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Devon has one of the highest concentration of military bases in the country – the Royal Navy, Royal Marines and Army all have a significant presence across the whole county. Across the wider South West peninsula, this equates to 36,000 service personnel. This means that the Armed Forces community (which includes serving, families, veterans and reservists) is equally large; with up to 5-10% of the 15,000 who transition out of the services each year choosing to stay in or move to our part of the world (with their families and all their routine as well as service-related health needs).
The Devon-based health systems are well-placed to support this community and already strive to meet the Armed Forces Covenant requirements; where constant moves, service-related injuries, impact on service and veteran families and carers, all suggest a more focused degree of care is necessary. Issues that arise include:
This is reflected in the NHS Constitution, which states '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 local health systems have all signed-up to the Covenant and work with local authorities to plan and deliver the right services required for this group of patients.
A veteran is anyone who has served for at least one day in the Armed Forces, whether regular or reserve. It means the same as 'ex service personnel'. Recording this status (and their families/carers) will enable context-aware support and allow appropriate services to be identified – see links in supporting information below and wider carers' support, charitable input or social care packages.
As there are two versions of Read coding in use, we would recommend the practice code a veteran as "military veteran" then the computer system will code correctly on whichever version it uses (including SNOMED in due course). When leaving the services, personnel are encouraged to register with a GP practice just prior to leaving and will come to the practice with a summary care record of their health and with details of how to gain access to their full service-related health notes. It is also useful to ask new practice-joiners whether they (or their family) have ever served in the military.
For most health needs, our local services are well-placed to provide excellent care. Most veterans leave their service time healthy, well and looking forward to their new lives. For a few, with more service-related complicated or specialist issues, a range of dedicated physical and mental health services are available (e.g. complex trauma, prosthetics, complex mental health), see supporting information below. The evidence suggests that mental health issues are comparable with the general population, with around 5-6% having a post-traumatic stress disorder (PTSD) diagnosis (though this may be higher for certain infantry troops), with health-seeking behaviour also equivalent. Having access to the service medical records, allied to correct coding, will support you delivering appropriate care and knowing where to find it.
The e-learning packages and RCGP FAQs (see supporting information below), have a full range of quick-access advice and guidance and DRSS will support referrals to local services. Where more complex/specialist services may be appropriate; especially where advice may be sought for accessing Specialised or national trauma, prosthetic or mental health services please contact Richard Swarbrick - Richard.firstname.lastname@example.org or DRSS - email@example.com
Those who have more recently served and their families generally lead fulfilling, healthy lives and only need to access our healthcare for the same reasons as anyone else. For a few, though, our ability to help them to get to more specific services, that can deal with the results of their service time, mean better outcomes for all.
RCGP 'FAQs and Top Tips for the busy GP'
Published: 16 November 2018