Guidance

Applicants' guide: 2024 awards round

Updated 4 March 2024

Applies to England and Wales

The 2024 awards round opens on 4 March and closes at 5pm on 15 April 2024.

About this guide

This guide is for NHS consultants, dentists and academic GPs who want to apply for a national Clinical Impact Award (NCIA), previously known as National Clinical Excellence Awards (NCEAs).

NCIAs exist as a retention and recognition scheme for senior clinicians who have the greatest national impact. We strongly encourage all eligible senior clinicians from all specialties, backgrounds and regions within England and Wales to apply. Similarly, we expect employers to use appraisal discussions actively to encourage and support applications from all high-performing clinicians working in their organisations, especially doctors and dentists who may be from underrepresented groups.

This guide covers the 2024 NCIAs competition in England and Wales and tells you:

  • how the award scheme works
  • who is eligible to apply
  • how to apply for an award
  • how your application is scored
  • how to appeal

Read this guide before you start preparing your application. We have also created a quick guide that you can refer to as you put your application together.

You should find everything you need to help you on the Clinical Impact Awards: guidance collection page.

If you have any questions that are not covered, you can contact us at:

Application deadline

You must submit your application by 5pm on 15 April 2024. Any applications received after this will not be considered.

You cannot submit your application until the employer sign-off element has been completed. Ensure your employer is aware of your application and allow enough time for this to be done.

If you’re based in Wales

If you’re based in Wales, you’ll find anything extra you need to know in the boxes throughout this guide.

Part 1: introduction

About ACCIA and the Clinical Impact Awards scheme

The Advisory Committee on Clinical Impact Awards (ACCIA) runs the NCIAs scheme for the Department of Health and Social Care (DHSC) in England. ACCIA provides governance for the awards for the Welsh Government in Wales. 

The national scheme recognises consultants, dentists or academic GPs who deliver national impact above the expectations of their job role or other paid work over the previous 5 years, or since a prior national award if within the last 5 years. The scheme specifically recognises the dissemination and implementation of that work and its impact on the wider NHS and public health.

You do not need to hold any local award or a previous NCEA to be eligible for a national impact award.

Health ministers agree a limited number (up to 600) of new awards each year in England, so the selection process is very competitive. Three levels of award are available in England, from lowest to highest:

  • National 1 (N1)
  • National 2 (N2)
  • National 3 (N3)

In Wales a lower level, National 0 (N0), also exists.

The awards last for 5 years and have an annual, non-pensionable value of:

  • £10,000 (N0)
  • £20,000 (N1)
  • £30,000 (N2)
  • £40,000 (N3)

You can apply for a new award at any time after you have completed a full year in an eligible role.

What you need to demonstrate

To be considered, your application needs to show what you have delivered that has had an impact at a national level, over and above the expectations defined in your job plan within the last 5 years.

There are 5 domains for you to tell us about your contributions and provide supporting evidence:

  • developing and delivering a high-quality service
  • improving the NHS through leadership
  • education, training and people development
  • innovation and research
  • additional impact, in which you can provide other evidence, particularly if it relates to published NHS or other relevant health objectives

In all of the domains, you should consider providing evidence of national impact relating to equality, diversity and inclusion.

If you apply, you need to give dated evidence of impact across the 5 domains described above. Do not repeat evidence across more than one domain unless it has discrete impact in each domain as it will only be scored once. Only the evidence in these domains is scored - the other parts of your application are not scored but provide context for the assessment of your evidence within the domains. These domains are described fully in part 5 of this guide.

Work in other countries is unlikely to be directly relevant for an award, so is not considered on its own. Overseas evidence may be supported if you can show that your overseas work has helped the NHS and the health of the UK public directly, or has had a direct reputational benefit for the NHS overseas. We do not give awards for, or otherwise credit, stand-alone overseas work.

The Ministry of Defence (MoD) runs its own awards scheme, but we also recognise eligible NHS employee contributions, over and above the expected standards, to military medical and dental services. These are assessed by a separate MoD committee.

See the published personal statements for an idea of the breadth of work and impact that is currently being recognised and rewarded under the scheme.

How we assess your application

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

We assess all applications against the same criteria, which you can find in part 5 of this guide. The detailed guidance that we provide for assessors on how to judge applications against these criteria will be published on the Clinical Impact Awards: guidance collection page.

There is a single online application form for all awards, so every applicant can highlight their contributions in the same way. Application forms are scored by our sub-committees, initially at a regional level, based solely on the strength of applications and the evidence provided in the forms. No other evidence can be provided, and evidence submitted after the deadline cannot be considered regardless of the reason.

The relative ranking of all applicants determines who gains which award level, based on the number of awards available at each award level.

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

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 (N3)
  • assessing applications for which the initial scores are tied at cut-off points or where governance queries arise - the National Reserve Sub-committee (NRES)

Wales has its own sub-committees which consider N0 to N3 awards. Wales does not operate an NRES process.

The sub-committees consider all applications in their area, except for those from public health consultants and academic GPs contracted by NHS England. These are assessed by the DHSC or ALB sub-committee, where they can be more easily benchmarked. Each regional sub-committee is allocated an indicative number of awards at each level. This is based on the number of national awards available, equally and 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 all regions and through the ALB committee. 

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 collated and an average score is derived. This average score allows applications to be ranked against all the others 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 rescores all those from each region falling within the N3 indicative allocation, plus an equal number of applicants scoring highest in the N2 allocation. This rescoring provides national benchmarking to determine who receives an N3 award. 

Each sub-committee is typically made up of:

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

Sub-committees may be divided into scoring groups to manage the workload. We ensure there is broadly equivalent diversity of scorers across these groups, to minimise any unconscious bias affecting the scoring.

Each group scores applications consistently against the assessors’ 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 N1, 200 N2 and 70 N3 awards each year at an annual value of £20,000, £30,000 and £40,000 respectively.

If you successfully gain an award, it will last 5 years, backdated to 1 April 2024. For NCEA holders under transitional arrangements, awards will last 5 years from 1 April 2025.

In Wales, the process for assessing applicants is different. For more details, contact the Wales secretariat at accia@wales.nhs.uk.

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 where clarification may be helpful, are discussed at the regional sub-committee meetings as part of our quality and governance review. Applications where questions have not been resolved are referred to NRES, which functions as a committee for rescoring only.

Applications that are tied at the cut-off point for N1 or between N1 and N2 awards are automatically referred for rescoring by NRESNRES is made up of the chairs and medical vice-chairs of the regional sub-committees, plus other experienced scorers. As a committee of our most experienced scorers, NRES acts as an additional 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.

Recommendations from the Wales sub-committee go to Welsh ministers for final approval after scrutiny from the main committee. 

If your award is approved, we will let you and your employer know in early 2025. There is a few weeks’ gap between when applicants are informed and when employers are notified. This is to allow all applicants to receive their results from ACCIA.

Local awards and commitment awards

We do not have any say in local awards in England or commitment awards in Wales. For more information about these awards, contact your employer. 

At present, you cannot hold a local and national award at the same time.

Running an open, transparent scheme

You will find information about ACCIA and the scheme on our website, including: 

All guidance for applicants, assessors and employers will be published on the Clinical Impact Awards: guidance collection page.

If you have a 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 you have a disability, include details about any reasonable adjustments you have agreed with your employer in your job plan. 

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

Extenuating circumstances

If there are extenuating circumstances you believe may affect your ability to submit a successful application, let us know as soon as possible before the application closing date, so we can support you and make sure your application is considered fairly. We cannot take any extenuating circumstances into account after you have submitted your application and it has been scored. 

Each case is treated on its own merits, and the outcomes from each are based on the rules relating to the current scheme. If you apply for an award and believe there are extenuating circumstances, you can describe these in the job plan, personal statement and/or relevant domains of the application form.

We understand that it can be difficult to share personal information. Our assessors receive specialist training on how to consider these types of circumstances, and any information you share will be treated with respect and in confidence. Extenuating circumstances should not put you off from applying - let us know about them so the sub-committee can take them into account in the scoring.

Part 2: check you are eligible

Who can apply for an award

You can apply for an NCIA if you are a fully registered medical or dental practitioner on the:

  • General Dental Council (GDC) specialist list
  • General Medical Council (GMC) specialist list
  • GP register

You need to:

  • be fully registered with a licence to practise
  • have been, and continue to be, 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

You must have met both of these conditions for at least one year, on 1 April in the award year in which you are applying.

The year does not usually include time spent as a locum or on other fixed-term consultant contracts. However, for consultants in a locum role for more than one year we may consider you eligible for an NCIA providing certain criteria are met. Contact accia@dhsc.uk to discuss as soon as you are considering applying as we may need to engage with your employer for confirmation. Eligible applicants may use evidence from their achievements as a locum in the same role, providing it falls within the relevant period.

For any applicant who has ‘retired and returned’ you must have returned to employment on a permanent consultant contract, with a maximum of 24 hours’ break. Rolling or locum contracts are ineligible. If your employer has defined policies that specify a minimum break period for retirees and/or only employs returnees on non-permanent contracts, these policies must be confirmed by your employer and provided to ACCIA together with your new arrangements to allow a full assessment of eligibility to apply for or retain an award.

In all cases, you must be on either:

  • an NHS consultant contract expressed in programmed activities (PAs)
  • an academic contract expressed in an equivalent pay scale with an honorary NHS consultant contract

Consultants working in Wales must be on an NHS consultant contract expressed in sessions or on an academic contract expressed in an equivalent pay scale.

If you’re not sure about your eligibility, contact accia@dhsc.gov.uk (for applicants working in England) or accia@wales.nhs.uk (for applicants working in Wales) well ahead of the application deadline.

Qualifying criteria

You will qualify if you are any of the following:

  • employed by an NHS organisation (in England or Wales), DHSC or its ALBs, the Welsh Government or similarly associated Welsh Government organisations, a university, medical or dental school, or local authority. Applications from employees of other organisations may be eligible, including those on permanent consultant contracts providing contracted-out NHS services. If you need any clarification, contact accia@dhsc.gov.uk or accia@wales.nhs.uk before you apply

In Wales, you will also qualify if you are employed by similar Welsh Government associated organisations. 

  • an academic GP, if your responsibilities are the same as consultant clinical academic staff and you are fully registered with a licence to practise. You can apply for awards if you:
    • are contracted to work at least half your hours in the academic part of your role
    • are a practising clinician providing some direct NHS services
    • have at least 3 PAs or equivalent sessions that are clinically relevant to help the NHS, including teaching and clinical research, in your contract
  • an academically employed consultant or a dental practitioner with an honorary NHS contract, who is fully registered with a licence to practise. Whether you qualify for an award does not only depend on your contractual contribution to the NHS in the provision of direct patient care. If you are an academic consultant, you will qualify for an award if you are contracted to carry out at least 3 programmed clinical activities or equivalent sessions that are clinically relevant to help the NHS. This includes teaching, training and clinical research. An applicant who is contracted to work fewer than 3 programmed clinically relevant activities (PAs) is not eligible to apply for or retain 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 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 GMC or GDC, with a licence to practise. You can apply for an award based on your work in this post
  • a consultant, fully registered with GMC or GDC, with a licence to practise, working as an NHS trust clinical or medical director, or a similar level medical management post if you remain on a PA-based consultant contract. If you are not sure if you are eligible, contact us and we will assess your contractual contribution over and above your expected duties, as well as your contractual status. As a dean, clinical or medical director, if the majority of your work is in a management role, you will qualify if you have an active consultant contract with a specific clinical, or clinical leadership, role that includes 3 clinically relevant PAs and continue to renew your licence to practise. If you move into general management, reduce to below 3 clinically relevant PAs and/or have a management contract outside the consultant pay scale, you are not eligible to apply for an award

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

As of 1 April 2023 if you begin receiving pension benefits up to 100% of your allowance, but continue in eligible employment, you are still eligible to apply for an award provided you continue to meet the standard eligibility criteria.

If you work less than full time (LTFT), you can apply for an award if you undertake a minimum of 3 clinically relevant contractual PAs. If you are eligible based on this minimum PA requirement and are successful, we will pay you the full award. If you are or become LTFT and hold an NCEA or are under transition from an NCEA based on legacy award values, you will receive a prorated award determined by what ACCIA deems your clinically relevant contractual PAs to be. 

Our chair and medical director determine ‘clinically relevant’ eligibility by considering the description of your activities that describe how you directly undertake clinical care, teaching, training and research activities within the allocated PAs in job plans. Administrative, oversight or management type activities are unlikely to be considered as clinically relevant. 

If you are thinking of changing jobs (NHS or university), we would recommend an early discussion with a potential new employer and specific consideration of how any newly proposed job-planning arrangements may affect eligibility for an award in the future. Employers may not be fully aware of all requirements, so you should also contact ACCIA for advice.

Reasons you may not be eligible for an award

You are not eligible to apply for an award if you are: 

  • not on the consultant pay scale as expressed in PAs or an equivalent
  • contracted to work fewer than 3 clinically relevant PAs - you should contact ACCIA for advice on this as this is not the same as 3 direct clinical care PAs
  • a locum consultant or a consultant on a fixed-term or rolling fixed-term contract, unless under specific employer policies for retire and return arrangements. If you become a permanent consultant, you can potentially use evidence from your locum or fixed-term roles in your 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 clinically relevant role
  • not fully registered with a licence to practise

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

You must let us know about any investigations that have been initiated as soon as possible. We must be updated on their progression, interim and final decisions, and be made aware of any sanctions, verbal or written warnings, by your employer or professional regulator (for example, GMC or GDC). We will look at each case individually, but we may remove your award if:

  • there are adverse outcomes following investigations or any disciplinary measures that result from a finding of a lack of maintaining high professional standards
  • if we believe you have failed to notify us appropriately or in a timely manner

If this happens, you will need to pay back any overpayments. See part 3 for more details. 

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

Part 3: how to apply

The timetable for national awards

You must submit your online NCIA application to us by 5pm on 15 April 2024. You will not be able to apply after this, regardless of the reason that you missed the deadline.

View the full indicative timetable for the 2024 national awards round

Filling in your application

You must fill in your own application form - nobody else can do it for you. 

You will need to apply online at the ACCIA portal.

You may find it helpful to draft and amend your application before you apply by downloading a copy of the form. This will be available shortly on the Clinical Impact Awards: guidance collection page.

When you apply, select the NHS organisation or ALB that holds your substantive or honorary contract, so that the right sub-committee considers your application. If you give the wrong trust or organisation, your application may not be considered for an award. If you are employed by more than one body, state all your employers, being clear which is your main employer based on your salary. 

Getting support for your application

We cannot accept applications without sign-off from your employers. They will need to complete the shortened part 2 of your application. This requires joint sign-off from all employers if you have more than one. 

If you work for a university, the chief executive of the trust where you 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 also that an up-to-date job plan has been agreed by both parties.

Employers are expected to have processes that ensure equality and diversity. They should have a balanced representation of applicants from their consultant staff.

Many membership and specialty organisations can provide assistance and general guidance with applications using tools made available to them by ACCIA. Organisations must not proofread, review or directly critique any part of an application. You can indicate on your form if you have sought advice from any such organisations.

From 2023, the process where some applicants received citations and rankings from these organisations (previously known as national nominating organisations) has been discontinued. This is because the favouring of some, but not all, applicants by allowing the inclusion of additional information, does not align with ACCIA’s equality objectives.

How appraisals fit into the process

To qualify for an award, you must have an annual appraisal. Your employer must confirm whether you have done this in the 12 months before your application. If you have not, they should confirm that every reasonable effort was made to conduct one. We recognise there may be circumstances where appraisals may have been delayed beyond the applicant’s control - if this is the case, the reason that no appraisal occurred needs to be stated. 

We do not need information about the appraisal, but your employer must confirm that you: 

You may have met the standard for job planning even if you do not have an agreed job plan - for example, if mediation is taking place. Explain this to your employer if they are delaying their sign-off for this reason.

Telling us about investigations or disciplinary action

On your application form, you must tell us if: 

  • you are being investigated about your work by your employer, GMC or GDC
  • you are going through local disciplinary procedures (trust or university)
  • successful legal action has been taken against you for your clinical practice, where you admitted responsibility or were found guilty in court
  • there are any civil or legal proceedings against you which may reflect upon your behaviour, judgement or professional standing that might subsequently be notified to GMC or GDC
  • you have faced any of these things in the last 5 years

The information you need to give includes: 

  • any investigations by external bodies, such as GMCGDC or the National Clinical Assessment Service (NCAS)
  • verbal or written warnings made by your employer or regulatory body and any restrictions on your practice
  • complaints against your performance or behaviour that your employer is formally investigating
  • the results of any finished investigations

We will record this information, but it will not be available to assessors and will not have a negative effect on your score. 

For live investigations, we adopt an ‘innocent unless proven otherwise’ approach. We may choose to wait until the investigations are over to review the outcome of your application. If we do this and you are subsequently granted an award, we will backdate it to when it would have been awarded, had we not waited until the end of the investigations.

If you start to be investigated or go through disciplinary procedures after you apply and before we announce the awards, you must tell us immediately.

If you do not tell us about any such issues, we will be concerned about your commitment to transparency and we reserve the right to cancel your application or withdraw your award.

Things to do when you apply

Start your application early enough to allow time to get sign-off from your employer and engage with any relevant local trust or university processes. Make your employer aware you are applying, to enable them to sign off your application in good time.

When you fill in your application form, follow the steps below.

Give clear dates for your achievements - if the dates are not clear, it will bring your score down.

Concentrate on evidence from the last 5 years and make it clear what you have achieved since any prior award (if relevant) and how your work has progressed since then.

If your last award was less than 5 years ago, give evidence since your last award and be clear about what you have achieved since then.

If your last award was more than 5 years ago, concentrate on evidence from the last 5 years.

Do not cut and paste information from previous applications - assessors compare new and older applications and will check for repeated information. Do not repeat the same evidence in different domains. It will only receive credit from the assessors once.

Avoid using acronyms. This is because sub-committee members (particularly lay members) reading the application may not be familiar with them. If you feel you need to use acronyms, write the society and group names in full at least once. The same applies to the names of committees and other ‘medical’ abbreviations, such as those used for diseases, operative procedures, specialist services, pathological processes or diagnostic techniques.

Do not include any website addresses or other external links to additional information. You must stay within the character limit for each domain and not seek to gain an advantage by linking to additional external evidence. Scorers will not access or score evidence that is not on the application form itself and may view the use of URLs, as a way to add to your evidence, negatively in the assessment of your application.

Give measurable and externally validated information such as outcome data or other quality metrics wherever you can and quote the dates, source and relevant benchmarks. This applies to clinical work, as well as research and education.

You must explain the impact you had and the relevant dates. Simply holding a position such as an ‘officer’ in a college or specialist society or serving as a chair or member of a committee will not in itself justify an award - your national impact needs to be clear and related to the period during which you did this work.

Use a new line for each entry and consider using spacing to make the information clearer and easier to read, but avoid merely providing a series of lists of activities or roles with no reference to impact.

Check with your employer that they have a registered contact on the ACCIA portal before you submit your application, otherwise they may not be notified it is awaiting their sign-off.

We may ask for more information if anything is unclear in your application.

If you are an NCEA holder applying under transitional arrangements, are not planning to retire in the next 12 months and there are special circumstances that could affect your application (such as ill health), tell us as soon as possible before the deadline. Our chair and medical director will review your case and may either:

  • consider extending your award, to avoid the potential loss of transitional benefits
  • advise you to ensure the extenuating circumstance details are captured in your application, or to defer your application

Each step of your application

Step 1: sign in

You can register on the ACCIA portal at any time but will only be able to start your application when the application window is open. If registering for the first time, select ‘new to the system’ and complete the form as a ‘Contact of an existing employer’. If your employer is not listed, applicants working in England should contact us at accia@dhsc.gov.uk. You will get an email with your login details and be asked to set up a password.

Applicants working in Wales should contact accia@wales.nhs.uk for any queries or issues.

Step 2: privacy notice

You need to agree to how we collect, process and store your information.

Step 3: start your application

Select ‘Apply for a Clinical Impact Award’ and the ‘2024 Award Round’. If you are continuing an application that has already been started, you may need to scroll down the page (particularly on smaller screens) to see the link to your draft application.

Step 4: complete your applicant profile

This information is for our monitoring purposes. Some information is not visible to scorers to minimise any unconscious or other bias. You need to add your: 

  • personal and contact details
  • GMC and/or GDC registration
  • current employment details for your primary NHS employer and primary non-NHS employer, if you have one
  • pension scheme membership and if you are an academic or teaching consultant
  • background and diversity details
  • details of any investigations or disciplinary procedures in the last 5 years

You can save your work at any time using the button in the middle of the screen.

You will need to complete and submit your profile before you are able to submit your application. If you applied in the 2022 or 2023 rounds, check that the information you provided remains accurate.

Step 5: your application details

Complete the ‘Details’ tab with the following information:

  • your consultant appointments in date order
  • any postgraduate qualifications stating the year you qualified and which institution you studied at
  • any current national award and which level
  • if you received a new NCEA at any level in 2021 or 2022
  • your registration and licencing status
  • your personal statement, including details of any organisation that has advised you in developing your application, along with your permission for us to publish it, if you are successful
  • if your primary employer is in England or Wales
  • if you have taken any part of your pension or retired and returned to work, giving us the dates that you did so
  • if your most recent national award has ended for any reason or was withdrawn

Save your work frequently using the button at the bottom of the page. You will need to have completed all the mandatory fields before you can submit your application.

Step 6: your job plan

It is essential that your job plan is clear, as it allows assessors to determine what your role is, acting as a benchmark for what would be within expectations of such a role. Provide specific details of your activities for the PAs in your contract, whether they are from the NHS, an academic institution or another source.

Use the ‘Job Plan’ tab to tell us: 

  • the number of direct clinical care, academic, supporting professional activities, additional PAs and total PAs that are specified in your agreed job plan. Round PA numbers up or down to one decimal point and provide more specific details, if needed, in the text. Make sure that the numbers provided in the various job plan fields add up to the total provided - where information in this section is incorrect it can make it harder for those scoring your application to assess what constitutes over and above your job plan
  • the activities you do for each of your PAs, including any changes in the last 5 years. If you believe there are extenuating circumstances that will affect the evidence you are presenting, include details here. If you wish to discuss this, contact accia@dhsc.gov.uk (for applicants in England) or accia@wales.nhs.uk (for applicants in Wales)
  • any other sessions you are paid for and any additional responsibility or other payments you receive
  • any sessions you are not paid for
  • any additional income from any wider roles outside your job plan - if you have additional income, explain how it relates to the evidence in your application (or not). We do not expect you to tell us the amount of any additional payment received, but we will check industry databases for any payments. We expect you to be transparent about what activities you may have received payments for within the last 5 years

Step 7: domains

Provide your evidence for each of the 5 domains. They are:

  • domain 1: delivering and developing a high-quality service
  • domain 2: leadership
  • domain 3: education, training and people development
  • domain 4: innovation and research - this can include up to 10 of your most significant publications within the last 5 years, whether web-based or multi-media outputs, including up to 5 reviews and textbooks
  • domain 5: additional national impact - here, tell us about other high-quality work with nationally or internationally recognised impact that has a direct benefit to the NHS

You must restrict your evidence to a maximum of 2,000 characters for each domain.

You can find more detail on what a good submission for each domain looks like and some examples in part 5 of this guide. The domain statements are the scored elements of the application, and all domains are scored for every application, so you need to fully utilise the available space.

Step 8: ratings and inspections

We need to know if your employer has been inspected by either the Care Quality Commission (CQC) in England or Health Education and Improvement Wales (HEIW) in Wales, and if so:

  • the date of the inspection
  • the rating and your role in the ratings
  • any improvement plans

If they have not been inspected or have been rated differently, tell us the details.

You will need to confirm that the information you have is provided is accurate to the best of your knowledge. 

Step 9: submit your application for review by your employer

Click ‘Submit’ in the bottom right corner to send your application to your employer. If you work for a university, this should be the nominated person at the trust where you hold an honorary contract that you named in step 1.

Your employer will be asked to confirm: 

  • if your application is supported or not supported - if it is not supported, they will be asked to explain why
  • that you are working to professional and personal conduct standards
  • that you have had a formal appraisal in the last 12 months, agreed a job plan, fulfilled your contractual obligations and complied with the Private Practice Code of Conduct if relevant (available to download on the NHS Employers page Guidance for the employment of medical and dental consultants)
  • if they are aware of any disciplinary or professional proceedings or investigations inside or outside the trust - if so, what they are and to comment on any outcomes, warning or sanctions that resulted

They will also be asked to provide a citation commenting on the merits of your application and your work towards meeting the trust’s objectives.

If your employer feels there should be any changes before they complete their section, they can return your application to you. If they do this, you will receive notes explaining their reasoning. 

An automatic notification will be sent to your employer when you submit your application for them to complete their section. However, we strongly advise that you personally inform the appropriate people by other means that this has been done, to ensure the form is completed in good time.

We cannot allow any late applications because of delays by your employer.

It is the responsibility of applicants to ensure that their employer completes this section in good time, and applications without this section completed cannot be accepted.

Step 10: review your employer’s section

When your employer has completed their section, they will send your application back to you to review. If you feel your employer’s section needs amending, discuss any proposed changes with them and contact accia@dhsc.gov.uk (for applicants in England) or accia@wales.nhs.uk (for applicants in Wales).

Step 11: submit your application

When all sections, including the employer section, are complete, you are ready to submit your application. After you submit, you cannot change your application through the portal, so check that you are happy with all aspects.

Your application is not submitted until this final section has been completed, even if both you and your employer have completed your sections. If you are unsure whether you have submitted your application properly, contact ACCIA.

If you find that you need to change something that is factually incorrect after it’s submitted, contact accia@dhsc.gov.uk. This will only be possible up to the deadline of the application window - no changes can be made afterwards.

Step 12: after submission

After you submit your application, it will move from ‘In Progress’ to ‘Submitted’ on the landing page when you log into your account again.

Withdrawals

If you decide not to continue your application for an NCIA, you may withdraw your application at any point during the awards round until the award results are announced. Once award results are announced, the awards are granted.

If you decide not to take up the award after the announcement, regardless if any of the award has been paid or not, we will consider you to have relinquished your award. Your employer will still be notified that you have successfully been granted a national award but have relinquished it. This makes you ineligible to hold a local award simultaneously under transition arrangements. Any decision to reinstate or grant a local award after that is entirely at the discretion of your employer.

Changes of circumstances during an awards round

Leaving the NHS during an awards round

To qualify for an award, you must be employed as a consultant in the NHS on 1 April 2024. 

If you are made redundant or you fully retire during an awards round and before we announce the award results, we will withdraw your application. 

Flexible retiring during an awards round

You must inform ACCIA if you have made an application for an award and retire during an awards round before we announce the results. We will take this to mean that you have withdrawn your application unless you and your employer confirm you are returning to work without any employment gap (or a gap that is no longer than your employer’s minimum, as stated in a written policy, on continuous employment) and maintaining the same job plan.

Amended job plans will need assessment of new contracts for eligibility as described in part 2, to confirm your application can continue. It may result in a shorter award if your application is successful. If you do not provide an updated eligible job plan by the time the awards are announced, we will not be able to grant an award even if your application is ranked as successful.

Part 4: applying for a new award

Awards are granted for 5 years. You may apply at any time during the tenure of your NCIA or NCEA (if held), but you cannot resubmit any evidence that has already been included in a prior successful application.

If you do not get a new award, you keep any existing NCIA or NCEA, whereas if you do get one, you are obliged to accept it.

Holders of existing NCIAs and NCEAs must give up any unexpired awards, even if the new award is at a lower level. NCEA holders will receive pay protection as described below and in annexes A and B.

For this reason and in general, it is essential that all evidence is dated. Undated evidence, or evidence from more than 5 years before your application is likely to be discounted or not scored by our assessors. 

You will be sent a reminder to apply for a new award in the year your NCIA ends. Your NCIA will expire in the year of the awards round and payments will end on 31 March. Any payment for a subsequent award will be backdated to the expiry date of your prior award if you are successful. If you are not successful, no further NCIA payments will be made until you gain a new award, when payments will be backdated to 1 April of the year that your application is successful. 

Existing NCEA holders will be sent a reminder the year before their award expires to enable them to apply under transitional arrangements. If they apply in the year of expiry, transitional arrangements do not apply.

We rely on you to maintain an up-to-date email address in your ACCIA record by logging in to your account and amending the address. It is your responsibility to apply for an award at the right time. Once an award has ceased due to failure to reapply, it cannot be reinstated.

We can review the holding or duration of an awards at any time. For example, if: 

  • you make significant changes to your job or job plan
  • you face disciplinary action from external bodies like GMCGDC or NCAS
  • you are taken to court and found guilty

You must inform ACCIA about any circumstances such as these as soon as possible to enable us to determine if it will have any effect on your award. Delayed notification of investigations or other matters where we believe you have not acted transparently may result in your award being cancelled.

Transition arrangements

Schedule 30 of the consultant contract sets out the transition arrangements for holders of NCEAs moving to any reformed national scheme.

To be eligible for transition arrangements, NCEA holders must successfully apply for an NCIA no later than the application round in the year before their NCEA expires. For example, for an NCEA expiring in 2025 an application must be submitted in the 2024 awards round. If no successful application is made, the NCEA will expire and any subsequent NCIA granted will not be eligible for transition arrangements. Should an NCEA holder apply earlier than the year before their current award expires, their NCIA and the 5-year transition period will commence on 1 April following the granting of their NCIA. See annex B for more information on application timelines.

All payments, including any ‘top-up’ payments and employer pension contributions for those in transition, will be paid by NHS England through the same route as NCEAs and NCIAs. It remains the responsibility of employers to ensure the correct payments are made and to advise ACCIA if there are any changes in circumstances of award holders, including if they join or leave a pension scheme.

Although NCIAs are paid at full value for award holders working less than full time, payments to award holders in transition arrangements will continue to be paid pro rata where appropriate as per the NCEA scheme rules. If an award holder in transition reduces their contract so that the pro rata transition payment is less than their NCIA, the NCIA value will be paid in full, but pension contributions will only be paid up to the pro rata value.

Schedule 30 does not apply to consultants in Wales, so there are no transition arrangements for NCEA holders in Wales. You should contact your employer to understand any arrangements.

Academic GPs in England who are employed on different terms and conditions to consultant doctors and dentists have different contractual arrangements. Schedule 30 does not apply so there are no transition arrangements for academic GPs not otherwise on an eligible contract. We will assume academic GPs are ineligible unless schedule 30 contractual eligibility at the time of NCIA application is confirmed by their employer.

Impact of transitional arrangements

Transitional arrangements only apply to applicants in England whose NCEAs are expiring after 2024. In Wales there are no transitional arrangements. However, award holders may still be eligible for pension protection and should contact their employer in the first instance for further information.

Schedule 30 of the consultant contract in England provides transitional pay protection for existing NCEA holders. This protection is costly, peaking at over £30 million in 2025 to 2026, and this has an impact on the funding available for new awards in the transitional period.

Applicants should review the details of the transitional arrangements carefully and discuss their personal circumstances with their employers if they have any questions. Any questions relating to awards that employers cannot answer can be put to ACCIA. We cannot, however, offer personal financial advice of any kind. Potential applicants may wish to seek appropriate external professional guidance in relation to such matters before submitting an application.

The cost of pay protection means we have had to alter some elements of the scheme for the transitional period, with any adjustments made each year if possible. For example, the numbers of NCIAs granted at each level may vary during the transition period. All these arrangements will be reviewed on an ongoing basis.

Local award schemes are subject to arrangements in the consultant contract and may be affected by any revisions to it. These are not managed by ACCIA, but by individual employers in England. More information can be found on the NHS Employers website. In Wales, employers give commitment awards. You can find out more about these from Welsh health boards.

More details on the transitional arrangements are in annex A. NCEA holders and their employers should read these carefully.

Reversion arrangements for NCEA holders in England

If an NCEA or NCIA holder applies in the awards round before their current award expires, but their application is unsuccessful, the reversion arrangements set out in schedule 30 apply to those eligible under the consultant contract. These specify that in these circumstances the holder will be granted a pre-2018 local Clinical Excellence Award (a legacy LCEA) according to the following conditions:

  • reapplication score equal to or greater than 27 - legacy LCEA level 8
  • reapplication score between 14 and 26.99 - legacy LCEA level 7
  • reapplication score equal to or less than 13.9 - no award

Any legacy LCEA will start on 1 April, immediately after the expiry of the prior NCEA or NCIA. Where no legacy LCEA is granted, there will be no award payments once the NCEA expires.

If an NCEA holder fails to apply at the latest by the awards round before their NCEA or NCIA expires, their award will continue until its expiry date, after which there will be no award payments. Any subsequent NCIA will be granted as a new award and backdated appropriately.

Academic GPs in England who are employed on different terms and conditions to consultant doctors and dentists are ineligible for these reversion arrangements.

Part 5: how your application is scored

Evidence of how your work has positively impacted the NHS in England or Wales

Clinical impact is about providing high-quality services to patients that:

  • go beyond your immediate remit
  • improve clinical outcomes for as many patients as possible outside your local area
  • use resources efficiently and make national services more productive

You need to show assessors evidence of how you have directly:

  • made services more efficient and productive
  • improved quality and delivery

You will need to demonstrate your role as an enabler and leader of health provision, prevention and policy development and implementation.

Assessors need to be sure that your achievements are relevant. They need to know when they occurred, or if you are still doing these activities.

It is essential that you make the dates of all your achievements clear. Without dates they will not receive any credit from assessors. 

Use the ‘domain’ section of the application form to give details of your achievements, as this is where they will be assessed. Only the domain section of the form is scored. All the other information provides context and corroboration.

For the domain section: 

  • you may not be able to show you have achieved over and above expected standards in all 5 domains - a lot will depend on the type and nature of your post and the nature of your job plan. Do, however, ensure you provide some evidence in all domains
  • you could get a national award based on an excellent local or regional contribution, if you can show how you have disseminated your work to have had an impact on the wider NHS
  • you should highlight the most important examples of your work, focusing on its national and international impacts. Providing fewer examples with more detail is preferable to an extended list with limited evidence
  • describe the impact you have had in any roles you list, including acknowledging the contribution of colleagues and other members of the multi-professional team
  • make it clear when your roles started and ended, or if they are ongoing

List your achievements against the original aims in your job plan or personal development plan. All evidence is benchmarked against the expectations of your job plan. 

Do not include evidence you gave for an earlier award unless it shows how you have actively built on or consolidated your previous achievements to have generated additional impact. 

Give quantified data, particularly outcome measures that: 

  • show what you have achieved since your last award, or over the last 5 years
  • include relevant dates, sources and appropriate benchmarks

If your clinical work is subject to national audit processes, include this information too. 

Committee members score the domain sections as follows: 

  • 10 = your application is excellent with clear and sustained, national and/or international impact
  • 6 = your work is over and above your contract terms and should have at least a regional impact, beyond your local area
  • 2 = you have met the terms of your contract or may have contributed more, but mainly within your locality
  • 0 = you have not met the terms of your contract, no dates within the last 5 years are present in the domain, or there is not enough information to make a judgement

What to include in each domain

You must include dates within the last 5 years. Failure to do so will severely limit the scores and the ability to gain any award.

There are 5 domains. Group your achievements in line with each one and avoid repetition across domains unless the evidence shows different aspects of your work that is relevant to the domain. 

Do not include any website addresses or other external links to additional information. You must stay within the character limit for each domain and not seek to gain an advantage by linking to additional external evidence. Scorers will not access or score evidence that is not on the application form itself and may view the use of URLs to link to additional evidence negatively in their assessments.

We recognise the extraordinary requirements of the COVID-19 pandemic, and the work that many healthcare workers have contributed. You may choose to include evidence related to this as part of your evidence over prior years. If you do, concentrate on the impact of your contributions over and above your local institution or expected role and focus on where it had an impact outside of your immediate remit.

We recognise how important redeployment and extended hours and remits were during the COVID-19 pandemic. These were broadly universal across the NHS. Recognition will similarly be given for efforts made to maintain other key clinical services, research activities, and teaching and training during the COVID-19 pandemic period. If such evidence is solely based on local work related to COVID-19 or mitigation activities, it is unlikely to be scored highly unless you can demonstrate how it had broader, and ideally, national impact. Remember to include other relevant work across the entire 5-year period in each domain. 

Domain 1: delivering and developing a high-quality service

In this section, give dated, benchmarked evidence of what you have 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 provide a good experience for patients. To gain a higher score you will need to show how you have cascaded your practice more widely to colleagues who have then implemented improvements based on your experience
  • consistently looking for, and introducing, ways to improve your service; sharing the learning and seeing it embedded in wider NHS or national or international practice

Explain which activities relate to your clinical services where you are paid by the NHS, and to other aspects of your work as a consultant. 

Include quantified measures if you can - like outcome data. These need to reflect the whole service you and your multi-professional team provide and how you have collectively disseminated your experience. Use validated indicators for quality improvement or quality standards, and other reference data sources in England, or the Health and Care Standards for Wales, ideally providing performance data against benchmark or national indicators for your specialty, showing local and wider improvements as a result of your work. 

For good patient experience, show how you ensured your patients are cared for with compassion, integrity and dignity, and how you have demonstrated commitment to their safety and wellbeing and have disseminated your approaches more widely.

Your evidence could show:

  • the cascading of your excellent standards for dealing with patients, relatives and staff based on surveys or collated 360-degree feedback that validate evidence of your patients’ quality care, and how you communicated it to colleagues
  • development beyond your immediate remit of excellent work in preventative medicine and public health - for example, in alcohol abuse, vaccination programmes, stopping smoking and preventing injury
  • how you have used wider NHS resources effectively to improve their efficiencies

Give evidence of the quality and breadth of your service from audits or assessments by patients, peers, your employer or external bodies. It will not affect your chances if there is less readily quantifiable evidence available in your particular specialty. 

Quote the source of the information you give and include all relevant dates. 

Domain 1 examples

Example 1: I have further developed efficiency and quality of the xxx heart magnetic resonance imaging (MRI) service and disseminated achievements beyond my job-planned activities.

  • since 2019 I have grown the service by 25% to 3,000 per year (largest in xxx of England)
  • in 2019 I introduced patient-centred governance (including annual 360 patient feedback, audit cycles, safety and quality reviews). The service was rewarded with European Association of Cardiovascular Imaging accreditation in 2022 based on its expansion to all other units in my region
  • through close university partnership I improve NHS service efficiency (in 2021 academics delivered NHS service with NHS staff reassigned to COVID care) and quality (rapid research-clinical translation)
  • while most other NHS wait times increased, I kept heart MRI wait below national pre-COVID benchmark throughout the pandemic - 2019 to 2021
  • in 2020, introduced a faster heart MRI protocol with equivalent quality to previous methods. This improved local service efficiency by 25% (more scans at same cost) and patient experience (shorter scan). Method published in a sector-leading xxx journal and disseminated internationally in 2022. Five other regional units adopted my methodology in 2022
  • pioneered new MRI methods for non-invasive, radiation-free diagnosis of heart disease in newborns in 2021 and in the foetus in 2022. Published the method (reference) and first clinical experience (in press 2022) to cascade beyond local service
  • in 2019, proposed an automated quantitative method in collaboration with UK and US scientists that allows more objective diagnosis of heart disease that can replace expensive radiation-based nuclear imaging. From 2021 the method was available to NHS patients in xxx and London and is now embedded in more than 10 NHS hospitals
  • in 2019, set up heart screening for patients at high cardiac risk (such as diabetes, rheumatoid arthritis), implementing the national NHS strategy and delivering an estimated yy preventable events in 2023 as compared to 2019 equating to an x% reduction

Example 2: I set up a short stay programme in 2019 which has the lowest length of stay for hip replacements in England - 2.7 days as against the England average of 6.1 days. Two-thirds (67%) of patients are home after 2 nights. Achieved 98.5% patient satisfaction. Readmission rate of 5.1% as compared to the regional average of 7%. This has been communicated in xxx fora and adopted as best practice standards by xxx body and is now in place across more than 100 trusts in England.

Give national or regional benchmark comparisons wherever you can. For example, standard mortality ratios, peri-operative complication rates, MRSA, C. difficile rates, venous thromboembolism (VTE) prevention, or length of stay data.

Show how you have significantly improved the clinical effectiveness of your local services and either improved services elsewhere, or used your 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. 

Make your evidence as measurable as you can, giving dates for all activities. Make your personal role clear, not just your department’s contribution, stating what you have contributed as part of a wider team, where relevant. Give specific examples of any changes you made after the results of an audit, or changes you contributed to as part of governance reviews. Be clear about how you helped these activities contribute to wider change in the NHS. 

Your evidence could, for example, cover the impact of your work on: 

  • developing and running audit cycles or plans for evidence-based practice to make your service and that of others 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, ways to overcome them and to implement new ways of working that delivered improvements in your locality and more widely that you can describe
  • analysing and managing risk - include details of specific improvements, or how you lowered risk and by how much to improve safety
  • providing a better service, with proof of the effect it had - for example, how your service has become quantifiably 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, at a regional or national level
  • developing new health or healthcare plans or policies and their implementation
  • large reviews, inquiries or investigations and how they have changed practice
  • devising and implementing national policies to modernise health services, new ways of working or professional practice

Give audit or research evidence to show where you have improved your service and disseminated this more widely. Quote the sources and relevant dates and outcomes in your own areas and those of other groups that you positively influenced. You do not have to have done the audits or research or all the implementation yourself. Show what changes you made, alone or in a team, with evidence that they were of high quality and made a difference to the wider NHS. 

Domain 2: leadership

In this section, show how you made a significant personal contribution within the last 5 years in leading and developing a service, health policy or guidelines, with national or international impact. Especially consider work that has delivered against objectives within the NHS Long Term Plan

Describe the impact you have had and outcomes you have generated in the specific roles you list. Your evidence can include, but is not limited to, proof of: 

  • your effective leadership techniques and processes - give specific examples of how you improved the quality of care for your patients and where you have, directly or indirectly, influenced other parts of the NHS to achieve these benefits
  • change management programmes or service innovations you have led - show how they made the service more effective, productive or efficient for patients, public and staff, beyond your direct remit
  • excellent leadership in developing and providing preventative medicine, particularly working across organisational or professional boundaries with other agencies, like governmental and non-governmental organisations and the voluntary sector, demonstrating the outcomes or impacts that have been delivered - for example, in delivering wider benefits where health inequalities exist
  • any ambassador or change champion roles - for example, if you were involved in a public consultation, or your job involved explaining complex issues and how this translated into changes in practice that were above expectations or cascaded regionally or nationally
  • how you developed a clear, shared vision and desire for change in others - for example, show how you invested in new ways of working and handled resistant behaviour to deliver the wider change desired outside of your remit, particularly where you did not have direct oversight responsibility
  • how you helped staff into senior leadership roles by removing barriers, encouraging diversity and achieving equality and inclusion outcomes
  • how you contributed to developing patient-focused services in your area, and cascaded the experience and expertise to influence others to adopt new ways of working
  • national impact through personal work and influence through any committee chairing or membership. Be specific about what you personally did, with a description of the impact of any output - membership alone is not enough
  • where you took personal leadership for clinical governance, including developing and implementing policies, services or change programmes regionally or nationally

Include evidence of your contribution, the source of any data you give, and relevant dates. 

Domain 2 example

National and international:

  • as Royal College of Physicians (RCP) special adviser on xxx since 2019 I lead the RCP’s xxx policy, interfacing with the Department of Health and Social Care. I organised a meeting at Number 10 (2021). I responded to xxx consultations, reports and news items
  • as chair of the RCP advisory group on xxx (2019), and advisory group on health inequalities member (2020), I’ve worked across professional boundaries and with patient groups to agree new policies xxx and yyy that have been adopted by xxx in 2022
  • I have developed and presented an xxx documentary xxx, England’s most pressing healthcare challenge?’, highlighting the complexities of xxx, viewed more than 13,000 times since March 2022
  • I co-chair NHS England’s Clinical Advisory Group for tier 3 and 4 services (from 2021) responsible for mapping and establishing services across England that has led to adoption in 50% of NHS trusts by 2023
  • I have been a trustee and chair of the nationwide patient charity xxx Empowerment Network UK steering group since 2019 (see domains 3 and 5) and together we have established a firmer platform for their funding and research relationships with NIHR
  • I am a trustee for the Association for the Study of xxx (ASX) since 2016 and organise annual national clinical network meetings to share best practice. I have organised 3 meetings in the last 5 years that included overseeing the scientific programme and speakers to an audience of 200 healthcare professionals
  • I am a currently a member of NICE xxx Clinical Guideline Committee (since 2021) responsible for updating the guidelines. So far we have updated the following 3 guidelines, X, Y, Z that were issued in 2022 and 2023 respectively
  • I am a member of the working group that led to the establishment of the National xxx Audit (since 2020) which has delivered an improvement in outcomes from x to y from 2020 to date

Domain 3: education, training and people development

In this section, give evidence to show your contribution over the last 5 years to wider education and training across the professions and to patients. Make it clear if any training or lecturing is externally or separately remunerated. 

Give evidence, if possible, of the impact of your work in supporting the NHS People Plan. It may be helpful to outline if it falls into any of the following categories. We do not expect examples for all these categories, and you can include other categories. 

Teaching

This can be medical undergraduate or multidisciplinary team teaching, if it is outside your job plan. Undergraduate teaching is not generally considered to be over and above your role if it is within your institution. Wider policy, or regional or national undergraduate education may be relevant. Give evidence of student feedback or other teacher quality assessments and especially focus on how your education has improved others’ performance and had a positive impact on healthcare more widely. Include how you directly played a role in curriculum development and/or assessment and, if relevant, provide 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 your own remit or job plan, preferably nationally or internationally. This might include: 

  • developing and introducing a new course, such as at master’s level
  • innovative assessment methods
  • introducing new learning facilities or techniques
  • 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 with relevance to the NHS (see notes above regarding the relevance of overseas work)
  • developing other innovative training methods, such as simulation-based

Supporting information could be presentations, invitations to lecture and publications on education - you must include dates and evidence of the national impact of these activities. 

Educating and informing patients and the public

This should include evidence of the impact of these activities, preferably nationally or internationally. This could include:

  • promoting good health and disease prevention within the community, which has delivered wider impacts
  • facilitating 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

Explain if you 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 describing a demonstrable impact on healthcare as a result.

Personal commitment to developing your teaching skills

You could include evidence of higher education academy membership and any courses you have completed, and how you have used these new skills or qualifications to improve the quality of your teaching or training.

Unexpected or non-mainstream contributions

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

Domain 3 example

My main leadership role as Royal College of xxx Medical Director for Education and Training from 2020 to date is to ensure continued high-quality workforce supply to support patient services in xxxology to meet national objectives.

I:

  • provided Royal College data in 2020 into the xxx review to support the need for 1,000 extra xxxologists
  • led nationally to support training programmes and trusts accommodating 150 new xxxology training posts in England and extra senior posts in 2021 and 2022. This included support to make the local business case given the financial benefit of trainees and this has successfully unlocked previously unavailable training capacity in each region
  • led the negotiation of changes to xxxology trainee recruitment with the national recruitment team. This new process successfully enabled increased numbers of candidates from x to y to be assessed in 2021 and 2022 to fill capacity from training post expansion
  • led a new process of recruiting trainees nationally at a more senior specialty training (ST) 3 level to meet workforce need and training number targets. This involved development of a detailed certificate of training equivalence to demonstrate ST2 competencies achieved elsewhere and required agreement of national heads of training. Fifteen candidates were offered training posts in May 2022
  • led the development of virtual and technology enhanced training material and imaging platforms with the new imaging xxx academies in England in collaboration with academy leads. This has promoted a sharing ethos, with remote teaching sessions made available across xxxology academies in 2021 to 2022 to support increasing training provision from x to y

Domain 4: innovation and research

This section looks at innovation and its impact in any relevant setting and may include evidence relating to activities and their impact beyond those 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 include benefits of digital technology, or other activities from projects with external partners that have demonstrated a benefit to the wider NHS or support GMC’s objectives of promoting research. 

Be clear what evidence is over and above any research, academic or other expectations of your role and give evidence of the wider impact of your research and/or innovation together with dates of the work, dates of publication or presentation if relevant, and dates of its impact. This includes developing the evidence base for measuring how quality has improved. 

On a separate line, give supporting evidence for what you have achieved in the last 5 years and how your innovation or research has quantifiably improved health outcomes - for example, adoption of new evidence-based techniques, innovative systems or service models, improved delivery of clinical benefits and more effective use of resources. Describe how you have disseminated your experience and innovation, so it has been adopted by others, and provide specific details of the quantified benefits this has provided over the relevant dated period.

You could also explain how you have improved patient and public engagement in research and innovation or encouraged new ways of thinking when it comes to improving patient services, detailing the specific benefits this has brought. 

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

  • health service practice
  • health service policy
  • developing health services

You could give details of the impacts you have delivered as a result of: 

  • large trials or evaluations - including systematic reviews - you have led or co-investigated and published in the last 5 years
  • how you have contributed as a research leader, and how you have helped and supervised other people’s research and mentored new investigators

You could include other examples of the personal impact you have made in your chosen research fields - for example, how your work on any review boards of national funding agencies or learned societies has delivered quantifiable improvements over a defined time period. 

You could also:

  • list any grants you have been awarded, specifying whether these are personal awards or have been granted as part of a departmental bid, specifying your role as chief or principal investigator on a study where relevant - explain how this funding is above expectations and what benefits it is delivering
  • describe peer-reviewed publications, chapters or books you have written or edited - explain your activity for each one (for example, senior author or editor) and any definable measures on how effective they have been in changing practice
  • give details if you played a major part in multicentre research studies - for example, the number of participants you personally recruited out of the total sample size for large clinical trials
  • include evidence of outstanding research that has led to new ways of preventing illness and injury, or facilitating more rapid, cost-effective and reliable diagnosis
  • show how you engaged with a funding council, the National Institute for Health and Care Research (NIHR) or a major research charity, specifying your role, such as a clinical director, senior reviewer or research and/or fellowship programme lead - give clear dates and evidence of impact

In the section on references, give details of achievements such as published peer-reviewed papers - not the names of referees - with a maximum of 10 references to be included. Publications listed should be from the last 5 years. Slightly older references may be included if their impact has become apparent more recently, but not if they have been included in a prior successful application.

Follow the formatting on the online form and ensure all boxes are populated. A publication with no indication of where it was published is unlikely to receive any credit from assessors, nor will very old papers, even those in major scientific journals.

Your evidence should include the relevance of these publications and the 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 clinical, NHS or other health impact. You may abbreviate the title and author list of any publications, but you must include the name of the journal or publication it appeared in with the date, volume and page numbers as relevant. Do not include website addresses or digital object identifier (DOI) links as scorers will not access these. Make it clear if you are a listed as an author on the paper or part of a collaborative study group. Overstating your role in a study or inappropriately claiming publication authorship will be viewed negatively by our scorers.

Domain 4 example

An excerpt from a high-scoring 2022 application:

Director, Musculoskeletal Research Group (MRG):

As a clinician scientist I am a clinician first. Our 36 researchers address questions from the clinic. Current programmes include:

  • understanding why rheumatoid arthritis (RA) flares
  • can RA be prevented in those at risk?
  • can patients in remission stop their treatment?
  • can established RA be cured?
  • why do RA patients lose muscle? Can it be reversed?

Success indicators:

  • active funding of £6.5 million as principal investigator (PI), £1 million as co-investigator from 2018 to 2022
  • 72 peer-reviewed papers published since 2018
  • prestigious EULAR Centre of Excellence status awarded in 2020 (for 3rd time: 2010 to 2025)

International firsts:

  • designed and completed (2022) the first trial to target joint lining cells in RA, for patients refractory to standard therapy
  • developed our own cell therapy to switch off RA. Phase 2 trial starts 2022

Collaboration:

  • I led RA-MAP, an academic and industry consortium seeking biomarkers to inform clinical management and drug discovery. Such partnerships critically underpin the UK industrial and life sciences strategies. Our Medical Research Council-funded work, published in 2022, involved over 150 researchers and 267 patients with early RA

Director of research:

  • our strategy endorses a mixed portfolio of commercial research, aligned with the UK’s innovation strategy and NHS Long Term Plan, and investigator-led research, equally critical for innovation within the NHS
  • our ‘Dragon’s Den’ in 2022 will encourage NHS staff to submit their best ideas for mentorship and seed funding

Deputy Director, NIHR xxx Biomedical Research Centre (BRC):

  • BRCs support research that tests treatments and assays in patients for the first time, driving NHS innovation. As deputy director of our £15 million BRC since 2019 I have overseen strategy across 6 themes. Patient and Public Involvement and Engagement (PPIE) plays an essential role in strategy development, involving x focus groups in the last 5 years, to provide our strong emphasis on training, education and people development. I also lead our musculoskeletal theme

Domain 5: additional national impact

This domain gives you an opportunity to provide evidence of wider beneficial impacts over the last 5 years that have not been captured elsewhere on your form in domains 1 to 4. You can also demonstrate the wider effect your work has had in areas that are national clinical priorities. In some cases this may relate to work within your job plan, but as is the case in other domains, you should try to demonstrate impact over and above the expectations of outcomes for which you are already paid by your employer. There is added value if appropriate metrics can be included and, as usual, accurate dating is critical.

This domain can include work for charitable organisations and work with a more direct patient or public focus - for example, fostering patient involvement in your research, or informing patient groups of new developments in disease management or prevention. Expanding upon (but not repeating) the national impact of research work or educational activities mentioned in domain 4 or domain 3 can score well. This is particularly true if it is clear how the impact of the work has been re-enforced through social media or other channels, and how it has demonstrably influenced the quality of healthcare delivery or preventative medicine regionally or nationally. However, you must not merely repeat or list activities that have been described elsewhere on the form, as repeated evidence will not score any points. This domain could also describe work on how you have addressed health and workplace inequalities and delivered interprofessional team building and new ways of working. It will be particularly well received if this is cascaded and implemented more widely in the NHS at a national level, with the impacts and benefits being described.

Domain 5 can also include international work in training, research or recruitment, but it is vital to clarify how this has had clear benefit to the NHS. An extensive list of overseas lectures and meetings, or accolades from foreign institutions, will not receive any credit. The same will apply to overseas work in service development or education, unless there is a clearly demonstrated beneficial impact to UK healthcare.

Particularly important areas are NHS priority disease areas, other areas where there is outstanding need and identified health inequalities or disparities. Unpaid innovative work with health and social care providers outside the NHS may also be cited in this domain, but clear evidence of positive impact must be provided.

You could include your work on delivering wider health policies, or work related to the NHS Long Term Plan or the NHS People Plan, particularly in reference to delivering collaborative working, demonstrating an inclusive culture and the health and wellbeing of NHS staff and their retention in the face of increasing pressures. Give details of the wider change you delivered and the magnitude of your impacts over a defined time period. Tell us if you are actively involved in a leadership capacity at a regional or national level in the delivery of the 2022 delivery plan for tackling the COVID-19 backlog of elective care, defining clearly the impact of your personal contribution above any paid backlog work if not mentioned elsewhere.

Consider providing evidence of the impact you have made on delivering improved ‘joined up care’ in line with the recommendations of the health and social care integration white paper in optimal settings by implementing new service models, or specifically digital innovations or efficiencies, across the wider health environments - particularly if you have expanded these beyond your immediate area or remit. Paid work on digital activities within your locality will not receive additional credit unless you can show how you have shared the beneficial impact more widely. Also consider activities and innovations you have developed in partnership with external partners which provided positive impacts to the NHS in line with the government’s life sciences strategy. Other unremunerated work with Health Education England (merged with NHS England), NHS Employers or DHSC may also be relevant, but you must cite definable, dated and current impact. A list of committee positions or chair roles will not accrue any credit in itself. Be very careful not to use undefined non-standard abbreviations and technical jargon. This is particularly, but by no means exclusively, an issue in relation to work done in the domains of artificial intelligence and health informatics. Applicants should always bear in mind that their applications will be scored by lay as well as professional assessors.

Domain 5 examples

Examples of high-scoring domain 5 evidence from the 2022 round.

As a member of the NHS England xxx Clinical Reference Group (2016 to 2022) I develop innovative policies and service specifications to improve current and future care and efficiency in all NHS tertiary services. This includes my detailed work on the NICE COVID-19 rapid guideline for the immunocompromised (May 2020) and the NHS England Multidrug Resistance Policy (2019).

I have jointly overseen xxx regional clinical management for COVID-19 complications. Since April 2020 the team conducted around 170 emergency consultations across the region.

I have led joint work between UK clinical research facility directors, the Medicines and Healthcare products Regulatory Agency and the Health Research Authority throughout 2019 to develop a national framework for the governance and safe conduct of highest risk phase 1 trials in clinical research facilities and the NHS. This was rolled out during the pandemic for experienced sites to support those without existing phase 1 expertise, expanding NHS and national capability to support public and industry funded new drug and vaccine development. We involved xx centres in this activity.

I ensure participant safety and effective trial delivery via my roles as:

  • Independent chair of the Data Monitoring and Safety Committee (DMSC) for a UK healthy human immune challenge trial since 2021
  • independent chair of the COVID-19 vaccine trial steering committee
  • member of the South African COVID-19 booster trial

I developed high-quality national guidelines via my membership of the NICE guideline committee for xxx (2020) and of the international xxx campaign working party (2018 to 2019). I was one of 3 Royal College representatives to the Academy of Medical Royal Colleges’ xxx Position Statement Working Party (2020 to 2022).

Part 6: appealing your unsuccessful application

All appeals for NCIAs are handled by ACCIA.  

To appeal, log into your account where you will find the steps you need to take.

You need to tell us why you believe the assessment process was unfair and give evidence.  

Submit your appeal for a national award within 28 days of when we inform you of the award results. If our dates change, this will be updated in the portal.

Reasons you can request an appeal

You can request an appeal if you think we did not follow the right processes when we assessed your application. You cannot appeal because you disagree with the outcome of your application, the scores awarded or the judgement of our scorers.

You can appeal if you believe:

  • the committee did not consider all the supporting information or documents you sent with your application
  • irrelevant information was taken into account
  • you were discriminated against due to characteristics such as your gender, ethnicity or age
  • the usual evaluation processes were not followed
  • the committee, or any of its members, showed bias or had a conflict of interest, such as where someone involved in a decision could be affected by the result

How we handle appeals

Our chair and medical director will look at your evidence and the processes that were followed to decide if your appeal is justified. They will then ask a panel of 2 sub-committee members - one medical and one non-medical - who were not involved in your application to review their proposed decision to ensure it is robust. If it is decided that there are no grounds for appeal, we will write to tell you why.  

If there are grounds for appeal and we cannot resolve the problem informally, we will set up a formal appeal. 

A separate panel of people who did not assess your application or the decision to progress the appeal will consider this. The panel will include:  

  • a medical or dental professional
  • an employer
  • a non-professional member as chairperson

They will look at:  

  • your appeal
  • the documents that set out our agreed assessment process
  • a written statement of what the committee did when they considered your application

You can see all the documents the panel considers. You can also send more written statements about your appeal and what you believe happened. 

The panel does not usually hear oral evidence. However, you can apply in writing to have an oral hearing. The panel chair will decide whether you can have one. 

If your appeal is successful

If your appeal is successful, our chair and medical director will consider the best way to put things right. Their decision will be consistent with other similar appeals.  

Even if your appeal against the process is successful, you may not get your renewal or a new award. If this happens, we will write to you to tell you why. 

Process and timeline for appeals

We try to resolve appeals in line with the process and indicative timeline set out below - if there are delays, we will let you know. 

  1. You must request an appeal within 28 days of the notification of the outcome of the annual awards round being sent to you.
  2. When we get your request to appeal, we will contact you within 5 working days to acknowledge its receipt.
  3. Our chair and medical director will review your case and decide whether you have grounds for a formal appeal.
  4. Within approximately 20 working days of the date we got in touch, our chair and medical director will let you know if there will be a formal appeal.
  5. If there is a formal appeal, we will set up a panel and agree a date for them to meet, usually within 20 working days.
  6. When our chair and medical director hear what the panel has decided, they will let you know the final decision, usually within 20 working days.
  7. In all cases, the panel’s decision is final.

Part 7: how to complain about ACCIA

We can only handle complaints about the work, staff and levels of service provided by ACCIA. You can email us at accia@dhsc.gov.uk.

We will not accept complaints relating to awards or change of circumstances decisions. Guidance for current award holders sets out how to appeal change of circumstances decisions.

If you want to make a formal complaint about ACCIA, we will need: 

  • a clear, detailed description of what your complaint is about
  • copies of any letters or emails related to the complaint
  • your email address so we can respond to you

When you have made your complaint, we will send an email to let you know that we have received it

Our complaints process has 3 stages: 

  1. Complaints go to the team leader of the ACCIA secretariat, who will liaise with the relevant sub-committee chair if necessary. The team leader will investigate, with a target of responding to your complaint within 20 working days.

  2. Complaints are investigated by the senior civil servant responsible for ACCIA. They will investigate, with a target of responding to your complaint within 20 working days.

  3. Complaints are investigated by a senior civil servant who is independent of the individual or team that your complaint references. They will investigate, with a target of responding to your complaint within 20 working days. 

What to do if you are not satisfied

At each stage of our complaints process, you will be provided with the information to escalate your complaint if you are unhappy with the response that you receive. 

If, after following the 3 stages of our complaints process, you are not satisfied with the outcome of your formal complaint, you can ask your local MP to refer it to the Parliamentary and Health Service Ombudsman

You have to go through your MP - you cannot approach the ombudsman directly. 

The ombudsman investigates complaints where government departments or other public bodies have not acted properly or fairly, or have provided a poor service. Government departments have to co-operate with the ombudsman by law. 

Appealing against a decision by the ombudsman

If you are unhappy with the ombudsman’s decision, you can appeal directly to the ombudsman.

Part 8: false statements or possible fraud

If we find any evidence of a false statement or fraud, we will take suitable action. 

This may include passing the details to: 

  • your employers
  • GMC or GDC
  • the NHS Counter Fraud Authority

Part 9: how we use your data

ACCIA collects data for the specific purpose of running the NCIAs scheme and has its own privacy notice. For more information see the ACCIA personal information charter.

Information about how DHSC, the data controller for ACCIA, handles your information is also available under the DHSC privacy notice.

Annex A: transition arrangements for NCEA holders in England

Schedule 30 of the consultant contract sets out the transition arrangements for holders of NCEAs moving to any reformed national scheme. There are 2 important provisions set out in the schedule:

  • a consultant who successfully receives a first NCIA for an equivalent or higher level of performance but attracting a lower value of award than paid under the NCEA scheme will receive an additional payment so that they are paid no less overall than the cash value of their NCEA
  • a consultant who receives a first NCIA for a lower level of performance will receive an additional payment so that they are paid no less overall than the cash value of the equivalent lower award in the NCEA scheme

The NCIA scheme has 3 award levels, and for the purposes of managing transition arrangements their equivalent to the former award levels is as follows:

  • N1 - equivalent to silver
  • N2 - equivalent to gold
  • N3 - equivalent to platinum

This results in NCEA holders who hold a full award (that is, not prorated) having the level of protected pensionable pay shown below, for their first NCIA, up to a maximum of the first 5-year period in the NCIA scheme. Subsequent NCIAs awarded are not subject to pay protection provisions.

Table 1: transitional arrangement values per award level

NCEA held NCIA granted Total pay Pensionable pay
Bronze N1 £36,192 £36,192
Bronze N2 £36,192 £36,192
Bronze N3 £40,000 £36,192
Silver N1 £47,582 £47,582
Silver N2 £47,582 £47,582
Silver N3 £47,582 £47,582
Gold N1 £47,582 £47,582
Gold N2 £59,477 £59,477
Gold N3 £59,477 £59,477
Platinum N1 £47,582 £47,582
Platinum N2 £59,477 £59,477
Platinum N3 £77,320 £77,320

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 NCEA. 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 about this in the response to the 2022 consultation on reforming the national Clinical Excellence Awards scheme.

Annex B: transition pay eligibility timelines

If you already hold an NCEA granted under the old scheme, transitional pay protection arrangements (described in more detail in a later section) apply in England between the old and the new schemes for a first successful NCIA application. To be eligible for transitional arrangements a current NCEA holder must apply the year prior to their award expiring.

If your new or renewed award was granted in any other year after 2019 and you have notified ACCIA of any changes to your job, employer or other changes in circumstances, your award duration may have been shortened. In that case you will have been personally informed of the end date of your award. It is your responsibility to ensure you apply in the year before the expiry of your NCEA. ACCIA cannot be held responsible for any failure to apply, nor for lack of receipt of any communications due to changes of contact address that have not been specifically notified to us as a preferred contact address.

If your NCEA is expiring in 2025 or in a later year, you can access these arrangements by applying in 2024. If your NCEA was renewed in 2019, your renewed award will have commenced in 2020 and will expire on 31 March 2025. Due to the COVID-19 pandemic the NCEA scheme was suspended in 2020 and no new awards were granted that year. No backdated new awards will have commenced in 2020.

The tables below set out grant and expiry dates.

Table 2: award first payment and expiry dates for NCEAs

Renewed NCEA granted Renewed NCEA paid from New NCEA granted at any level New NCEA backdated and paid from Expiry date Latest NCIA application to maintain pay protection
2019 2020 Not applicable (note 1) Not applicable (note 1) 31 March 2025 2024
2020 (note 2) 2021 (note 2) 2021 2021 31 March 2026 (note 2) 2025 (note 2)
2021 (note 3) 2022 (note 3) Not applicable Not applicable 31 March 2027 (note 3) 2026 (notes 2 and 3)

Note 1: no new awards were granted in 2020.

Note 2: renewed awards granted in 2020 were granted only for one year due to the COVID-19 pandemic, requiring renewal or new reapplication in 2021. Renewals from 2020 that were subsequently re-renewed in 2021 were granted for 4 years and paid from 2022 so expire 2026.

Note 3: 2021 5-year standard renewals expire in 2026. Subsequent renewals from 2020 renewed in 2021 expire in 2025.

Table 3: awards first payment and expiry dates for NCIAs

Pay protected NCIA granted Pay protected NCIA paid from New NCIA granted at any level New NCIA backdated and paid from Expiry date Latest application for continuous backdated pay of successful new NCIA (note 4)
Not applicable Not applicable 2022 2022 31 March 2027 2027
2022 2023 2023 2023 31 March 2028 2028

Note 4: no further schedule 30 NCEA pay protection applies after the first successful NCIA or unsuccessful application in the year prior to expiry.