Veterans Health

#1
I left the radc after 13 yrs six months ago and I'm now a snr manager for a northern primary care trust. One of the directors approached me yesterday asking for my input into the rollout of war-pension services to veterans of recent campaigns (but not NI for some reason - trying to find out why!).

Any way I now find myself in a position where I can influence the provision of services. Apart from the need for priority on hospital waiting lists and appropriate mental health care can any members advise on services they think we should look into?

Many Thanks

AF
 

BiscuitsAB

LE
Moderator
#2
Aquafresh said:
I left the radc after 13 yrs six months ago and I'm now a snr manager for a northern primary care trust. One of the directors approached me yesterday asking for my input into the rollout of war-pension services to veterans of recent campaigns (but not NI for some reason - trying to find out why!).

Any way I now find myself in a position where I can influence the provision of services. Apart from the need for priority on hospital waiting lists and appropriate mental health care can any members advise on services they think we should look into?

Many Thanks

AF
how about prosthetics and from a selfish point orthotics. unfortunately a significan number of the lads coming back from afghan need artificial limbs and as I'm sure you already know the damm things break and also the sockets need attention and often resizing sue to muscle wastage.

from my own perspective I'm lucky enough to have artificial limbs but do have to get my shoes made cause im a spac. and getting either shoes or new inserts seems to take an age.

On a forward planning basis I think that investment in the area of hearing loss is a definate must, there is going to be a massive requirement for care and aid in that area, my own lad has had his hearing shot to blazes in a permanant way after two tours of Afgahn.
 
#3
"On a forward planning basis I think that investment in the area of hearing loss is a definate must, there is going to be a massive requirement for care and aid in that area, my own lad has had his hearing shot to blazes in a permanant way after two tours of Afgahn."
Biscuits AB, agree with you on that one, been out for 19 years now and even now get tinnitus as do most of the guys who were in at same time, some even worse than tinnitus. So that is one area, as well as mental health, I think there will major problems in the near/middle to long term.
 
#5
I think priority is required to be given for treatments for qualifying conditions provided by anyone contracted to provide services for the NHS, and is not limited to that provided directly by salaried NHS employees ?

Your PCT might therefore usefully look at independent practitioners, dental or GP medical, where some of the delays arise, to ensure they give priority to Veterans - at least to assess whether their conditions relate to Service. As Dentists will not know the conditions of most potential registrants before assessment, therefore Veterans should be seen immediately to assess !
 
#6
Not related to enemy action but is due to 23 years wear and tear, I left the mob recently and I was undergoing some excellent treatment at Headley Court which I was told the end result would be surgical intervention, this has suddenly stopped and Ive heard nothing from them since the end of June.
Is it normal to be dropped like a hot stone during treatment as soon as you leave?
 

elovabloke

ADC
Moderator
#7
Filbert Fox said:
Not related to enemy action but is due to 23 years wear and tear, I left the mob recently and I was undergoing some excellent treatment at Headley Court which I was told the end result would be surgical intervention, this has suddenly stopped and Ive heard nothing from them since the end of June.
Is it normal to be dropped like a hot stone during treatment as soon as you leave?
In my experience this is the case and you will have to start all over again with your GP. And try telling him you’re a priority case.
 
#8
Filbert Fox said:
Not related to enemy action but is due to 23 years wear and tear, I left the mob recently and I was undergoing some excellent treatment at Headley Court which I was told the end result would be surgical intervention, this has suddenly stopped and Ive heard nothing from them since the end of June.
Is it normal to be dropped like a hot stone during treatment as soon as you leave?
Hope you're enjoying retirement FF -- time to put your feet up! :D

The following is the FAQ page from the MOD Vet site:

UK Vets FAQ's

Given FF's situation, could I suggest that the communication of what is availble and how the systems in place "mesh" together is made clearer and easily available to all stakeholders, in particular, those that the service is designed to treat?

As an example, and having been through this loop, would somebody from ARRSE like to draft an "Overview" of mental health services in relation to military service and an explanation of how the CMT / NHS CMT / GP's and Combat Stress pass information and patients to each other, with a couple of simple flow-charts - indicating routes and desired outcomes through the system?

This is not a bleat - but I don't think I am the only one who is unclear on this area. It also strikes me that many GP's are confused in how to best treat / refer vets.
 

elovabloke

ADC
Moderator
#9
ABrighter2006 said:
This is not a bleat - but I don't think I am the only one who is unclear on this area. It also strikes me that many GP's are confused in how to best treat / refer vets.
You have a good point. My GP is an EX RAF doc who, due to bizarre circumstances was the doc who diagnosed by problem back in the late 80's and he is clueless on how to get me back in the system snell like.
 
#10
Ah, not only me!

I think part of this, is the referal mechanism, and the need for "who" does the referring.

The other concern that I have here is the time-delay resulting from this bouncing around, and therefore the delay in treatment. A realistic expectation of how soon, a vet goes from GP's consulting room, to sitting in front of somebody who really knows what he / she is doing in relation to experience / expertise is required and should be available nationally. A sort of Soldier's Health SLA?

If it were not for advice given to me throuh ARRSE from The Monstar earlier this year, I would still be attending "Happy Club" every Thursday afternoon. So cheers Mons! :)
 
#11
would have been nice to have been told, all I was told was that Id get a referral very soon because they really needed to get it sorted before I left!
 
#12
guys,

Suggest - if you have access - get onto ArmyNet and post these in the CGS site that Hitback has been running with - there is a SO1 who is extremley good at putting these issues to CGS
 
#13
GP3_Bunny said:
guys,

Suggest - if you have access - get onto ArmyNet and post these in the CGS site that Hitback has been running with - there is a SO1 who is extremley good at putting these issues to CGS
Thanks GP3 - I no longer have access - perhaps if you do, you could do the honours?

Given the "spotlight" which the closure of dedicated facilities / NHS responsibilities for mil pers has, there should be a clear set of instructions available to all. If such a blueprint does exist, then it is yet another example of pizzpoor communication of the message.

It is too easy at present for individuals to be "lost in the system" whilst the most arcane systems try to talk to each other. The worst of this, is that with effective information management and communicatations, more vets would get better quicker.
 

elovabloke

ADC
Moderator
#15
ABrighter2006 said:
GP3_Bunny said:
guys,

Suggest - if you have access - get onto ArmyNet and post these in the CGS site that Hitback has been running with - there is a SO1 who is extremley good at putting these issues to CGS
Thanks GP3 - I no longer have access - perhaps if you do, you could do the honours?
AB I suggest you get your self access which I managed without to much problem. As GP states the SO1 who links into the thread is making things happen.

ArmyNet
 
#16
ABrighter2006 said:
Filbert Fox said:
Not related to enemy action but is due to 23 years wear and tear, I left the mob recently and I was undergoing some excellent treatment at Headley Court which I was told the end result would be surgical intervention, this has suddenly stopped and Ive heard nothing from them since the end of June.
Is it normal to be dropped like a hot stone during treatment as soon as you leave?
Hope you're enjoying retirement FF -- time to put your feet up! :D

The following is the FAQ page from the MOD Vet site:

UK Vets FAQ's


Given FF's situation, could I suggest that the communication of what is availble and how the systems in place "mesh" together is made clearer and easily available to all stakeholders, in particular, those that the service is designed to treat?

As an example, and having been through this loop, would somebody from ARRSE like to draft an "Overview" of mental health services in relation to military service and an explanation of how the CMT / NHS CMT / GP's and Combat Stress pass information and patients to each other, with a couple of simple flow-charts - indicating routes and desired outcomes through the system?

This is not a bleat - but I don't think I am the only one who is unclear on this area. It also strikes me that many GP's are confused in how to best treat / refer vets.
I'm a TA psych nurse (was on Herrick recently) and an NHS Commissioner in MH services. The two largest problems in the NHS are the lack of suitably trained/experienced individuals to carry out therapies (me in my trust and my Herrick boss in the next door trust, and I'm not a full time clinician now) and lack of info from the military once people have left. I'm also in a northern PCT.

This may be a conversation to have via personal mail, then I can give you my thoughts properly!
 
#18
From the Office of David Nicholson CBE
Chief Executive of the NHS in England
12 December 2007
To: Chief Executives of Primary Care Trusts
Chief Executives of NHS acute and mental health
trusts
Chief Executives of NHS Foundation Trusts
Copies: Chief Executives of Strategic Health Authorities
Richmond House
79 Whitehall
London
SW1A 2NS
Tel: 020 7210 5142
Fax: 020 7210 5409
david.nicholson@dh.gsi.gov.uk

Dear Colleague
Subject: ACCESS TO HEALTH SERVICES FOR MILITARY VETERANS
This guidance updates and extends existing guidance on priority treatment for
war pensioners – HSG(97)31. From 1 January 2008, all veterans should
receive priority access to NHS secondary care for any conditions which are
likely to be related to their service, subject to the clinical needs of all patients.
Action
Primary Care Trusts – to ensure that GPs, in making referrals for diagnosis or
treatment, are aware of the current priority treatment provisions and of their
extension to all veterans who have a condition that is likely to be related to
their service.
Acute and mental health trusts, NHS Foundation Trusts – to ensure that
clinical staff are aware of HSG(97)31 and its extension to all veterans, for
conditions which are likely to be related to their service, subject to clinical
need.
Background
Under long-standing arrangements, war pensioners are given priority NHS
treatment for the conditions for which they receive a war pension, subject to
clinical need. Current guidance on this is HSG(97)31. This guidance states
that NHS hospitals should give priority to war pensioners, both as out-patients
and in-patients, for examination or treatment which relates to the condition or
conditions for which they receive a pension or received a gratuity, unless
there is an emergency case or another case demands clinical priority.
There are about 5 million veterans in England (a veteran is defined as
someone who has served at least one day in the UK armed forces).
Research shows that for most members of the armed forces, service is a
positive experience, allowing them to enjoy a more favourable life trajectory.
Some veterans do, however, have service-related health conditions. There
are about 170,000 veterans who receive war pensions (or another form of
compensation) as a result of a service-related condition, and who therefore
have eligibility for priority treatment under the NHS for their service-related
condition. Other veterans will have received a lump sum gratuity rather than
a pension because the degree of disablement caused by service is relatively
minor: they too are eligible for priority treatment for service-related conditions,
as are veterans who have an assessed degree of disablement cause by
service but to whom no award is paid.
Some service-related health problems do not manifest themselves until after
a person has left the armed services. Claims may be made for a war pension
at any time after service termination. Hull Teaching PCT has recently
extended priority access to the NHS to all military veterans, for service-related
conditions, where a healthcare professional suspects that a veteran’s
condition may be associated with their military service.
Extension of current guidance
The Hull approach represents good practice and should be followed
nationally. Where a person has a health problem as result of their service to
their country, it is right that they should get priority access to NHS treatment,
based on clinical need. They should not need first to have applied and
become eligible for a war pension.
It is recognised that, with much faster access to NHS treatment for all
patients, the priority treatment provisions are less significant than they were.
Nevertheless, there may be occasions where a veteran could benefit from
priority access. It is suggested that veterans are mostly likely to present with
service-related conditions requiring:
• audiology services - the guidance on priority treatment for war pensioners
applied also to service-related noise-induced hearing loss which is
accepted as caused by service but for which no award was paid because
the level of disablement fell below the threshold for compensation. Lack
of clarity about this group’s entitlement to priority treatment in the past
may mean that there will be some backlog coming forward now. In
addition, there will be future groups of veterans for whom hearing loss
may be an issue.
• mental health services – veterans sometimes do not seek treatment for
service-related mental health problems until some years after discharge.
It can be particularly difficult establishing whether a condition is due to
service and its implication for treatment. Clinicians may be interested in
the recently launched veterans’ mental health pilots and the Ministry of
Defence Medical Assessment Programme at St Thomas’ Hospital in
London which provides a free assessment for veterans with operational
experience since 1982: information about both can be found at
www.veterans-uk.info.
• orthopaedic services – because of injuries during a person’s time in the
armed forces which begin to present problems some time after discharge.
Next steps
GPs are therefore asked, when referring a patient that they know to be a
veteran to secondary care for a condition that in their clinical opinion may be
related to their military service, to make this clear in the referral (as long as
the patient wishes the referral to mention they are a veteran).
Where secondary care clinicians agree that a veteran’s condition is likely to
be service-related, they are asked to prioritise veterans over other patients
with the same level of clinical need. But veterans should not be given priority
over other patients with more urgent clinical needs.
It is for clinicians to determine whether it is likely that a condition is related to
service.
The extension of priority treatment to veterans should apply to new GP
referrals from 1 January 2008. Except in exceptional circumstances, the
change should not apply to anyone who has already been referred to
treatment or who is already undergoing treatment, as to prioritise them at this
stage could affect other people who have already received dates for
appointments. In addition, it would not be appropriate for secondary care
staff systematically to ask patients whether they are veterans suffering from a
condition that they believe is related to their military service. It may however
be that veterans will raise with clinicians the fact that they believe that their
condition is related to service, and then it will be for the clinician to decide
whether priority should be given to their case.
It is important to note and make clear to patients that a veteran who has a
disorder recognised as qualifying for priority treatment does not necessarily
fulfil the criteria for award of war pension. Where a GP considers that a
condition is likely to be due to service and it is significantly disabling, then
they could suggest to the individual to apply for a war pension since there
may be entitlement to a pension or gratuity and to other benefits such as free
prescriptions.
Veterans who are not war pensioners will not have the same access to free
prescriptions etc that war pensioners receive.
Veterans are able to use the NHS complaints system in the same way as war
pensioners to resolve any breakdowns in the arrangements for priority
treatment.
Equality issues
Historically, the make up of the armed forces has not been representative of
the population: in particular, many more of the armed forces are men than
women, and this impacts on the proportion of veterans who are men. In
addition, disabled people cannot join the services as they are not expected to
be able to meet physical and other selection requirements.
The proportion of members of the armed forces who come from ethnic
minorities and the proportion who are women have increased in recent years,
and the armed forces have active equal opportunities policies. These policies
will in due course impact on the relative proportions of different groups who
are veterans.
If you have any queries about this letter, please contact
jane.allberry@dh.gsi.gov.uk.
Yours sincerely
David Nicholson CBE
NHS Chief Executive
 
#19
I hope you do not mind but I have copied your post as it is very helpfull.

One question I have on this. If you recieve a lump sum for your condition because it is assessed below the 20% are you still a priority if you need treatment for that condition.

For those interested and not in the know, there is an interesting thread developing on Vets matters on ArmyNet. Unfortunatly it's not in the Vet area yet.
 
#20
As there are email contact detials in the script, could I suggest you contact them and Cc it to War Pensions at Blackpool.
And if you really want to put the cat amongst the pigeons, sent it to your local MP as well!

I suppose in reality, it all depends on your condition / disability and how it effects your everyday life?

However, if you DON'T ask, you will not know, all the best and lets us know on here, as this i am sure will help others :D
 

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