PACE Setter sign up sheet

The application form can either be downloaded, completed, scanned and emailed to us at enquiries@pacesetteraward.nhs.uk or completed online below.

The PACE Setter Award process is most effective when facilitated and supported by a Local Award Panel (LAP) which is usually established by the local CCG, or equivalent organisation. If there is no LAP in your area, your practice may still apply for the Award but please indicate this information on your application form below. Where possible, the PACE Setter team will work with leaders in your local health community to set up a LAP.

Your Details
Your Name:*
First Last
Your Job Title:*
Your Telephone:*
Your Email*
Name of your CCG:*
About Your Team
Name of General Practice or Community Provider:*
Name of lead clinician (GP) for PACE Setter application:*
First Last
Name of lead practice nurse (if applicable):
First Last
Name of lead practice manager (if applicable):
First Last
All other members who will form the core team making the PACE Setter application:
Your General Practice or Community Provider Details
Tell us about your practice population and characteristics (in brief):*
Why does your team want to join the PACE Setter programme?*
Reporting Back
How did you hear about PACE Setter Award?*
Are you willing to share lessons learned as well as best practice? This forms a key feature of our initiative:*
- Yes
- No
Do you know about your PACE Setter Local Award Panel?*
- I have a PACE Setter Local Award Panel (LAP) in my area
- I do not have a PACE Setter LAP in my area
- I don’t know if I have a PACE Setter LAP in my area
Would you like to add any supporting documentation?
Drop files here or
Statement of Intent
On clicking the submit button you are confirming your agreement with the following statement:
On behalf of my organisation, I am applying to be part of the PACE Setter Award programme. We, as a core team, commit that we will complete the award process and be willing to share our best practice and lessons learned with the wider health community.
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Email
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PACE Setter sign up sheet

Your Details

About Your Team

Your General Practice or Community Provider Details

Reporting Back

Statement of Intent

On clicking the submit button you are confirming your agreement with the following statement: