Home / Explore QICN / Awards / William Rathbone X Award for Executive Nurse Leadership / Nomination form for the William Rathbone X Award

Nomination form for the William Rathbone X Award

The William Rathbone X Award Nomination Form

Excellence in the Executive Nurse Leadership of Community Nursing Services

Please complete all sections on this form.

Nominee Details

In this section, please provide the details of the person you wish to nominate for the award.

Name of nominee(Required)

First Last

Nominee's work email(Required)

Nominee's work phone(Required)

Nominee's job title(Required)

Name and address of employing organisation(Required)

How does the nominee demonstrate excellent strategic nursing leadership, support for staff and positive outcomes for patients in the delivery of community nursing services?(Required)

This is not about a single episode of leadership, but how they apply a consistent approach to their work. Please use specific examples where possible (500 words max).

Please reference the following where relevant: 1) Evidence of achievements such as CQC (or equivalent) ratings and annual staff survey outcomes. 2) Reputation of the nominee in the wider sector, such as active contribution to the national agenda for community nursing.(Required)

Please use specific examples where possible (500 words max).

Nominator Details

Nominations should be made by the organisation's Chief Executive. In this section, please provide details of your own role.

Name(Required)

First Last

Designation(Required)

Email(Required)

Phone(Required)

Work address for correspondence(Required)

Contact details of second person who knows the nominee, who may also be contacted by the assessment panel(Required)

Please state: 1) Name, 2) Address, 3) Email address, 4) Phone.

It is essential that you do NOT inform the nominee that their name has been submitted for consideration for this award in order to avoid disappointment to nominees who are not selected.

Nominations will be assessed by a panel consisting of Trustees of the QNI, chaired by the Chair of the QNI’s Council. The Chair or another panel member may telephone you for further information.

About the Network

Explore QICN

Nursing in the Community

Support for nurses

News and Events

Nomination form for the William Rathbone X Award

The William Rathbone X Award Nomination Form

Nominee Details

Nominator Details

Video title

About the Network

Search the site

Nomination form for the William Rathbone X Award

The William Rathbone X Award Nomination Form

Nominee Details

Nominator Details

Video title