Guidance

Assessors' guide: 2025 awards round

Published 30 April 2025

Applies to England and Wales

About this guide

This guide is for scorers of the national Clinical Impact Awards (NCIAs). It covers the 2025 competition in England and Wales and tells you:

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

Read this guide before you start scoring your allocated applications. New assessors may also find it useful to read the applicants’ and employers’ guides for further background information on the scheme and information on transitional and reversion arrangements.

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, contact us at accia@dhsc.gov.uk.

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

Timetable for the 2025 awards

The 2025 awards round closes at 5pm on 27 May 2025. The first round of scoring will take place between 30 May and 14 July 2025.

View the full indicative timetable for the 2025 national awards round.

The Advisory Committee on Clinical Impact Awards (ACCIA) will email assessors with the exact dates for regional sub-committee meetings.

Part 1: introduction

About ACCIA and the Clinical Impact Awards scheme

ACCIA runs the NCIAs scheme for the Department of Health and Social Care (DHSC) in England. ACCIA also provides governance for the awards for the Welsh Government.

Health ministers have agreed a limited number (up to 600) of new awards each year in England (and 37 in Wales), 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)

Consultants can apply for a new award at any time after they have completed a full year in an eligible role, with a permanent NHS contract (fixed-term and locum contracts are not usually eligible). If they already hold a national Clinical Excellence Award (NCEA) granted under the old scheme, transitional arrangements apply in England between the old and the new schemes (see the applicants’ guide for more information on transitional arrangements).

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

Based on the strength of applications, our regional sub-committees and our main committee will recommend applicants for national awards to health ministers, for them to approve. The level of award recommended depends on the scores given by our committees after careful review of the evidence in each application. The relative ranking of all applicants determines who gains which award level, based on the number of awards available at each award level.

What the national scheme rewards

The national scheme rewards consultants or academic GPs who deliver national impact above the expectations of their job role or other paid work. They specifically recognise the dissemination and implementation of that work and its impact on the wider NHS and public health. Applicants do not need to hold any local award or a previous NCEA to be eligible for an NCIA.

To be considered, applications need to show what impact has been delivered for the NHS over and above the expectations defined in an applicant’s job plan. Evidence needs to be:

• from the previous 5 years, or since a prior national award if within the last 5 years
• ideally at a national level

There are 5 domains for applicants to tell us about their contributions and provide supporting evidence (explained further in part 5 of this guide):

1. Developing and delivering a high-quality service.
2. Improving the NHS through leadership.
3. Education, training and people development.
4. Innovation and research.
5. Additional impact, in which applicants can provide other evidence, particularly if it relates to published NHS or other relevant health objectives.

In all domains, ACCIA encourages applicants to provide evidence of impact over and above their role, at regional and ideally national level.

To apply, applicants need to give evidence of impact across the 5 domains. Only the evidence in these domains is scored - the other parts of an application are not scored but provide context for the assessment of the evidence within the domains.

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 applicants can show that their 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.

Regional sub-committees

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

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 - National Reserve Sub-committee (NRES)

Wales has its own sub-committees which consider N0 to N3 awards.

The N3 and NRES committees are made up of our most experienced scorers, with representation from every regional sub-committee.

The sub-committees consider all applications in their area except for those from public health consultants and academic GPs contracted by the UK Health Security Agency and NHS England. These are assessed by the DHSC or ALB sub-committee where they can be benchmarked more easily. Each regional sub-committee is allocated an indicative number of awards at each level. This is based on the number of national awards available, 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 are volunteers. They come from a range of backgrounds with experience and expertise in many different areas.

Each sub-committee is typically made up of:

• 50% medical and dental professionals
• 25% non-medical professionals and 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.

Part 4 of this guide sets out the assessment process.

Running an open, transparent scheme

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

• a list of all national award holders
• personal statements from people who received a new award in 2022
• governance information, including:
  • the members of our main committee and our sub-committees
  • summaries of the minutes for the main committee’s meetings
• annual reports about each awards round

All guidance for applicants, assessors and employers is available on the Clinical Impact Awards: guidance collection page.

Part 2: eligibility for an award

An NHS consultant, dentist, clinical academic or academic GP may be eligible for a national award providing they meet the eligibility criteria.

Assessors must read the eligibility criteria and should flag any eligibility discrepancies when reviewing applications during the scoring phase. This could include noticing a break in employment or an applicant not having an eligible contract.

You should ensure that all applicants you assess meet the minimum criteria of having at least 3 programmed activities (PAs) or equivalent sessions that are clinically relevant to support the NHS. These 3 PAs can comprise a portfolio of clinical, teaching and research activities, but should normally include at least one PA in direct clinical care.

Retirement and pensions arrangements

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

In all retirement cases, the ACCIA secretariat will flag to assessors when a truncated evidence period should be considered.

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

For general retirement information for award holders, see the change of circumstances guidance.

Part 3: the application process

Applications can only be made online at the ACCIA application portal.

Please see part 3 of the applicants’ guide for the full application process.

Support for applications

For the 2025 awards round we will not be asking employers to provide a narrative statement about each applicant. Instead they will be asked to confirm the veracity of the information provided on the form and of compliance with contractual obligations and disclosure.

We cannot accept applications without sign-off from the applicants’ employers. This requires joint sign-off from all employers if there is more than one. Further details are available in the employers’ guide.

Membership and specialty organisations can provide guidance and assistance on the application process, but they must not edit, proofread or review individual applications.

Part 4: the assessment process

There is a single online application form for all awards, with no renewals. 

An online application form will be submitted for competitive scoring in the first instance to one of the 13 regional sub-committees or to the ALB committee.

Separate arrangements are in place for applicants in Wales. 

A 2-stage scoring system then operates.

In the initial scoring round, all applications will be assessed on merit. ACCIA generates a ranked list on the basis of mean scores for the applicants as normalised between any regional scoring groups.

The second stage is to determine the final allocation of N3 (the highest award level) and N2 awards in each region. The first allocation of N3s and matching number of top-ranked N2 awards for all regions are then referred for re-scoring by the national N3 committee. This is composed of chairs and medical vice-chairs drawn from the regional sub-committees and other experienced scorers. 

This committee will re-score the applications together with all other similarly placed applications from all other regional sub-committees. Roughly, the top ranked 50% after review by the N3 committee will receive an N3, while the bottom 50% will be recommended for an N2 award.

All successful awards are currently subject to a governance review by the ACCIA chair, medical director and the main ACCIA committee.

The final number of awards may be limited by the funding available and is ultimately subject to ministerial approval.

Regional sub-committees

The regional sub-committee members have responsibility for stage 1 scoring. Depending on the volume of applications within a region, applications may be assessed in single or multiple scoring groups, with applications randomly assigned in the latter instance.

As a regional sub-committee member, you will be allocated to one of these groups and score typically between 30 and 70 applications. In some cases, scorers will be allocated to a different region to:

• balance diversity and workload
• deal with conflicts of interest - for example, if a professional regional sub-committee member is also applying for an award

A small number of experienced assessors may also be asked to join NRES. ACCIA will inform all scorers of their obligations at the end of the application round, when all the applications have been submitted and we have a clear idea of the number of applications that need to be assessed.

Regional sub-committee meetings will typically be held online using Microsoft Teams, or in some cases hybrid depending on circumstances. They will be organised and attended by one or more members of the ACCIA secretariat. These will take place in summer and autumn 2025, with dates to be advised in advance. 

Before each meeting, the ACCIA chair or medical director will review all provisionally successful allocations.

All discussions regarding NCIAs are confidential, and no aspects must be disclosed or discussed outside of the meeting. The secretariat takes notes of the outcomes regarding applications, but regional sub-committee meetings are not formally minuted.

Any application where we have questions will be flagged in advance to the regional sub-committee scorers for discussion at that meeting. The purpose of the meeting is to discuss the relevant issues and decide on the need for referral to NRES. There is no re-scoring regionally or changing of marks or ranking, and your role at the regional committee meeting is to provide corroboration and triangulation of information on the form where possible. 

You must not consider any additional information known but absent from the written application. It is not your role as a regional sub-committee member to lobby for any particular individual.

Applications below the derived cut-off scores are not discussed, though applications will be referred to NRES in the event of a tie of these scores.

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

Applications referred to NRES will be scored again by members of that committee who did not score the application in the first round. Depending on the ranking after NRES scoring, first round award levels may stand or may be downgraded by one place. Applications ranked at N2 level after first round scoring can only be downgraded to N1.

Scorer training

All new regional sub-committee members are required to attend scorer training in May 2025. Each session will last 2 to 3 hours and will take place using Microsoft Teams.

Experienced scorers will also be asked to attend a short session to understand what’s new for 2025.

Part 5: how to score an application

Your role as an assessor - principles and priorities

Your role as an assessor is to assess clinical impact that is over and above an individual’s job plan at a regional and national level. Clinical impact is about providing high-quality services to patients that:

• go beyond the applicant’s immediate remit
• improve clinical outcomes for as many patients as possible (nationally)
• use resources efficiently and make national services more productive

You must: 

• assess evidence on the application form in the 5 domains against expectations in the job plan provided, considering any extenuating circumstances as necessary - only the domains part of the application form is to be assessed
• base the assessment only on written information presented in the form - not hearsay, reputation or prior personal knowledge
• score independently without discussion or consultation
• be consistent and fair in your scoring, remaining constantly aware of the possibility of conscious and unconscious bias
• declare any conflicts of interest to the ACCIA secretariat as soon as they are known
• not assess any information from website addresses or other external links applicants may include to provide additional information
• not access or score evidence that is not on the application form

Sub-committee members should not participate in the scoring or discussion of applications from:

• close personal friends or family members
• those with whom they have a managerial or subordinate reporting relationship

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

The role of professional, lay and employer representatives is to score and assess individual applications, not to represent any specialty, organisation, race or sex.

Confidentiality

Confidentiality is paramount and applies equally in:

• assessing and scoring applications
• discussions at regional sub-committee or other meetings
• discussion of applications at training sessions
• informal mentoring and discussions with applicants
• discussion or casual conversations outside of committee meetings

You should only confer with other sub-committee members (who are not themselves applying) once you have all scored the applications and scoring has closed. If you have any concerns or need advice about an application or the scoring process, you should raise them with your committee’s chair, medical vice-chair and with the ACCIA secretariat (accia@dhsc.gov.uk).

Under no circumstances should you discuss the process with any of the applicants or any other party.

Job plan

The ‘job plan’ section of the application is an important benchmark for expectations of the applicant’s paid roles.

Work that is paid as part of the job plan is considered out of scope. Only work above and beyond the contracted responsibilities should be assessed. Other work that is paid from elsewhere should also not be scored highly unless it is made clear how its impact is above the expectations of its remuneration and has a clear benefit to the NHS.

Domains

Applicants need to describe achievements from within the last 5 years, or since their last successful award if less than 5 years, and how these are linked to the NHS. Evidence without dates cannot be scored as assessors cannot be confident it relates to the appropriate time frame. You should:

• differentiate between impact (results and output) and activity (input)
• score achievements that are national more highly

Applications that describe activity alone, without impact, should not get high scores.

To determine if a consultant is performing over and above the expectations of their role, it is helpful for assessors to review achievements against the original aims in their job plan.

An applicant could get a national award based on a local or regional contribution above and beyond their contractual duties if it has been disseminated and had a demonstrable impact on the wider NHS.

In all cases, dates must be included. You should not credit evidence if you are not confident it applies to the correct evidence period.

Assessors should not credit evidence outside of the correct time frame, unless it shows how they have actively built on or consolidated previous achievements in the last 5 years, or since their prior award if less than 5 years ago.

Any evidence that is repeated can only be scored in one domain, unless it relates to a different aspect of the same work. For example, where an applicant shows evidence of impact on the quality of undergraduate education but also in the leadership of other teaching staff.

Similarly, applicants are expected to adhere to the individual domain themes with their evidence, although we recognise that there can be elements of overlap between the evidence in each domain. If evidence appears misplaced in a domain, you may choose to score it positively but you should not credit evidence that is clearly out of scope for that domain (for example, evidence of impact of academic research in the service delivery domain).

Committee members should score the domain sections as follows:

• 10 = the application is excellent with clear and sustained national impact
• 6 = the work is over and above the applicant’s contract terms and should have national, or at least regional, impact, beyond their local area
• 2 = an applicant has met the terms of their contract or may have contributed more but mainly within their locality
• 0 = an applicant’s impact and contribution is not clear with no or few outcomes and/or dates to allow assessment and judgement

Employer sign-off

The employer section is not scored. It should only be used to corroborate the evidence in the application.

The employer sign-off process has changed this year. Employers do not have to write a narrative statement about each applicant.

The purpose of employer sign-off is to confirm the veracity of the information provided on the form and the applicant’s compliance with contractual obligations and disclosure. Employers will also be asked about whether the applicant has contributed as appropriate to the organisation’s Care Quality Commission (CQC) or Health Inspectorate Wales (HIW) inspections or improvement plans.

Employers are asked to comment on any disciplinary matters. If these have not concluded, we always presume innocence unless it has been proven otherwise. ACCIA will determine any action required once the matter is completed.

Applicants who work less than full time

Consultants working less than full time (LTFT) are eligible to apply for awards, providing they meet the minimum of 3 clinically relevant PAs criteria.

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

We advise you to look carefully at the job plan for all applicants. This is particularly important for LTFT applicants in order to help you decide if the contributions described in the domains on the form (clinical and/or academic) are over and above their contractual responsibilities, regardless of having 3 or 10 PAs.

High PA job plan

In recent years we have started to see a trend of high PA job plans. This can make it particularly difficult to understand what work is over and above an applicant’s contractual duties.

Assessors must pay attention to the volume of PAs and must critically assess whether the evidence the applicant has presented is over and above work or already remunerated and part of their contractual duties.

The principle of the national scheme is to recognise and reward over and above contributions. Where work is already in scope of an applicant’s contractual obligations (and therefore already remunerated), you should not credit it in an application for a national award.

Applicants with a national role

It can be difficult to assess applicants who have a national role as their day job.

You must focus on the ‘over and above’ element, comparing the job plan details against the evidence in domains to deduce what work is part of the applicant’s contractual duties and what might reasonably be considered to be additional impact.

Extenuating circumstances

Consultants can describe any extenuating circumstance in the job plan, personal statement and/or the relevant domains of the application form.

It can be difficult for applicants to share personal information. We expect assessors to treat any such information with respect and in confidence.

Pay careful attention to applications where a consultant’s circumstances and job plan have changed during the course of the 5-year assessment period. For example, an applicant may describe periods of absence, perhaps due to maternity leave or ill health during the relevant 5-year period. In such cases, you should consider work done over a more prolonged time period when assessing the application, but in no circumstances can evidence presented in a previous successful application be credited a second time.

The ACCIA secretariat will make assessors aware of applicants who can be credited for an extended period of evidence based on an extenuating circumstance.

Investigations or disciplinaries

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

This information will not be made available to assessors, unless relevant, due to our approach of innocent until proven otherwise.

Inspection ratings

We now ask for an organisation’s latest inspection outcome in the employer section. Inspections outcomes have never been part of the scoring. If a consultant is on the board of an organisation in special measures and is recommended for an award, we will inform the main committee.

Disability

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

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

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