an applicant has a disability, where relevant, any reasonable adjustments they have agreed with their employer should be explained in the job plan section of the application form. Employers may add explanations about any disabilities or other relevant aspects in their comments.

We treat all applications equally and use the same scoring criteria for everyone.

Extenuating circumstances

If there are extenuating circumstances that an applicant feels may affect their ability to submit a successful application, we would like them to let us know as soon as possible before the application closing date, so we can provide support and make sure the application is considered fairly. We cannot take any extenuating circumstances into account after the application form has been submitted and it has been scored.

Each case is treated on its own merits, and the outcomes from each one are based on the rules relating to the current scheme. If a consultant applies for an award and believes there are extenuating circumstances, these can be described in the job plan, personal statement and/or the relevant domains of the application form.

Pay careful attention to applications where a consultant’s circumstances and job plan have changed during the course of the 5 year assessment period. Applicants are strongly encouraged to be precise about the timing of any such changes in working pattern, and to provide dates for the achievements that they are presenting for assessment. For example, an applicant may describe periods of absence perhaps due to maternity leave, or ill-health during the relevant 5 year period. In such cases, it is reasonable to take into account work done over a more prolonged time period when assessing the application.

We understand that it can be difficult for applicants to share personal information. As assessors we expect you to to treat any such information with respect and in confidence.

Transitional arrangements for people with existing national Clinical Excellence Awards

With the introduction of a new NCIA scheme from 2022, existing national CEA holders are subject to prior CEA rules for their awards and tenure. There is a transitional period based on previously agreed schedule 30 arrangements for CEA holders applying for a first new award.

Rules that apply to existing national CEA holders:

• if an application is made for a first new award before an existing national CEA would have been due for renewal under the old scheme and are unsuccessful, the individual keeps their existing CEA until its expiry – they may apply for an NCIA again up to the year before the CEA’s expiry

• if a CEA would have been due for renewal and the application is unsuccessful, the reversion arrangements to receive a legacy, pensionable local CEA will continue to apply. The level of the local award depends on the score obtained in the new NCIA application

• if a consultant applies in the year their national CEA expires, this CEA will lapse before the annual NCIA award round is completed and the applicant will not be eligible for the transitional arrangements

• if an applicant successfully gains a new NCIA before their existing national CEA expires, the NCIA will start when the NCEA expires – the value of legacy CEAs and its pensionable benefits are protected for the duration of the first new award at an equivalent level

• if an NCIA is gained at an equivalent or higher level to their national CEA, the payment received will be no less than the value of their existing national CEA

• if an NCIA is gained at a lower equivalent level, the applicant will receive no less than the legacy national CEA payment at that level – there will be an obligation in this case to accept the new NCIA and give up any unexpired CEA; local awards cannot be held simultaneously with NCIA awards that benefit from schedule 30 protection

The equivalent levels are:

• N1 NCIA – equivalent to silver CEA
• N2 NCIA – equivalent to gold CEA
• N3 NCIA – equivalent to platinum CEA

Any CEA award holders who enter the transitional arrangements will not currently be eligible for local CEA payments.

Initially, due to the cost of the transitional arrangements, NCIA holders are not eligible for local awards in England at the same time whether or not they held a prior national CEA. This will be reviewed during and after the transition period to see when national and local awards can be held concurrently. You can read more information about this in the consultation response.

Part 2: eligibility for NCIAs

Who can apply for an award

To apply for an NCIA, a doctor or dentist needs to be a fully registered medical or dental practitioner on the General Dental Council (GDC) special list, General Medical Council (GMC) specialist list or GP register.

The applicant must be:

• fully registered with a licence to practise
• a permanent NHS consultant or academic GP in a permanent clinical academic role in higher education at the same level as a senior lecturer or above, for at least one year on 1 April in the award year – the year does not include time spent as a locum, but applicants can give evidence from their achievements as a locum in the same role

For consultants in a locum role for more than one year, we may consider them eligible for an NCIA if you as their employer confirm that they are employed on terms consistent with a permanent consultant contract.

In all cases, an applicant must be on an NHS consultant contract expressed in programmed activities (PAs), or on an academic contract expressed in an equivalent pay scale.

Qualifying criteria

A consultant will qualify if they are:

• employed by an NHS organisation (in England or Wales), DHSC or its arm’s length bodies, a university, medical or dental school, or local authority. Applications from employees of other organisations may be eligible, including those on consultant contracts providing contracted out NHS services. Those individuals are encouraged to contact us at accia@dhsc.gov.uk before applying if any clarification is required

• an academic GP if their responsibilities are the same as consultant clinical academic staff and they are fully registered with a licence to practise. An academic GP can apply for an award if they: 

  • work at least half their hours as an academic GP
  • are a practising clinician providing some direct NHS services
  • do at least 5 PAs or equivalent sessions that help the NHS – including teaching and clinical research

• a consultant or a dental practitioner with an honorary NHS contract who is fully registered with a licence to practise. Whether they qualify for an award does not only depend on their contribution to the NHS in the provision of direct patient care. A full-time academic consultant will also qualify for an award if they carry out at least 5 programmed clinical activities or equivalent sessions that help the NHS. This includes teaching, training and clinical research. An applicant who works less than full time and does fewer than 3 programmed clinical activities (PAs) is not eligible to apply for an award

• a fully registered public health consultant on the GMC specialist register or on the GDC specialist list with a licence to practise

• a postgraduate dean, fully registered with the GMC or GDC with a licence to practise, who competed for the role against GPs and consultants and is responsible for postgraduate trainees across all specialties

• a consultant or academic GP later employed as a dean or head of school in medicine or dentistry, fully registered with the GMC or GDC with a licence to practise. They can apply for an award based on their work in this post

• a consultant fully registered with the GMC or GDC with a licence to practise working as an NHS organisation clinical or medical director, or a similar level medical manager post. We would anticipate consultants working in this capacity clarifying their eligibility with ACCIA prior to application – with particular reference to their contractual contribution over-and-above the expected duties in the role, as well as their contractual status. If the majority of the work is in a management role, an applicant can still qualify if they have an active consultant contract with a specific clinical or clinical leadership role, and maintains their licence to practise. If a consultant moves into general management and/or has a management contract outside the consultant pay scale, they are not eligible to apply for an award

As an NHS consultant, it does not make a difference if they have agreed to the national terms and conditions of service, or other terms with an individual organisation.

The Ministry of Defence runs its own award scheme, but we also recognise eligible NHS employee contributions over-and-above the expected standards to military medical and dental services. 

If a consultant works LTFT, they can apply for an award if they undertake a minimum of 3 clinically relevant contractual PAs. If an applicant is eligible based on this minimum PA requirement and is successful, we will pay the full award. However, if a consultant is working LTFT and in a transition provision from a national CEA based on schedule 30 legacy award values, they will receive a pro-rated award.

Retirement and pensions arrangements

If a consultant retires during an awards round before we announce the results, we take this to mean that the application has been withdrawn.

If a national CEA would have been due for renewal in 2022 and a consultant expects to retire up to 6 months after the award is due to expire in March 2023, we may consider extending the award without the need to apply for a new NCIA.

National CEA awards are consolidated with the pension, which means it is taken into account when the pension is calculated. These awards stop when a consultant retires or claims their pension. If a consultant takes all or part of their pension from the NHS Pension Scheme, Universities Superannuation Scheme or transferred out benefits, they do not qualify for an existing award. If they return to work on a permanent NHS consultant contract retaining or regaining full registration with a licence to practise, they can apply for a new NCIA.

NCIAs are not consolidated with pensions. If a consultant retires with an NCIA, the award will end – coincident with loss of eligibility. Further details are available in the applicants’ guide on the application guidance page.

If a retired consultant applies for an NCIA when they come back to work, assessors and employers should only consider and reflect upon the consultant’s achievements since their new contract started. They should not consider evidence used to apply for the last award, evidence from before the new contract date, or evidence that is not clearly dated.  

A consultant who did not have a national award when they retired can still apply for an NCIA.

Consultants that may not be eligible for an award

A consultant is not eligible to apply for an award if they are:

• not on the consultant pay scale as expressed in PA or an equivalent
• a locum consultant – though if an applicant then becomes a permanent consultant, they can potentially use evidence from the locum role in their application if it is relevant
• a consultant who primarily works in general management, such as a chief executive, general manager, chief operating officer, or a senior university office-holder without a specific clinical role
• not fully registered with a licence to practise

Investigations into a consultant’s work and disciplinary or legal action against an individual can affect their award or application. This includes interim, temporary or final court orders or penalties relating to professional or personal conduct that may reflect badly on their judgement, or the expected standards of the profession.

Consultants must let us know about any investigations or sanctions by an employer or professional regulator (GMC or GDC) and their progression, interim and final decisions and any sanctions. We will look at each case individually, but we may remove an award if there are adverse outcomes following investigations or disciplinary measures, or if we believe a doctor has failed to notify us appropriately or in a timely manner. If this happens, any over payments will need to be repaid. If employers become aware of such matters, they are also expected to notify ACCIA. 

We also ask about an organisation’s latest inspection outcome. If an organisation is in special measures, we expect a consultant to comment on any relevance of this to their role. We will also ask their employer to check that you are happy with any response when you sign off the application. If a consultant is on the board of an organisation in special measures and is recommended for an award, we will inform our main committee.

Part 3: the application process

Filling in the application

A consultant must fill in their own application form – nobody else can do it for them.

Applications can only be made online at the ACCIA application portal. Detailed advice on how to make an application is available in the applicants’ guide on the application guidance page.

On application, a consultant must first select the NHS or arm’s length body that holds their substantive or honorary contract and their specialty, so that the right sub-committee considers the application. The employer is selectable via a ‘search’ in the new online application form. If an individual is employed by more than one body, they are asked to state all of their employers and roles – being clear which is the main employer based on who pays their salary.

Support for applications

We cannot accept applications without sign-off from the employer(s). They will need to complete a short form to verify the application; this requires joint sign-off from all employers if there is more than one. Further details are available in the employers’ guide.

If a consultant works for a university (clinical academic), the chief executive of the organisation where they hold an honorary contract, or their nominated deputy, should complete this section. It is ACCIA’s expectation that both the relevant NHS organisation and the university or medical school will be involved in the approval process and the preparation of any supporting citation, and that an up-to-date job plan has been agreed by both parties. See Part 5 below on how to interpret citations.

A consultant applying for a new award can seek support from a royal college or society with which they may be associated (an NNO). Our list of approved nominating organisations is available on the ACCIA home page. They may choose to rank the application in comparison with other applicants and provide a supporting citation. An applicant is only allowed to have a ranking or endorsement from one NNO. If endorsement is sought from more than one NNO, it is the responsibility of the applicant to be transparent with all parties. Only 2 NNOs can be selected initially, and an application can only be submitted with one NNO ranking and citation.

NNOs and employers are expected to have processes that ensure equality and diversity. They should have a balanced representation of applicants from their consultant staff for employers, from their membership, and from the wider specialty for NNOs. The nominators’ guide contains further information.

Timetable for 2022 national awards

Consultants must submit their online national Clinical Impact Award application to ACCIA by 5pm on 22 June 2022. Applications will not be valid after this – regardless of the reason that the deadline was missed.

The indicative timetable for the 2022 awards round is set out below. This may change based on the impact of the coronavirus (COVID-19) pandemic and other operational factors – we will review it regularly:

• 27 April to 16 June 2022 – applications open
• 27 June to 4 September 2022 – scoring
• 8 September to 9 October 2022 – N3 scoring
• 12 September to 25 November 2022 – governance review
• 14 November to 11 December 2022 – NRES scoring
• December 2022 – main committee finalisation of recommendations
• January 2023 – recommendations to and sign off by ministers
• end of January 2023 – notifications sent to successful applicants and finance processes initiated to back pay awards
• February 2023 – appeals window opens

General advice for applicants

Applicants are advised to start their application early enough to allow time to get sign-off from your employer and engage with any relevant local NHS organisation, nominating organisation or university pre-selection processes.

When a consultant fills in their application form, they are advised to follow the steps indicated in the applicants’ guide. Knowing what advice has been provided to applicants should help assessors apply their scoring criteria fairly, what to look for in a good application, and where problems and inconsistencies may arise – see Part 5 for further information.

In the applicants’ guide, it is advised that candidates applying for an NCIA are expected to: 

• give clear dates for their achievements – if the dates are not clear, it will bring the score down

• concentrate on evidence from the last 5 years, make it clear what has been achieved since any prior award and how a consultant’s work has progressed since then

• confirm if their last award was less than 5 years ago, give evidence since this last award and be clear about what has been achieved since then

• if their last award was more than 5 years ago, concentrate on evidence from the last 5 years

• not repeat information from old applications – assessors will compare new and previous applications and will check for repeated information

• write society and group names in full – avoid acronyms because sub-committee members reading the application may not be familiar with them. The same applies to other medical abbreviations, such as those used for diseases, operative procedures, or diagnostic techniques

• give measurable information such as outcome data wherever they can and quote the dates, source and relevant benchmarks

• explain the impact of their work – simply holding a position such as an officer in a college or specialist society will not in itself justify an award (the national impact needs to be clear)

• use a new line for each entry, consider using bullet points to make the information clearer and easier to read

• be prepared for scrutiny by ACCIA if anything is unclear in their application

We make it clear that if there are special circumstances that could affect an application such as ill health, we are keen to know as soon as possible before the deadline as we may consider extending an award.

Part 4: the assessment process

While we have moved to a non-stratified system of scoring with no renewals, the fundamental principles and processes of the assessment scheme have not changed. As explained above, an online application form will be submitted for competitive scoring in the first instance to one of the 13 regional sub-committees or to the ALB committee, with separate arrangements in place for applicants in Wales and for the armed services. 

Each region is pre-allocated an indicative number of awards at each level (N1, N2 and N3) to retain the equity of regional opportunity for success. This continues to be based on the number of awards available nationally and the number of applications received. A 2-stage scoring system then operates.

In the initial scoring round, all applications will be assessed on merit, scoring each domain a 0, 2, 6, or 10 (see Part 5), and a ranked list generated on the basis of mean scores for the applicants, with provisional allocation of a certain number of awards at N1, N2 and N3 level on the basis of mean scores for the applicants. For example, in the event of there being 2000 applications this year, and a planned final total award number of 600 assuming a 30% success rate, a large region may have an indicative number of say as many as 400 applications. With a fixed proportion of N1, N2 and N3 awards – 55%, 33% and 12%, this would mean that in the initial scoring round, the region sub-committee would recommend 66 awards at N3 level, 40 awards at N2 level and 14 awards at N3 level. The cut-off score is dictated by the indicative numbers and the distribution of the average scores within a region.

To determine the final allocation of N3 (platinum equivalent) and N2 awards in this region, the 14 presumptive N3s and 14 top-ranked N2 awards are then referred for rescoring by the national N3 committee, comprising chairs and medical vice-chairs drawn from the English regions, and selected other experienced scorers. This virtual committee will rescore the 28 applications together with all other similarly placed applications from all other regional subcommittees. At a national level, the aim will be to allocate 70 applications at N3 level. These will be those ranked in the top 50% by the N3 committee, while the bottom 50% will be recommended for an N2 award.

The N2 pool nationally will therefore comprise 70 applicants drawn from the lower ranked 50% from the national N3 committee and 130 individuals chosen through stage 1 scoring – making a total of 200 awards.

Governance review

N3 awards will be subject to governance review by the ACCIA chair, medical director and the main ACCIA committee, as were platinum awards previously. Chair and medical director scrutiny will also be applied to all N1 awards and the lower N2 cohort with referral to NRES, as was previously the case. Detailed NRES processes will be advised at a later date and will depend on the numbers of applicants referred.

See Annex A for a diagram of the scoring process. The final number of awards may be limited by the financial envelope available, and is ultimately subject to ministerial approval.

Regional sub-committees

A regional sub-committee (RSC) has a lay chair, medical vice-chair (MVC) and typically between 15 and 30 members. These roles are voluntary and regularly refreshed. Applications are vetted and approved by the ACCIA chair and medical director. A number of new chairs and MVCs have been appointed in 2022.

It is the RSC members who have responsibility for stage 1 scoring. All applicants for an award will be typically randomised to 2 groups – or in a region with very large numbers of applicants, 3 groups. As an RSC member, you will be allocated to one of these groups and score typically between 30 and 70 applications. In some cases, scorers will be allocated to a different region, something we introduced in 2021 to balance diversity and workload, and deal with conflicts of interest – for example, if a professional RSC member is also applying for an award. A small number of experienced assessors may also be asked to join the national reserve committee. ACCIA will inform all scorers of their obligations at the end of the application round, when all the applications have been submitted and we have a clear idea of the number of applications which need to be assessed.

RSC meetings will typically be online using Microsoft Teams, or in some cases hybrid depending on circumstances. They will be organised and attended by one or more members of the ACCIA secretariat. These will take place in the autumn with dates to be advised 4 to 6 months in advance. Prior to each meeting, all provisionally successful allocations will be reviewed by the ACCIA chair or medical director.

Any application where we have governance concerns (typically 5% to 10% of successful applications) will be flagged in advance to the RSC scorers for discussion at that meeting. The purpose of the meeting is to discuss the relevant issues and decide on the need for referral to NRES (see Part 4). There is no rescoring or changing of marks, and your role at the regional committee meeting is to provide corroboration and triangulation of information on the form where possible. No specific additional information known to committee members but absent from the written application can be considered at this point, nor is it your role as an RSC member to lobby for any particular individual. Applications below the derived cut-off scores are not discussed, though applications will be referred to NRES in the event of a tie of these scores.

From 2022, RSC meetings will be chaired by the ACCIA chair, with support from the local chair and MVC. There is the option for the RSC chair or MVC to organise a pre meeting on the same day or on another occasion to discuss those applications flagged by the governance review, or other local issues, but this is no longer compulsory. The same rules apply, and scores cannot be modified in any way.

All RSC members will be expected to attend the scorer training ACCIA are offering in the spring of 2022. This will be delivered in an interactive way using the Microsoft Teams platform. Each session lasts between approximately 2 to 3 hours. Attendance is required at only one session and we are offering this on 12 separate occasions over a 6-week period. We would still expect you to attend even if you did so last year – in view of the changes we have made in the scheme for 2022. The secretariat will contact all assessors in order to make the necessary arrangements.

Part 5: how to score an application

Your role as an assessor – principles and priorities

Your role as an assessor is to assess clinical impact. This about providing high quality services to patients that go beyond a consultant’s immediate remit, that improve clinical outcomes for as many patients as possible, use resources efficiently and make national services more productive.

Applicants also need to show you evidence of how they worked to make services more efficient and productive and improved quality at the same time, as well as demonstrating their role as an enabler and leader of health provision, prevention and policy development and implementation. There will also be an opportunity to demonstrate a commitment to, and nationally relevant impact on improving the NHS through leadership, education, training, people development, and innovation and research. Applicants do not need to show they have achieved over-and-above expected standards in all these areas – a lot will depend on the type and nature of their post.

You are expected to: 

• assess evidence on the application form in the 5 domains against expectations in the job plan provided, considering any extenuating circumstances as necessary

• base the assessment on written information presented – not hearsay or reputation, or prior personal knowledge

• review the employer sign-off and citations to triangulate the evidence; citations, personal statements and other components of the application form are not scored

• review the national nominating organisation ranking and citation to provide corroboration and triangulation of national impact as presented in the specific domains

• score independently without discussion or consultation

• be consistent and fair in your scoring, remaining constantly aware of the possibility of conscious and unconscious bias

• identify any major conflicts of interest, and if necessary omit to score one or more applications, informing ACCIA of why you elected to take this course of action. A candidate will not be disadvantaged by this as the aggregate scores from the other scorers are still averaged in the same way

• declare any conflicts of interest to the secretariat as soon as they are known. To ensure the probity of the awards process, sub-committee members should not participate in the scoring or discussion of applications from close personal friends, family members or those with whom they have a managerial or subordinate reporting relationship

• sub-committee members applying for an award should take no part in the scoring of any applications or the associated discussions within their region or if relevant within any national committee

• seek advice as necessary – from ACCIA, a MVC or a chair

Professional members should not score or discuss any applications in a particular region if they are applying in that region, and may be asked not to score in NRES or N3 scoring.

Professional, lay and employer representatives are there to score and assess individual applications – not to represent any speciality or organisation, race or gender.

Confidentiality is paramount and applies equally in these contexts:

• assessing and scoring applications
• discussions at Regional Subcommittee or other meetings
• discussion of applications at training sessions
• informal mentoring and discussions with applicants

You should only confer with other sub-committee members (who are not themselves applying) once you all have scored the applications and scoring has closed. If you have any concerns about an application or the scoring process, you should raise them with your committee’s chair, MVC and with central ACCIA. Under no circumstances should you discuss the process with any of the applicants.

Assessing the domains

Applicants need to make it clear that their achievements are relevant. As an assessor, you need to know when they occurred or if an applicant is still doing these activities. It is essential that they make the dates of their achievements clear, as without dates they cannot be scored. You should differentiate between achievements (results and output) and activity (input) – scoring achievements that are national more highly. Activity alone should not generate high scores.

Expectations of applicants:

• an applicant could get a national award based on an excellent local or regional contribution if it has been disseminated and had an impact on the wider NHS
• they should highlight the most important examples of their work focusing on its national and sometimes international impacts
• they should describe the impact they have had in any roles listed, including acknowledging the contribution of colleagues and other members of the multi-professional team
• applicants should make it clear when their roles started and ended, or if they are ongoing

To determine if a consultant is performing over and above, it is helpful if they list their achievements against the original aims in their job plan or personal development plan.

An applicant should not include evidence given for an earlier award unless it shows how they have built on or consolidated your previous achievements.

Quantified data is particularly useful, including outcome measures, that:

• show what has been achieved since a previous award, and specifically over the last 5 years
• include relevant dates, sources, and appropriate benchmarks

If work is subject to national audit processes, it may be helpful if applicants include this information too – be advised that it is much easier to quantify clinical quality and performance in some clinical areas than others.

The ‘Job Plan’ section of the application form forms an important benchmark for expectations of the applicant’s paid roles. It should list clearly and separately each direct clinical care, supporting and other PA the applicant is paid for, including (if relevant) a detailed breakdown of any academic PAs (research, teaching, and university management responsibilities). It should state clearly which activities the NHS pays for directly and which, if any, are paid for by others such as a university, research council, the National Institute for Health Research (NIHR), another research funder or deanery.

Applicants should also describe any other paid roles that are relevant to the evidence provided in the application – how many PAs they represent and for what activities. We do not need to know the amount paid.

If they receive any income outside their job plan from wider roles that may be relevant to the evidence provided in their application such as editorial payments, consultancy or lecture fees, or roles or shareholdings in private companies (such as non-executive roles or senior positions in spin-off companies between academia or NHS organisations and the private sector), these should be outlined in this section. 

We do not need to know the amount paid and there is no requirement to list private or wider income if it is not relevant to the evidence set out in the application.

Committee members should score the domain sections as follows:

• 10 = the application is excellent with clear and sustained national and or international impact
• 6 = the work is over-and-above the applicant’s contract terms and should have national or at least demonstrable regional impact
• 2 = an applicant has met the terms of their contract or may have contributed more but mainly within their locality
• 0 = a consultant has not met the terms of their contract or there is not enough information to make a judgement

What to look for in each domain

There are 5 domains, achievements should be described in line with each one avoiding repetition across domains unless the evidence shows different aspects of work that is relevant to the domain. In all cases, dates must be included.

We recognise the extraordinary requirements of the COVID-19 pandemic and the work that many consultants, academic GPs and multiple other healthcare workers have contributed. Applicants may choose to include evidence related to this as part of their evidence-base over prior years. If this is the case, look for evidence of impact of contributions over-and-above an applicant’s expected role, where it has had an impact outside of their immediate local remit.

We recognise how important redeployment and extended hours and remits have been in COVID-19, and that these are broadly universal across the NHS. Recognition should be given for efforts made to maintain or restart other key clinical services, research activities, and teaching and training during the pandemic period. While local work related to COVID-19 was essential, it should be scored higher where there is clear evidence demonstrating how it has had broad and ideally national impact.

Domain 1: delivering and developing a high-quality service

In this section, applicants should give evidence of what has been achieved in relation to:

• providing and developing a safe service with measurable, effective clinical outcomes based on delivery of high technical and clinical standards of service that provides a good experience for patients, and how they have cascaded this more widely to colleagues who have implemented improvements based on this experience. Relevant publications, or a citation from an NNO may provide corroboration

• consistently looking for and introducing ways to improve their service – sharing the learning and seeing it embedded in practice

Applicants should explain which activities relate to clinical services where they are paid by the NHS, and to other aspects of their work as a consultant.

Applicants should include quantified measures like outcome data. These need to reflect the whole service the multi-professional team provide and how they have collectively disseminated their experience. Applicants should use validated indicators for quality improvement or quality standards and other reference data sources in England or the healthcare standards for Wales – ideally providing performance data against benchmark or national indicators for their specialty, showing local and wider improvements as a result of their work.

For good patient experience, applicants should show how they have ensured patients are cared for with compassion, integrity and dignity and how they have demonstrated commitment to patient safety and wellbeing.

Evidence could show:

• excellent standards for dealing with patients, relatives, and staff. Surveys or collated 360-degree feedback to validate evidence of patients’ quality care
• excellent work in preventative medicine and public health, for example, in alcohol abuse, vaccination programmes, stopping smoking and preventing injury and where this work has been further developed outside their immediate remit
• how wider NHS resources are used effectively and their efficiencies improved

Look for evidence of the quality and breadth of a service from audits or assessments by patients, peers, the employer or external bodies. It should not impact negatively on your scoring if there is less readily quantifiable evidence available in a particular specialty.

Evaluate the source of the information given and whether all relevant dates have been included.

Here are some examples:

“In an analysis of mixed arterial interventions (20xx), our vascular unit had relative risk of death 0.61 in the UK and the third largest arterial series in the country. We have benchmarked these data and the specific factors that have led to improvements so that others can benefit from our experience. My contribution to this outcome was…”

“Data from the intensive care national audit (ICNARC) (May 20xx), shows our unit is one of the top 10 for survival with a standardised mortality ratio (SMR) of 0.65, meaning 60 patients lived who were expected to die. This performance has improved steadily since 20xx when our SMR was 1.35. In sharing this with ICNARC we established the predominant factors for survival and share best practice to improve outcomes more widely. My contribution to this outcome was…”

“I have set up a short stay programme which has the lowest length of stay for hip replacements in England – 2.7 days as against the England average of 6.1 days… 67% of patients are home after 2 nights… 98.5% patient satisfaction service… readmission rate of 5.1% as compared to the regional average of 7%. This has been communicated in xx forums and adopted as best practice standards by xx body.”

National or regional benchmark comparisons are useful, if available. For example, standard mortality ratios, peri-operative complication rates, MRSA, C. difficile rates, venous thromboembolism (VTE) prevention, or length of stay data.

A strong applicant may show how they have significantly improved the clinical effectiveness of their local services and either improved services elsewhere, or used their experience to enable others to do so. Similarly, this experience may be translatable to other clinical services in the wider NHS in other areas. This includes making services better, safer and more cost effective more widely, particularly in addressing differences in outcomes between different geographic regions, or diverse patient groups. Relevant publications authored by the applicant may be informative.

In all cases it is helpful if an applicant makes their personal contribution clear, not just their department’s contribution, stating what they have contributed as part of a wider team where relevant. Examples of any changes made after the results of an audit, or changes to which the applicant contributed as part of governance reviews. Look for evidence of how the applicant may have personally helped these activities contribute to wider change in the NHS.

Evidence could, for example, cover the impact of work on:

• developing and running audit cycles or plans for evidence-based practice to make the service measurably better
• national or local clinical audits and national confidential enquiries
• developing and using diagnostic and other tools and techniques to find barriers to clinical effectiveness, and ways to overcome them and implement new ways of working
• analysing and managing risk – details of specific improvements, or how risk was lowered and safety improved
• providing a better service, with proof of the effect it has had – for example, how a service has become more patient centred and accessible
• improving the service after speaking to patients or setting up and engaging with patient support groups
• redesigning a service to be more productive and efficient, with no decrease in the quality, particularly at a regional or national level
• developing new health or healthcare plans or policies
• large reviews, inquiries or investigations
• national policies to modernise health services, new ways of working or professional practice

Look for audit or published research to show where the consultant’s work has directly improved their service and disseminated this good practice more widely.

For example:

“The development of a gastro-intestinal bleed service has resulted in excellent outcomes. Mortality 2% vs. 7.1% nationally. Risk standardised mortality ratio (SMR) of 0.58 National Audit. I presented these data at xxx conference leading to adoption of new guidelines from 20 xx. My contribution to this outcome was…”

“Based on superior outcomes I developed an international reputation for complex aortic surgery and thoracic abdominal aneurysms attracting referrals from other parts of the country. Our unit has the largest practice in the UK. We pioneered a hybrid open and endovascular operation for aneurysms involving the thoracic and abdominal aorta: first 75 cases elective mortality of 12.5%, elective and urgent of 16%. The world’s best reported results have mortality of 13%. Our thoracic aortic stent programme is the largest in UK with mortality of 3.8%. I have continued to develop my techniques and their assessment through ongoing audit. I have shared these widely leading to their national and international adoption and improvements in national data of xx%. My contribution to these outcomes was…”

“I have developed a continuous patient pathway with GP services for all preadmission clinics and day case surgery patients, ensuring venous thromboembolism (VTE) risk assessment, appropriate thromboprophylaxis (including an extended duration component) with bleeding and VTE incidence, prevalence and follow-up data. This is already improving our understanding and awareness of the issue but also stimulating us to work with GP colleagues to streamline the process and expand its remit more widely. We estimate that, in the area piloted, xx bed days have been saved over the 6-month period of the pilot which has been further expanded into additional trusts with xx impact.”

“I used multidisciplinary team working to effect systemic change throughout our unit, saving nearly 1,000 bed days. This reduced the requirement for elective beds by 25%…I developed 2 half session theatre days. This has greatly improved theatre efficiency…I helped set up and develop the Orthopaedic Outreach Team which greatly reduced length of stay and was highly commended in the 20xx HSJ Awards.”

Domain 2: leadership

In this section, an applicant should show how they made a significant personal contribution to leading and developing a service, health policy or guidelines with national or international impact. Especially consider work that had delivered against objectives within the NHS Long Term Plan.

Applicants should describe the impact and outcomes generated in the specific roles they list. Evidence can include, but is not limited to, proof of:

• effective leadership techniques and processes – giving specific examples of how they improved the quality of care for patients and where they have directly or indirectly influenced other parts of the NHS to achieve these benefits

• change management programmes or service innovations they have led – showing how they made the service more effective, productive or efficient for patients, public and staff, beyond their direct remit

• excellent leadership in developing and providing preventative medicine, particularly working across organisational or professional boundaries with other agencies, such as local councils and the voluntary sector, demonstrating the outcomes or impacts that have been delivered – for example in delivering benefits where health inequalities exist

• how applicants helped staff or teams more widely improve patient care – giving specific examples and their outcomes such as mentoring or coaching. Consultants who work in England may mention the guidance on talent and leadership planning

• any ambassador or change champion roles, for example if they were involved in, or their job involved explaining complex issues and how this translated into changes in practice

• how applicants developed a clear, shared vision and desire for change in others – for example, showing how they invested in new ways of working and handled resistant behaviour to deliver wider change outside of their remit, particularly where they did not have direct oversight responsibility

• how applicants helped staff into senior leadership roles by removing barriers, encouraging diversity and achieving equality and inclusion outcomes

• how applicants contributed to developing patient-focused services in their area and cascaded the experience and expertise to influence others to adopt new ways of working, particularly at a regional or national level

• national impact through personal work and influence through any committee membership. Look for evidence of what was done personally, with a description of the impact of any output. Membership alone is not enough

• the effects of team leadership where the applicant had full or joint responsibility or having taken turns with other leaders to lead specific areas of complementary work

• where applicants took personal leadership for clinical governance, including developing and implementing policies, services or change programmes

Applicants are required to show specific evidence of contribution, the source of any data and relevant dates.

Here are some examples:

“As the lead obstetrician for Delivery Suite I have improved normal labour and birth through the initiation of a rigorous audit and examination of our processes and the impact of them on maternal and perinatal outcomes. The team’s work was recognised by winning the All Parliamentary Group for Maternity Services Award for 20xx resulting in updating of regional guidelines based on our local experience. This work has been shortlisted for the Royal College of Midwives’ annual award.”

“I continue to lead the weekly obstetric risk management meeting. The reduction in reportable incidents when this meeting was established has continued and has now fallen from x% in 20xx to y% in 20xx. We continue to audit and improve our practice, reporting nationally.”

“I undertook a detailed review and redesign of the antenatal clinic service which has improved patient waiting times. We shared this with our trust leadership and instituted similar practices across the trust and now regionally. This has led to an increased clinic capacity of x over the last 2 years “

“In my role as chairperson of the regional neonatal network between 20xx and 20xx, I championed the rationalisation of beds and care levels across acute hospitals. As a result, transfers of neonates for clinical and nonclinical reasons have reduced by 10% resulting in reduced risk and improved outcomes of …x. See further data below.”

Work in roles in education, such as chairperson of a training committee should not be cited in this domain. Applicants should include that information in domain 3.

Domain 3: education, training and people development

In this section, an applicant should give evidence to show their contribution to wider education and training across the professions and to patients. It should be made clear if any training or lecturing is externally or separately remunerated.

Where relevant, applicants should give evidence of the impact of their work in supporting the NHS People Plan and if it falls into any of the following categories. We do not expect examples for all these categories and other categories can be included.

Teaching

This can be medical undergraduate or multidisciplinary team teaching, if it’s outside the job plan. Undergraduate teaching, or local academic management activities (for example chairing an examination board) that are a core part of an individual’s job plan are not considered to be over and above their role.

Applicants are encouraged to give evidence of student feedback or other teacher quality assessments and especially focus on how their educational work has improved others’ performance and has had a positive impact on healthcare. As an assessor, you should look for evidence of a personal role in curriculum development and/or assessment and, if relevant, evidence of wider adoption of novel work in these areas in UK medical schools, or internationally.

Leadership and innovation in training

This should include evidence of the impact of these activities outside of an applicant’s own remit, preferably nationally or internationally. This might include:

• developing and introducing a new course, such as at masters level
• innovative assessment methods
• introducing new learning facilities
• writing successful textbooks or developing online teaching or training modules, or an app
• contributing to postgraduate education and life-long learning
• contributing to teaching and assessment in other UK centres or abroad
• developing other innovative training methods, such as simulation-based

Supporting information could be presentations, invitations to lecture, and publications on education – evidence should be included of the wider national impact of these activities.

Educating and informing patients and public

Examples could include how applicants:

• promote good health and disease prevention within the community which has delivered wider impacts
• facilitate the development of patient support groups at a regional or national level that can show improved patient engagement and outcomes, tangible improvements in preventing illness and injury, or improved patient and public involvement in research

College or university success in teaching audits

An applicant could explain if they helped a college or university succeed in regulatory body and quality assessment audits for teaching. This could include undergraduate or postgraduate exams, or supervising postgraduate students and trainees leading to a demonstrable impact on healthcare as a result.

Personal commitment to developing teaching skills

Evidence could be included of higher education academy membership or fellowship and any educationally focused courses completed, and how these new skills or qualifications have been implemented in practice to improve and modernise training and education.

Unexpected or non-mainstream contributions

This could be any other teaching or educational commitment that has had national impact and is outside the job plan, or other paid work, that is not recognised in standard ways.

Here is an example:

“My course for xxxx (20xx to 20xx), innovative in its integrated health systems and active learning approaches, has sought and used intensive feedback to enable modification of the course before wider roll out. It is approved for continuing professional development by xxxx, and shows significant gains in knowledge and skills, and excellent participant feedback. This has translated into an x% increase in qualified staff available for xxx work and a resultant increase in quality of care and outcomes from y to z over the 5-year period covering 20xx to 20xx.”

Domain 4: innovation and research

This section looks at innovation and its impact in any relevant setting and may include evidence of impactful work than the activities that are traditionally considered as research.

It can include new care pathways that have been developed and implemented, improved ways of working and process efficiencies that have been adopted widely, and have demonstrably made more cost effective use of NHS resources. It can also include benefits of digital technology or other activities from projects with external partners that have demonstrated a benefit to the wider NHS, or that support the GMC’s objectives of promoting research for doctors.

Applicants should be clear what evidence is over-and-above any research, academic or other expectations of their role and give evidence of the wider impact of the research and/or innovation. This may include developing the evidence base for measuring how quality has improved.

In the section on references, applicants should show details of achievements such as published peer reviewed papers – not the names of referees or electronic links to papers or reviews. The majority of any publications listed should be from the last 5 years. Evidence should include the relevance of these publications and wider impact they have had. Providing the number of citations each paper has had or its academic score is not sufficient without further explanation of its impact.

As an assessor, you should look for linkage between this section and evidence provided in other parts of the form. For example, if in domain 1 or 2 an applicant has indicated that they have played a major role in the development of a clinical guideline, look for a relevant publication. The guideline itself may have been published in an official document (such as through a government agency) or in a relevant journal.

When assessing publications, you should be aware that it is easier for investigators in certain specialities to publish work in so-called high-impact journals such as The Lancet or the British Medical Journal (BMJ), than in other clinical areas. The short explanatory comments attached to a paper should help, and may for example confirm that a particular journal is the leading one in that area, something of which you may not be aware as an assessor.

On a separate line, applicants could explain what they have achieved in the last 5 years and how this innovation or research has quantifiably improved health outcomes. They must give supporting evidence. For example, they could give details of new evidence-based techniques, innovative systems or service models developed that others have adopted more widely.

Applicants could also explain how they have improved patient and public engagement in research and innovation both in the planning and delivery stages, or encouraged new ways of thinking informed by patient involvement when it comes to improving patient services, detailing the specific benefits this has brought.

Applicants should describe the effect of their research (including laboratory research) and any new techniques they have developed and the wider benefits delivered on:

• health service practice
• health service policy
• developing and improving health services and enhancing patient care

As an assessor, you should look for a clear explanation of how their research is currently relevant to the health of patients and the public, or how it may do so in the future.

Applicants could give details of the impacts delivered as a result of:

• large trials or evaluations (including systematic reviews) they led or coinvestigated, and published in the last 5 years. It may be helpful to look at the publication list to corroborate the applicant’s involvement in this work
• their contributions as a research leader, how they have helped and supervised other people’s research and mentored new investigators. For example, look at the publication list to see whether the applicant has published paper(s) with research students, or other members of the multi-professional research team

Applicants could include other examples of the personal impact they have made in their chosen research fields. For example, how their work on any review boards of national funding agencies, charities or learned societies has delivered quantifiable improvements over a defined time period.

Applicants could also:

• list any grants they hold personally (specifying their role as chief or principal investigator where relevant) and explain how this funding is being used to deliver benefits. You should bear in mind that it may be some time (5 to 10 years) before a research grant produces tangible results. It is also the case that there is not always a direct relationship between the monetary value of a research grant and the resulting impact of the work funded

  • important research findings and clinical innovations can result from relatively modest grants, and obtaining multimillion pound grants without evidence of quality outputs should not in itself earn a high score. Evaluating the publications section may be useful. You should, as an example, consider whether the grant funding resulted in one or more high quality papers or reports

• describe peer-reviewed publications, chapters or books written or edited – defining their editorial activity for each one, for example senior editor, and any quantitative measures on how effective they have been in changing practice

• give details if they played a major part in research studies in more than one centre, for example personally recruiting participants to large clinical trials

• include evidence of outstanding research that has led to new ways of preventing illness and injury, or more rapid, cost-effective and reliable diagnosis

• show how they have engaged with a funding council, National Institute for Health Research (NIHR) or a major research charity, specifying their role (clinical director, senior reviewer, or research or fellowship programme lead). Applicants must give clear dates and evidence of their roles and impact.

Here are some examples:

“As Director of Research and Development (R&D) in the last 3 years, I have positioned the trust as one of the leading 5 NHS research centres in the country, and developed a research service to support clinicians with robust governance processes, a clinical trials office, a research design service, and funding for research time. This has led to an increase in research output of x, which has provided input to xxx national guidelines and policies.”

“My research is in stroke, which is a public health priority for prevention and improvement of care. The development of a public health model for chronic disease using stroke has proved relevant to assessing needs and evaluating innovative models of care improving prevention strategies to reduce the incidence of stroke from y to z. In acute stroke, we have reduced the time to assessment and intervention from x hours to y hours over the last 3 years resulting in improved outcomes and functionally independent discharge rates from y% to x% My R&D leadership role has enabled academic and clinical organisations to develop joint National Institute for Health Research (NIHR) centres in biomedical and health services research and training for population and patient benefit.”

“I have developed booking systems for use in emergency and trauma theatre settings. These secure systems allow cases to be booked into emergency theatres from anywhere in the hospital, informing all emergency staff of pending cases and their preparedness. The system links with hospital investigation reporting systems allowing blood investigations for each patient to be accessed. In addition, the trauma booking system can be linked to a radiological teaching package. When a fracture type is booked onto the system, the booking doctor is offered the opportunity to look at the system of classification for that fracture type and to review teaching radiographs of each type. The system won a 20xx national Theatre Innovation Award for IT and has improved our outcomes from x to y over the last 5 years. I have piloted the wider use of these systems outside of our trust and these have been adopted in 5 other trusts with a net benefit of x.”

Domain 5: additional national impact

This domain is an opportunity for applicants to provide evidence of wider beneficial impacts that have not been captured elsewhere in the information provided on the form in the other domains, and/or to demonstrate how their work has had a wider effect on areas that are national clinical priorities. This could relate to work within their job plan, but should demonstrate the national impact over and above the expectations of activity that they are paid to do.

Applicants can include any work for charitable organisations, and work which may have more of a patient or public focus, tackling health and workplace inequalities and fostering interprofessional team building or new ways of working. It can also include international work in training, research or recruitment that is of clear benefit to the NHS.

Other relevant activities are NHS priority disease areas such as cancer, its diagnosis, prevention, treatment and outcomes, communicable and non-communicable diseases or other areas where there is outstanding need or identified health inequalities or disparities. It may also cover public health and patient care pathways. For example, an applicant could seek to demonstrate how they prevented inappropriate emergency department attendance or generated other benefits, such as working with social care providers, Information Commissioner’s Offices (ICOs) or third parties in other ways.

Applicants could include work on delivering wider health policies or their impact related to the NHS Long Term Plan and/or the NHS People Plan, particularly in reference to collaborative working, demonstrating an inclusive culture and the health and wellbeing of NHS staff and their retention in the face of increasing pressures. In all cases, applicants should give details of how they are delivering wider change and the magnitude of any impacts over a defined time period. They may choose to inform us if they are actively involved in a leadership capacity at a regional or national level in the delivery of the COVID-19 backlog plan – clearly defining the impact of their personal contribution.

Applicants may consider providing evidence of the impact on delivering improved joined up care in line with its recommendations in optimal settings, by implementing new service models or specifically digital innovations or efficiencies across the wider health environments. This is particularly if they have expanded these beyond their immediate area or remit. They may also offer evidence of involvement and leadership in activities and innovations that have been developed in partnership with external partners, which provided positive impacts to the NHS and are in line with the government’s life sciences strategy.

There is also scope for including impacts on outcomes improvement, particularly in areas identified with unmet need or where there is undue national or regional variation in outcomes across the NHS.

This domain could also be used to provide additional evidence that is related to evidence from a prior domain. Applicants should avoid repeating evidence however, as it will only be scored once. They should take the opportunity to demonstrate different aspects of their work that is over and above their job role and how these have had incremental impact.

As an assessor, your priority is to look for evidence of outputs that have had a real impact, rather than activity alone.

Citations provided by the employer or NNO are not scored themselves. They provide triangulation and corroboration of information that is provided by the applicant elsewhere on the form. They cannot and should not be seen as a means to compensate for poor quality evidence in domains.

Employer citations primarily serve to confirm that the applicant’s job plan has been agreed, and that they are meeting their contractual obligations as defined in that job plan. We expect confirmation that a consultant has engaged fully with local appraisal processes as required for revalidation by the GMC. We anticipate that all consultants will be supported by their employer. If an employer elects not to provide support, they should indicate why this is the case. A consultant can still apply for an NCIA. This information will be available to you as an assessor in the form and you will have to take a view as to its relevance in the context of the application as a whole.

The person (for example, a trust medical director or senior human resources (HR) manager) who is writing the employer citation may or may not be in a position to comment on the bulk of the nationally or regionally-focused work that an applicant will have included on the form. They may instead focus on local clinical or management activity. This makes employer citations of variable value. A citation that does not mention or endorse an applicant’s national work should not be viewed negatively.

For the NNO citation, NCIA have asked NNOs to focus specifically on the endorsement of an applicant in relation to their contribution to the wider NHS and their speciality, rather than their consultant’s work for the organisation itself. For example, if an applicant has authored a new clinical guideline for the treatment of a particular condition, the relevant specialist society acting as an NNO should be in a strong position to tell NCIA and you as the assessor, whether this guideline is now widely adopted in the NHS, and is having a significant positive impact on clinical practice.

As set out above, and further detailed in our nominators’ guide in the application guidance page, the number of NNOs has been reduced this year and only one NNO citation is permitted per applicant to streamline the assessment process. As a result, some applicants will not have an NNO citation accompanying their application. This was frequently the case under the former ACCEA scheme and should not be viewed negatively. 

Many applicants without NNO citations have achieved awards in the past, and some consultants may not elect to seek support through this route which often requires early and sometimes laborious engagement with a society. Recent research has shown that in many cases citations only have a marginal influence on the final score achieved by applicants.

Assessing applications from less than full time applicants

Consultants working LTFT were eligible to apply for ACCEA awards under that scheme. Many high quality applications were received with a high success rate, although the payment for these awards was pro-rated in proportion to the number of programmed activities worked. Under the new ACCIA scheme, LTFT consultants will still be eligible, however if successful, the award will be paid at the full level – N1, N2 or N3. To qualify, a consultant must have a contract that incorporates a minimum of 3 clinically-relevant PAs.

If a consultant is working LTFT and in a transition provision from a national CEA based on legacy award values, they will receive a pro-rated award (see Part 1).

Consultants elect to work LTFT for a range of reasons, personal and professional. NCIA does not require an applicant to indicate why they have chosen to do so. However, where there are extenuating circumstances, for example ill-health, that have precipitated the need to work LTFT, an applicant may choose to inform NCIA directly, and/or mention these on their form in their job plan, personal statement or in a relevant domain (see Part 1).

We advise you to look carefully at the job plan for all applicants – this is particularly important for LTFT applicants in order to help you decide if the contributions described in the domains on the form (clinical and/or academic) are truly over and above what might be expected.

You are also advised to pay careful attention to applications where a consultant’s circumstances and job plan have changed during the course of the 5 year assessment period, perhaps working part of the period LTFT, and part full-time. Applicants are strongly encouraged to be precise about the timing of such changes in working pattern and to provide dates for the achievements that they are presenting for assessment.

Annex A: ACCIA scoring process 2022

Diagram 1: scoring process 2022

The flow chart sets out an example of how the scoring process might look if there are 600 awards available.

First, the secretariat would calculate indicative numbers. These would then be split by region proportionate to the number of applications received. At this stage regional sub-committee scoring will take place.

Then all the available National 1 awards and the top proportion of National 2 awards will go to the National N3 Committee for scrutiny. Meanwhile the lowest National 2 awards and all National 1 awards will be sent for scrutiny by the chair and medical director.

Once the chair and medical director scrutiny and National 3 committee review has taken place, all National 1 and National 2 awards should be approved, bar a select few submitted to the National Reserve sub-committee.

The remaining National 3 awards will simultaneously be reviewed by the chair, medical director and ACCIA main committee. Once all these processes are complete the awards will be decided. The final list of successful applicants will be sent for ministerial approval.