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NHS for Veterans

#1
Hi,

My name’s Dom, I work for NHS London, the body that oversees the NHS in greater London. We’re running a project to assess what the armed forces community (including veterans and families) thinks about NHS services for veterans in London, from Primary care and dentistry to mental health. We’ve got a few ideas but there’s no point us coming up with something without talking to you all first. So does anyone have any thoughts about veterans and the NHS in London, or ideas about how we can make things better for the armed forces community?
 

Fang_Farrier

LE
Kit Reviewer
Book Reviewer
#2
Well as regards NHS dentistry, up here in the Highlands we have some long waiting list to get seen by an NHS Highland dentist.

However Forces families are one of the groups that can get "fast tracked" straight into registration.
 
#3
Well as regards NHS dentistry, up here in the Highlands we have some long waiting list to get seen by an NHS Highland dentist.

However Forces families are one of the groups that can get "fast tracked" straight into registration.
You're not kidding about the lack of NHS dentists who are accepting patients in the Highlands; otherwise the main hospital Raigmore, do a pretty good job compared to the horror stories we hear about the NHS down south.

Another Highlander.
 

Fang_Farrier

LE
Kit Reviewer
Book Reviewer
#4
You're not kidding about the lack of NHS dentists who are accepting patients in the Highlands; otherwise the main hospital Raigmore, do a pretty good job compared to the horror stories we hear about the NHS down south.

Another Highlander.
Depending on where in the Highlands you are, I may be able to give you some things to say to the NHS Helpline to get you seen quicker!

If you're still having difficulties just send a PM.
 
#5
Given he is from some London PCT, I doubt if they are remotely interested in the Highlands or anywhere else for that matter. No doubt another tick box exercise to be shown to be taking an interest.
Try asking the DEfence Medical Services in Whitehall.
 

Fang_Farrier

LE
Kit Reviewer
Book Reviewer
#6
Well given that he asked "So does anyone have any thoughts about veterans and the NHS in London, or ideas about how we can make things better for the armed forces community?"
I thought a little bit of what happens elsewhere might be relevant.
For the purpose of NHs work called benchmarking. IE what does everybody else do.
 
#7
It's always useful to know what's going on in other regions; access to dentistry always crops up as a key concern for military families. Although some of our evidence suggests that dentists are available, but getting the right information about availability is harder than it should be. Of course London's a slightly different animal than the highlands!
 
#8
What is the capability and funding of prosthetics? Currently a great cause of concern is the aftercare of veterans once they have left the service.
 
#9
The NHS in England is committed to matching the quality of prosthetics provided by the DMS; that's not to say this isn't a big challenge, most NHS organisations provide prosthetics to elderly, unfit patients, and aren't used or set up to cater to the young, fit patients from the military. The funding isn't the problem, but getting the message to front line clinicians about what they should be doing for veterans takes a while to filter through.

Again in London we're not sure how many veterans this affects, and haven't received any complaints related to prosthetic provision.
 
L

Lechies

Guest
#10
Hi,

My name’s Dom, I work for NHS London, the body that oversees the NHS in greater London. We’re running a project to assess what the armed forces community (including veterans and families) thinks about NHS services for veterans in London, from Primary care and dentistry to mental health. We’ve got a few ideas but there’s no point us coming up with something without talking to you all first. So does anyone have any thoughts about veterans and the NHS in London, or ideas about how we can make things better for the armed forces community?
Not from London, but my view of the NHS is pretty dim, after waiting 2 years for a reversal of a procedure that eventually the NHS coughed up perhaps wasn't the best way forward, they've now knocked an operation that was meant to happen in march back 6 months because of swine Flu, I'm sick to ******* death of the NHS, bunch of *****, the lot of you.
 
#11
The NHS in England is committed to matching the quality of prosthetics provided by the DMS; that's not to say this isn't a big challenge, most NHS organisations provide prosthetics to elderly, unfit patients, and aren't used or set up to cater to the young, fit patients from the military. The funding isn't the problem, but getting the message to front line clinicians about what they should be doing for veterans takes a while to filter through.

Again in London we're not sure how many veterans this affects, and haven't received any complaints related to prosthetic provision.
The current agreement is to maintain the prosthetics, there is nothing in place to say they will be replaced after their 5-7 year life span. The message to front line clinicians is simple in thi case - soldier has a prosthetic that requires replacing, there is nothing to think about the effort has already been done by Headley Court.
 
#12
The current agreement is to maintain the prosthetics, there is nothing in place to say they will be replaced after their 5-7 year life span. The message to front line clinicians is simple in thi case - soldier has a prosthetic that requires replacing, there is nothing to think about the effort has already been done by Headley Court.
My understanding is that we're committed to maintaining AND replacing prosthetics to at least the same quality as DMS ones. I think (not an expert) that certain prostheses (C-legs) require the patient to be very physically fit, so after seven years a patient may not be able to maintain fitness to use a replacement C-Leg so they get then next best thing; again this replacement should be as good as anything DMS provides.

Agree that the message is simple, but persuading clinicians to take it on board isn't always easy.
 
#14
Given the recent White paper and the demand for cheaper alternatives, I would not expect the DMS standard to even enter the equation. With the Salami slicing of the NHS prior to it's privatisation, the post code lottery will soon (2013) feature in what you can or can't have.
It's all about bean counting these days. Just watch for the ward closures and new independent treatment centres hiking off all the juicy work and leaving the more costly proceedures in NHS hands
 
#15
My understanding is that we're committed to maintaining AND replacing prosthetics to at least the same quality as DMS ones. I think (not an expert) that certain prostheses (C-legs) require the patient to be very physically fit, so after seven years a patient may not be able to maintain fitness to use a replacement C-Leg so they get then next best thing; again this replacement should be as good as anything DMS provides.

Agree that the message is simple, but persuading clinicians to take it on board isn't always easy.
There is no next best thing to a C-Leg, I asked this very question of the leading prosthestist he replied that for a double, above knee amputee it is a c-leg or wheelchair.

You do have to be fit for a C-leg, but that is fit as in civvy terms, (I.E not a 95yo granny or 30 stone lardy) and not military terms (I.E tabbing round Afghan with a 50kg load.

A C-Leg costs £17,500 in component form a civvy company will charge in the region of £47k per leg for fitting, often more than 1 pair will be required.

The budget of one PCT prosthetics dept was £2.1m for 1800 patients. Headley has spent over £400m on approx 250 patients in the last couple of years. This does not include facilities maintenance and HR requirements.

How is a PCT going to explain to a patient who lost his legs in a traffic accident that he's only entitled to douglas bader specials whilst the bloke opposite is trying on the latest iron man upgrade? I thought treatment was all about clinical need.
 
#16
Perhaps Dom needs to merge his various threads.
Clinical need and budgets don't mix. Clinicians do what's best, bean counters say what is affordable, making GPs do both will lead to tears and a mixed bag of treatment
 
#17
It would be good if injuries caused through service could be "Fast tracked" in the NHS. I have problems with trapped nerves in my back from stupid nag riding and partial deafness from tanks. I didn't have any problems with the nerves as my local hospital (West London) sorted me out fairly quickly.
I do understand it could be very hard to work it out, as a lot of problems don't show themselves straight way and / or most squaddies don't always report problems to their Medical centre when they happen.

If there were more benefits to have served in the forces, it could also allow recruiters to raise the bar during the recruitment process as more may be interested. I know we do have the best army in the world, But it could save future standards from slipping.

Also veterans and their issues could be again graded - Amputees, long term health issues with breathing, or walking down to those who left without prblems, but still served.
 
#18
Veterans receive priority treatment when recommended for secondary specialist care if their injury or ailment is considered as a result of service.

Veterans should inform their GP of their service and explain why the injury or ailment may be as a result of service.
 
#19
Don't know if this is the right place to ask this, but I am an RGN, RMN with counselling cert and CBT cert. I would love to work with vets as I have an interest in PTSD but don't seem to be able to find an opening any suggestions?
 

Fang_Farrier

LE
Kit Reviewer
Book Reviewer
#20
Just for interest here's part of an email from a contact at the SVPA, though primarily dealing with dental treatment it should cover all other aspects of health care

"Thank you for your e-mail enquiry regarding dental treatment arrangements.
May I firstly explain that once service personnel leave the forces, the NHS has a responsibility to provide basic healthcare for their needs. This also applies to their need for dental treatment.
War Pensioners who are issued with a Prescription Exemption certificate can obtain free NHS supplied medication prescribed by their doctor to treat their accepted condition(s). It does not cover all conditions, or treatment required.
However, if special dental treatment is required due to the War Pensioners accepted disability(s), Article of 21 of the Service Pensions Order gives the Secretary of State discretionary powers to assist with these costs if they are not covered under other UK legislation.
In order to consider the re-imbursement of your patients costs, prior approval must be sought from the Service Personnel & Veterans Agency(SPVA) Treatment Group before the treatment begins by applying to this office.
Please ask your patient to contact the SPVA (address below) with full details of the work to be carried out, and approximate costs. We will then assess the request and a decision will be issued as soon as possible, with instruction on how to proceed if appropriate.
I hope this answers your question and gives you some background, but if I can help any further please"
 

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