There are statutory requirements for those working in the NHS and Local Authority in respect of the Armed Forces community. A greater understanding of the specific statutory requirements and needs has been developed by the existing Senior Leadership Team for the Sussex Armed Forces Network over the last ten years which has included Kent and Medway for the last 6 years. This has been achieved through close working with the Armed Forces community, Armed Forces charities and the MOD. In addition to the statutory requirements, there is also a moral obligation which must be addressed to meet the specific needs identified for this community of Regular Serving Personnel, Reservists, Veterans and their families. All commissioners and providers must ensure members of the Armed Forces community are treated fairly and are not disadvantaged in their day-to-day lives due to their service, preventing any harm.
The Military Covenant states:
The first duty of Government is the defence of the realm. Our Armed Forces fulfil that responsibility on behalf of the Government, sacrificing some civilian freedoms, facing danger and, sometimes, suffering serious injury or death as a result of their duty. Families also play a vital role in supporting the operational effectiveness of our Armed Forces. In return, the whole nation has a moral obligation to the members of the Naval Service, the Army and the Royal Air Force, together with their families. They deserve our respect and support, and fair treatment. Those who serve in the Armed Forces, whether Regular or Reserve, those who have served in the past, and their families, should face no disadvantage compared to other citizens in the provision of public and commercial services. Special consideration is appropriate in some cases, especially for those who have given most such as the injured and the bereaved. This obligation involves the whole of society: it includes voluntary and charitable bodies, private organisations, and the actions of individuals in supporting the Armed Forces. Recognising those who have performed military duty unites the country and demonstrates the value of their contribution. This has no greater expression than in upholding this Covenant.
The Military Covenant is a promise from the nation to those who have served and their families. On 3rd November 2011 The Military Covenant was enshrined in law and put into the Armed Forces Act.
What this means to a health professional is that we need to offer ex-service personnel (Veterans) ‘Priority Treatment’.
Veterans receive their healthcare from the NHS, and should receive priority treatment where it relates to a condition which results from their service in the Armed Forces, subject to clinical need. Those injured in Service, whether physically or mentally, should be cared for in a way which reflects the Nation’s moral obligation to them whilst respecting the individual’s wishes. For those with concerns about their health, where symptoms may not present for some time after leaving Service, they should be able to access services with health professionals who have an understanding of Armed Forces culture.
In simple terms this means that if a Veteran is suffering from a health condition that can be attributed to their military service then they should be given priority treatment. However, to prioritise this does not mean they would just jump to the front of the queue. If people already waiting have a clearly greater clinical need they should be prioritised, but if those waiting have an equal clinical need then the Veteran should take priority.
From July 2015, the NHS Constitution was updated and now states:
The patient will be at the heart of everything the NHS does. …. As part of this, the NHS will ensure that in line with the Armed Forces Covenant, those in the Armed Forces, Reservists, their families and Veterans are not disadvantaged in accessing health services in the area they reside.
The Armed Forces Act 2006 was updated in 2011 and now the 2021 revision is currently going through parliament and it is expected to become a legal requirement from April 2022. The new Covenant Duty places an obligation on relevant public bodies and persons, when exercising certain aspects of their public functions, to have due regard to the three principles of the Armed Forces Covenant.
The Duty will require those who are subject to it to consciously consider the Armed Forces community, and the principles of the Covenant, when developing policy and making decisions in the areas of housing, healthcare and education.
Former Personnel, Ex-Service Personnel or Veteran are all terms that can be used to describe someone that has served in any of the three branches of the British Armed Forces.
The Military Covenant states that;
The Armed Forces Community includes:
Regular Personnel – Individuals currently serving as members of the Naval Service (including the Royal Navy and Royal Marines), Army or Royal Air Force.
Reservists – Volunteer Reservists, who form the Royal Naval Reserve, Royal Marine Reserve, Army Reserve (Territorial Army) and the Royal Auxiliary Air Force, and Regular Reservists, Regular Reservists are ex regular service personnel who on leaving the regular services have a reserve commitment.
Veterans – Those who have served for at least a day in HM Armed Forces, whether as a Regular or as a Reservist and this includes the Merchant Navy
Merchant Navy – ‘Anyone who has served on a commercial vessel at a time when it was operated to facilitate legally defined UK military operations by HM Armed Forces’ and these personnel are called “UK Merchant Seafaring Veterans”
Families of Regular Personnel, Reservists and Veterans – The immediate family of those in the categories listed above. This is defined as spouses, civil partners, and children for whom they are responsible, but can where appropriate extend to parents, unmarried partners and other family members.
Bereaved – The immediate family of Service Personnel and veterans who have died, whether or not that death has any connection with Service.
Common Mental Health Disorders – The rates of common mental disorders (e.g. depression or anxiety) are similar to the general public in Ex-Service Personnel. However deployed Reservists are found to have higher rates than deployed Regular or non-deployed Reservists. Most significant for those who have served and transferred into civilian life is Adjustment Disorder and significant numbers are affected by this to varying degrees.PTSD – The rates of PTSD in the combined Regular Forces and Veteran population is about 6% compared to between 4% and 5% in the general population. In the Reserve Forces (The Army Reserve was previously known as the Territorial Army), the rate is around 6% to 7%. In Sussex, Kent and Medway there are few Regular Forces but a large contingent of Reserve Forces, especially Infantry.
Suicide - There are no accurate figures for Ex-Service Personnel. Though there are sub groups and time periods after serving which increases the risk. There is currently research being undertaken and these results are expected this year. See the Mental Health and Suicide Prevention factsheet for more information. The following information in respect to Serving Personnel is from the annual Statistical Notice providing summary information on suicides that have occurred among Serving UK Regular Armed Forces Personnel during the 20-year period 2001-2020.
Alcohol and Drugs – Alcohol misuse is a significant problem for both Serving persons and Service leavers. The Hatch et al (2013) study shows that there is an 11.4% of serving personnel with alcohol misuse and 15.1% of service leavers. However, recent research by Kings College Centre for Military Health Research (KCMHR) suggests that alcohol consumption has declined.
Aggression and Violence – The MacManus et al (2013) study showed that there was an increased threat of violent behaviour in UK military and ex-military. This threat is mainly in men under the age of 30 and this can be increased if they have been deployed in combat roles and traumatic events as well as having post deployment alcohol misuse.
Gambling is a growing concern in the Armed Forces, with research showing that those in the military are 8 times more likely than the general population to have gambled. This is in part due to high adrenaline levels, boredom, culture, determination and ease of access.
1.41% Veterans and 0.17% Civilians
Some of the effects it can cause are:
Seriously injured personnel have also benefitted under the Covenant. Developments since 2010 include the introduction of a Transition Protocol for Seriously Injured Service Leavers to create a seamless transition from Armed Forces to NHS care and the provision of a nationally commissioned specialist prosthetic and rehabilitation services for amputee veterans. Furthermore, the Veterans’ Prosthetics Panel meets regularly to consider applications for prosthetic components for veteran amputees. Additionally, three cycles of IVF infertility treatment are available to Veterans.
A Royal British Legion report on hearing problems among Service Personnel and Veterans 2015.
In summary, 11% of surveyed Veterans reported having problems hearing and 6% reported tinnitus (ringing in their ears). Based on the Royal British Legion latest estimates on the size of the Veteran population, this amounts to over 300,000 Ex-Service Personnel living with hearing loss.
If comparing different age groups, Veterans under the age of 75 are about three and a half times more likely than the UK population to report difficulty hearing. Those who have served in more recent conflicts may be at even greater risk: audiometric tests on infantry troops returning from Afghanistan in 2007/08 indicated that up to 14% had suffered from hearing loss.
A national campaign is calling for healthcare professionals to ensure they’ve signposted blind and vision impaired Ex-Service men and women to vital sight loss services and support, regardless of how they lost their sight.
Blind Veterans UK are the leading organisation supporting vision impaired Ex-Service men and women, regardless of when or for how long they served (also assisting those who have been injured in the line of duty within the emergency services). Blind Veterans UK help get our blind Veterans back on their feet, recover their independence and discover a life beyond sight loss.
The “Chavasse Report” highlights the current problems and provides the solutions to ensure the on-going care of musculoskeletal problems for all Service Personnel by the NHS from 2014 onwards.
Musculoskeletal injuries are the most significant cause for medical discharges accounting to 60%. The commonest age range of discharged Personnel is 30-45 years. As a consequence, it is likely that there will be a considerable need for on-going musculoskeletal health provision for these Veterans as they age.
Our Reservists, as a consequence of the reorganisation of our fighting forces, will assume a more central role in our Nation’s security. Again, the most common complaint preventing deployment or training is musculoskeletal. All clinicians must consider that Reservists and Regulars need to be back to work quickly and at a higher fitness level in preparation for deployment after any injury or surgery. Therefore speed for referrals, treatments and increase in intensity for physiotherapy. Links to local gyms may be beneficial.
There is also the hidden group of MSK issues which Veterans have highlighted to the Network where they have carried an injury whilst they served that as a result can cause issues which manifest many years later.
Veterans Trauma Network (VTN)
The VTN provides care and treatment to those with a service-attributable physical health condition. Despite the name “trauma”, VTN deals with all physical health issues in Veterans as a result of their time in service - from recurrent heat illnesses to problems after limb loss, from traumatic brain injury to service-related fertility issues. The VTN is closely linked to Veterans’ Mental Health Services and charities such as Blesma and Blind Veterans UK and can offer comprehensive care focused around a Veteran’s needs.
The VTN is a collection of 13 NHS Veteran Trauma Centres (VTC) and four specialist units, each with military and civilian medical experts who will be able to help the Veteran with their physical service-related issues. The VTN will work with the Veteran to develop the best clinical plan for the Veteran’s needs. The VTCs are:
The specialist units are:
Each Centre and Unit has clinicians with different specialities so an individual’s care may not necessarily be local to them however, the VTN will find the best person to support the individual’s health needs.
The VTN is run largely by healthcare professionals who are either Veterans or Serving Personnel themselves. GPs can email firstname.lastname@example.org to refer Veterans to the service, where they will benefit from specialist care by military and civilian experts. You can also be referred by Blind Veterans UK and Style for Soldiers. (A copy of the referral form is available from the AFN’s website.)
More information can be obtained by emailing Blesma at email@example.com or calling them on 020 8548 7080.
As families and carers can be seriously impacted when their loved ones are injured, they can also be supported by the VTN to access services that may help them. The VTN works with Veterans who have been injured, as well as their families and academic research partners, to better understand the impact of this work.
Veterans Prosthetics Panel (VPP)
The VPP provides funding on a named Veteran basis to NHS Disablement Service Centres (DSC) to ensure that Veterans who have service related limb loss can access high quality prosthetics regardless of which DSC they attend. For more information see NHS website.
Further information can be obtained by contacting Blesma using the details above.
Veteran Rehabilitation Project
NHS England and NHS Improvement are currently funding and leading a project within the Veterans Covenant Healthcare Alliance (VHCA) and GIRFT (Get It Right First Time) structure to establish the exemplar pathway for rehabilitation ensuring Veteran’s services as a key element of these pathways. Rehabilitation clinicians undertaking this project aim to create care pathways and a set of clinical recommendations for Veterans in the NHS. This project will consider rehabilitation in the Ministry of Defence, to aid the transition of military personnel into NHS care. The outcomes from this work will be shared as soon as they are available.
NHS England and NHS Improvement is responsible for commissioning IVF for Armed Forces couples, even if only one of them is serving. More information about the policy can be viewed via the NHS England website.
For further information on Maternity, Assisted Conception and Adoption see AFN Factsheet.
Respiratory conditions are not as well-known as other diseases or injuries that the Armed Forces community may have as a result of having serving with the Armed Services. See the Respiratory Health factsheet for more detailed information.
Veterans are at triple the risk of developing chronic lung disease compared to the general population. Occupational lung disease can come from exposure to cigarette smoke, sand, dust, chemicals, airborne heavy metal and chemical particles from exploded munitions, aeroallergens found in desert regions and smoke from burn pits.
Asbestos was widely used throughout the Armed Forces, particularly in construction and shipbuilding due to its excellent heat resistant properties and non-flammable nature. Many MoD personnel have therefore come into direct contact with asbestos over the past 50 years. Earl Howe, Minister of State, Ministry of Defence, stated: “From 01/04/2003 to 30/09/2016 there have been 761 Ex-Service Personnel with Mesothelioma of these 721 are deceased”.
All Veterans diagnosed with Mesothelioma as a result of Service will have the choice between receiving a traditional War Pension or £140,000 in lump sum compensation, regardless of their age at the time of diagnosis.
Claims can be made via Veterans UK on 0808 1914 218.
Non-freezing cold injuries usually happen in the outdoors, when people are exposed to cold and wet conditions for a prolonged length of time. Known as ‘trench foot’ during World War I, the condition affects the hands and feet, and sometimes the genitals. NFCIs, as they’re commonly called, can cause chronic pain, numbness and swelling in the parts of the body affected, and can permanently affect a person’s ability to use their hands and feet. It’s also more common in those of Black African and Black Caribbean descent while Gurkha are of a protective descent. With no cure available, painkillers are the only source of temporary relief for soldiers with the condition. Screening tools, such as the DN4 questionnaire, and treatment algorithms for neuropathic pain should now be used in the management of these patients.
The injuries are preventable and the MoD has its own guidance on how to reduce cold injuries during outdoor exercises. This includes simple steps such as:
A survey of Armed Forces Personnel who served in the Falklands War found that 64% of soldiers in infantry units had experienced symptoms of non-freezing cold injuries. These injuries had had a lasting impact on their careers and family life.
For soldiers who fought in the Falklands War and those who serve today, the long-term effects of NFCIs can be devastating. Soldiers are almost always medically downgraded or discharged from duty as they can no longer take part in outdoor activities due to the loss of feeling in their hands. The nature of the injury means most servicemen can no longer work in the outdoors and the effects are often mental as well as physical. Many go on to develop depression and anxiety because of the impact of the injury on their career and family lives.
In September 2016 the Defence Medical Services launched the Mefloquine Single Point of Contact for current and former Service Personnel who have concerns about their experience of mefloquine (commercial/trade name Lariam). Mefloquine is one of a number of effective anti-malarial drugs used in many parts of the world.
The Single Point of Contact can also be contacted by either emailing firstname.lastname@example.org or calling on 0306 7705 059.
How do I find out if I have taken Mefloquine? If you are a Veteran or Reservist you are advised to contact your local NHS GP who may have already obtained a copy of your military medical records and will be able to advise if Mefloquine has been previously prescribed to you. If your NHS GP has not yet accessed your military medical records they can do so by following the process in section 9 of this factsheet.
Alternatively, you can submit a Subject Access Request (SAR) to gain access to your personal data held by the Ministry of Defence.
Adverse reactions to any drug are required to be reported by Medical Officers to the Medicines and Healthcare products Regulatory Agency (MHRA) in line with standard UK medical practice. There are a number of compensation schemes administered by Veterans UK on behalf of the MoD.
IPC4V is a personalised care approach for Serving Personnel who have complex and enduring physical, neurological and mental health conditions that are attributable to injury whilst in they were in service. It provides a framework for effectively planning and delivering personalised care in line with the Armed Forces Covenant. Central to this is an improved discharge planning process, starting approximately nine months before these individuals leave the military. This means that the MoD, health and social care, Armed Forces charities and other organisations involved in the care of these individuals are brought together at an earlier point in the care pathway, ensuring care and support arrangements are in place as they transition to civilian life and beyond.
Ex-Service Personnel with a complex and life-long health condition may be eligible for the veterans personalised care programme. Eligible individuals will have a single personalised care plan for all their health and wellbeing needs that is developed with them and a range of organisations, including health and social care and military charities. To apply, individuals should contact their local Clinical Commissioning Group.
The MoD annual National Statistical Notice provides summary information on the number of deaths whilst in Service in 2020 among the UK Regular Armed Forces, and the trends over the ten-year period from 2011-2020. This information updates previous notices and includes new data for 2020.
Overall, in 2020, the UK Regular Armed Forces were at a statistically significant lower risk of dying compared to the UK general population. More specifically, the UK Regular Armed Forces were at a:
The lower risk of dying among UK Regular Armed Forces Personnel compared to the UK general population may be explained by the ‘healthy worker effect’, as discussed in the report.
There was a downward trend in the rate of deaths among UK Regular Armed Forces Personnel over the latest ten-year period. This was the result of a higher number of deaths during 2011 and 2012 due to operational activity in Iraq and Afghanistan with the rate falling following the drawdown of troops from Afghanistan. Since 2014, there have been only three lives lost as a result of hostile action (one in 2015, in 2018 and in 2020).
When looking at the changes in the rate of death for specific years:
Since the early 2000’s, land transport accidents (LTA) have been one of the largest cause of deaths among the UK Regular Armed Forces. The advancement of vehicle safety systems and road safety campaigns run by MoD has contributed to a declining trend in the rate of deaths as a result of LTA. Between 2016 and 2019 the number of UK Regular Armed Forces Personnel dying as a result of a LTA remained stable at around an average of 12 deaths each year. However, in 2020 this number fell to six LTA deaths. COVID-19 restrictions on travel may have contributed to this fall.
Between 2013 and 2017, the UK Regular Armed Forces Personnel were at a 62% statistically significant increased risk of dying due to a LTA compared to the UK general population.
Since 2005-2007, there has been a downward trend in the Tri-Service rate of LTAs. The latest three-year moving average rate (2015-2017) was 8 per 100,000. Since the end of the 1980’s, Army personnel had the highest rate of LTA deaths among each of the Services. As advised, the advancement in vehicle safety systems and road safety campaigns run by MOD throughout this period contributed to the downward trend in deaths as a result of LTAs. Two further campaigns also had an impact:
In 2020 the Land Traffic Accidents were 7 (provisional, subject to change following coroner’s inquests into 12 deaths) at 12% which has dropped it out of the top 3 for the cause of death.
Within the Armed Forces community there is the full range of diversity. There are some specific needs within these communities whether similar to the protected characteristics and individuals may relate to or as a result from serving within the Armed Forces has that characteristic.
There is history of the Armed Forces community not seeking help and from this there is a need to ensure that they have been handed to the next service to ensure that they do not slip out of the system. Although there is extended help available with those who have an understanding of what this community may have endured, there is a need for each service to collect the data from the question “Have you or any member of your family served in the British Armed Forces?” to help them provide the appropriate care for this community.
In addition to the Carers Act 2014, the Equality and Diversity Act 2010 also ensures that carers should not experience ‘discrimination by association’.
Due to the protection afforded to carers there is a requirement to understand the culture and impact of the Armed Forces community on carers or as a carer to prevent the protected group from being discriminated against.: The impact that caring can have on a person may cause isolation, feelings of guilt and resentment, poor physical and mental wellbeing, navigating health and social care services, sleep problems, travelling, juggling paid employment/education with caring, giving up work, financial hardship, lack of respite and not knowing where to go for support. There is a requirement to identify carers and to remove some of the barriers to engagement with support and ensure they receive assistance from Armed Forces friendly local and national organisations that support carers.
1 in 10 of all carers in the Ex-Service community agrees that they struggle to cope. There are both adults and young carers in the Armed Forces community.
There is a requirement to gather evidence of the particular needs of Service children when it comes to childcare provision within the UK to identify whether there is any disadvantage due to the nature of Armed Forces Personnel work. The system should ensure that the specific needs of children of Service Personnel are recognised.
Frequent house moves have a negative effect on school performance and the National Audit Office reported that 28% of respondents to a consultation about Service children had moved seven times or more since their children had started school. See more information in the Support to the Armed Forces factsheet.
The ban on members from the LGBT community serving in the Armed Forces was lifted in January 2000. Prior to this, a number of Armed Forces Personnel were discharged from Service on the basis of their sexuality. Some received convictions under specified legislation that has now been de-criminalised, while others were discharged solely on the basis of their sexuality, without any conviction.
In the course of their discharge, some Personnel either forfeited medals directly, or were prevented from continuing to serve and thus denied the ability to regain medals that might previously have been forfeited for unrelated reasons.
The MOD is committed to addressing this historical wrong and is introducing a policy which enables individuals to apply to have their medals restored.
There were thousands of LGBT+ service personnel dismissed or forced from the services prior to this date. This had significant impact on their lives.
Fighting with Pride (military Charity) is support the health and wellbeing of the LGBT+ veterans, service personnel and their families and in particular those most impacted by the ban.
The UK Armed Forces Biannual Diversity Statistics report is statistical release that presents information relating to the gender, ethnicity, nationality, religion and age of Military Personnel employed by the Ministry of Defence (MOD).
There are significant numbers of Gurkhas/Nepalese working and living within Kent and Medway/Armed Forces. There is a Nepalese Healthcare Toolkit which can be found on the Armed Forces Network website. In addition the Forces Connect App will have a specific section for this community. The App has some translated information and it is essential that the community is offered translators when needed to ensure appropriate communication.
There are some specific health needs for this community for example diabetes and TB.
In July 2013, the MoD re-imposed a five year UK residency criteria for Commonwealth citizens wishing to join the Armed Forces; having previously waived the criteria in 1998. In May 2016 a limited waiver of the residency was introduced to allow the recruitment of up 200 Commonwealth citizens per annum into skill shortage roles.
On 5 November 2018, the MoD announced that it has now removed the five year residency criteria for up to 1,350 personnel per year. This announcement and subsequent recruitment may in part have caused the increase in the commonwealth intake in the 12 months ending 31 March 2020.
Work has started within the Network to ensure those from Commonwealth countries are provided with support that meets their needs and an additional factsheet is currently being developed.
It was on 8 July 2016 that the exemption on women serving in ground close combat (GCC) roles was lifted, with roles opening up on an incremental basis. The decision to lift the exclusion was on the basis of equality of opportunity and maximising talent. The remaining GCC roles opened to women in late 2018, after additional health mitigations were put in place. There are no quotas for women joining GCC roles and applications are treated in the same way as for all other roles; additionally, there has been no lowering of standards for women joining GCC roles.
Since 2019 all roles with the Armed Forces have been open to women. The Armed Forces are exempt from elements of the employment provisions of the Equality Act 2010 for reasons of combat effectiveness. At 1 April 2020 there was a greater proportion of female officers in the Future Reserves 2020 (18.3%) than the UK Regular Forces (13.6%). Compared with the UK Regular Forces, the Future Reserves 2020 has a higher female representation of Officers in every Service.
In June 2020, a scoping study was undertaken looking into the health and well-being needs of female veterans in the UK. The report ”We Also Served” provides the results from the study and highlights the recommendations for prioritising research and other activities with female veterans in the UK going forward.
The NHS is responsible for providing all hospital and most community services for Serving Personnel (except for mental health, general practice and rehabilitation services). The NHS also provides nearly all community, general practice and hospital services for the families of Serving Personnel, Reservists and Veterans. Included as part of this are the various dedicated services and initiatives to support the Armed Forces community.
NHS England and NHS Improvement, together with the Royal College of General Practitioners, are rolling out the Veteran Friendly GP Practice Accreditation Scheme across England. This scheme, which is intended to help ensure practices are equipped to best care for Veterans and their families, has already accredited over 550 surgeries.
All ex-Armed Forces personnel are given a summary of their medical records on discharge, which they are advised to give to their new GP when register. Copies can also be obtained by contacting the numbers below:
There is specific eLearning which has been developed by the Royal College of General Practitioners, Health Education England and E-Learning for Healthcare. These went live in May 2016.
The following wording has been taken from the national e-learning and could be added to your referrals:
On receipt of referral, this information should go onto the providers system and an access policy needs to be in place to aid staff to treat these patients in accordance with the requirements.
All organisations are being asked that when they are registering or taking any equality or diversity information from clients/patients to ask the following or similar questions:
Only by asking the question can we know if someone has served and therefore enable access to additional help, ensure that they are not disadvantaged and aid the actual care of that person and their family.
The GP contract specifically includes the terms of extended temporary registration for Armed Forces Personnel. The contract has been amended to allow registration of a specified cohort of wounded, injured or sick personnel for up to a maximum of two years with global sum payments included. Registration is subject to approval by Defence Medical Services, which retains responsibility for on-going occupation health needs and will provide practices with a summary of the medical records as a minimum.
GP Practices should be using the Veteran and Reservist codes. If not, how do they assure themselves that they are aware of this population and their responsibility toward them within the military covenant?
The generic, if details are limited, read code for Ex-Service Personnel is: Xa8Da (history relating to military service) or 13JY, SNoMed CT 302121005.
Obviously people who are or have been in the Armed Forces, or Reservist are part of the covenant as are dependents. However, people can become no longer dependent hence the 13WG code which if added after a 13WV, 13WW or 13WY code which would exclude someone unless they have a Serving code, Veteran code or Reservist code at any time.
There are often 'military families' so there will be a number of people who may no longer be dependent on a parent who's in or has been in the Armed Forces who subsequently enlist them self.
Serving Armed Forces
There is an Armed Forces Network ”How to Guide” for all NHS Trusts that helps with understanding on what things a Trust could consider for this community. It includes employer requirements (See section 10 of the guide) as a provider in raising awareness, accepting referrals and onward care.
The VCHA aims to improve NHS care for the Armed Forces community by supporting trusts, health boards and other providers to identify, develop and showcase the best standards of care. The aim is to have all NHS Trusts accredited as ‘Veteran Aware’ by November 2022. They need to have demonstrated their commitment to eight core manifesto standards, including signing the Armed Forces Covenant, raising awareness of Veterans’ healthcare needs among staff, and establishing links with local support providers.
The Defence Relationship Management (DRM) partners with organisations throughout the UK, helping them understand the value of signing the Armed Forces Covenant and building mutually beneficial partnerships with Defence. It provides support on employing Reservists, Veterans, Cadet Force Adult Volunteers and military spouses and improving fairness for the Armed Forces community in the consumer market.
There is a need to that all employees are cared for whether as a:
Organisations who take positive action to make their workplace more Reservist friendly and support the wider Defence People requirements may be eligible for Employer Recognition Scheme (ERS) awards.
NHS Employers is taking action to ensure the NHS takes into account the Armed Forces community by bringing together employers from across London and the South NHS Employers Network.
A Champions’ Scheme for NHS Reserve Forces Champions, in partnership with the Ministry of Defence (MoD) and the Department of Health. The scheme has been created to increase the awareness of Reservists within the NHS and to highlight the benefits that employing Reservists can have for organisations and employers.
Step into Health offers an access route into employment and other career development opportunities within the NHS to members of the Armed Forces community. NHS Employers supports organisations in adopting the programme, ensuring that Step into Health is embedded into recruitment strategies and workforce supply routes.
The programme recognises the transferable skills and cultural values that Armed Forces personnel have developed, and how these skills and values are compatible with working in the NHS.
Sussex, Kent and Medway have two Networks, the Sussex Armed Forces Network and the Kent and Medway Armed Forces Network which provides the leadership, engagement, pathway redesign, training, development and communication across this region for the Armed Forces community linking and working with the Civil Military Partnership Boards to deliver required action plans. The Networks, hosted by a Sussex Clinical Commissioning Group, brings together a wide range of organisations including NHS Clinical Commissioning Groups, NHS Trusts, Councils, Ministry of Defence representatives, local charities, education and emergency services, who work closely to ensure the specific needs of the local Armed Forces community are being met and considered across local services.
The Network website has the pathways for Sussex, Kent & Medway, Surrey, Hampshire and London covering key topics including mental health. It also includes materials for the Gurkha Nepalese community.
The pathway information/data has been used to populate the Forces Connect app, which is available for download for free from both the Apple App and Google Play stores.
Locally the approach has been taken to support all services to be able to work with the Armed Forces community meeting their needs. To date over 2000 Armed Forces Service Champions have been trained to support local services in working with the Armed Forces community. These Service Champions are embedded in a wide selection of mental health teams, MSK services, Police, Probation, Fire and Rescue, Charities, Local Authorities, and the Dept of Work and Pensions. Each Service Champion has received training on military culture as it states in the Military Covenant, plus details of the local resources to support Veterans and given a resource pack to take back to their work place.
The Armed Forces Network was commended for its work on developing a unique set of relationships to ensure organisations are identifying and meeting the specific needs of the Armed Forces community through local health, care and other services. By working together it has been able to break down organisational barriers and develop bespoke pathways of care for the British Armed Forces (whether Serving, Reservist or Veterans) personnel and their families and raise awareness of the community covenant through a full range of events, factsheets and online training.
This is a local service which is led by Lt Col B Caesar RAMC who is a University Hospitals Sussex NHS Foundation Trust Consultant Trauma and Orthopaedic Surgeon (currently serving as Regular within the British Armed Forces). Although the clinic is based in Sussex they will accept patients from out of area. There is a specific referral form and they would be pleased to work with local organisations as it has successful links to the National Veterans Trauma Network.
This service is funded by NHS England and it brings together all the following services.
The contact details for the Op COURAGE: The Veterans Mental Health and Wellbeing Services around the UK are as follows:
South East England
North of England
East of England
Urgent and emergency support from other NHS Services
If you experience a mental health crisis you can also get help by dialling 111, booking an emergency GP appointment, visiting A&E or calling 999. If you're still serving, you can also call the military mental health helpline on 0800 323 4444.