The London NHS Armed Forces Network

All Strategic Health Authorities have been instructed by the Department of Health to establish a network to ensure that Armed Forces personnel, their dependants and veterans suffer 'No disadvantage' from their Service. The London NHS Armed Forces network launched in 2010.

The London network brings together the NHS, the Defence Medical Service and third sector organisations, including The Royal British Legion and Combat Stress. Dr Andy Mitchell, a former doctor in the RAF and London's Medical Director, chairs the network for the SHA. We were lucky enough to get Dr Andrew Murrison MP to talk at the launch; Dr Murrison is a former Royal Navy Surgeon Commander and served in Iraq in 2003. As well as being Secretary of State (Health) Andrew Lansley's Parliamentary Private Secretary, Dr Murrison's 2010 report Fighting Fit, has made several recommendations to improve the mental healthcare of Service personnel and veterans, many of his recommendations have a direct impact on the NHS.

Issues

The Armed Forces community has a very similar health profile to the rest of the country, but there are some specific challenges they face particular to their Service: Forces families move more regularly than most, often every 2-3 years; this can have an impact on their ability to access medical care and ensure that the existing waits they have had for treatment are protected as they move around.

Approximately 22000 people leave the military per year, the overwhelming majority are fit and well and manage the transition smoothly. The Networks are being established to identify if there are any gaps in the transition process and ensure that those gaps are as few and small as possible.

London has a relatively small serving population, only about 5000 regular with a similar number of reservists; the majority of regular personnel are based in Westminster. In London therefore the focus is more on veterans than those currently serving. Anyone who has Served for a single day is counted as a veteran, one of the challenges that we face in trying to care for this community is that there's no way to keep track of veterans when they leave the Service, there are approximately 4.5 million veterans in the UK, and we believe there are around 400,000 in London.

The Network commissioned a review into the current provision of mental health services to veterans in London. The report identified a number of gaps and made some recommendations on how to mitigate against them:

Solutions

Bridge the gap where veterans' presentations are too complex for IAPT/Primary Care but insufficiently acute for secondary care

• Veterans' health problems are no different to normal patients, but they have a wealth of additional services available to them through Veterans Charities We need to raise GPs' awareness of these services.

Use existing systems better to gather information on veterans demographics

• GP practices already have the capability to record veteran status, we need to ensure they do so, building the bridge between identifying a veteran and the additional services available to them

Support GP's to know when they're treating a veteran and the range of additional services that are available to veterans.

• Standardise recording of status as veteran as part of registering with GP practice. Create an Electronic Directory of Service (DoS) for veterans available for GPs on their IT system.

Tackle Stigma: Veterans perceptions of the NHS; NHS' perceptions of veterans.

• GP education national e-learning package, with CPD points, being rolled-out nationally. Identify GP champions, to help spread understanding of veterans. Explore NHS branding on veterans' charity websites to facilitate the break down of barriers.

Improve accessibility of NHS services (geographic boundary and funding issues)

• Develop guidance for commissioners to ensure efficiency of referral pathways, minimising waiting times and bureaucracy for patients and doctors.

Should you have any further questions please feel free to contact the team via: ArmedForces@london.nhs.uk