Why is BFAT a load of crap



My unit is depoying to the beach with no sea in the next few weeks, just had our ATD BFAT lesson/test. :mad:

What do you Medic/Nursey type people think of the little flip book? :-X :mad:

Why are Team Medic courses being binned, and why isnt my unit entitled to an RMA 3 anymore? :-/

Some units deploying with us are having advanced medical skills taught to them, but the medic who took our lesson, considers we dont need it (the medic aint coming with us by the way....)

ps any female nurses want to give me some one on one training........... ;) give me a shout.......
as a healthcare professional personally i think the book is a load of rubbish. The knowledge in it should be retained in a soldiers skull it was when I was first taught first aid at Guards depot. But given the inteligence or lack of it in many squadies its a good reminder.
Its designed for infantry in a contact or immediatly after a contact to keep someone alive till the coy medic gets on scene and unfortunatley to stop certain procedures starting on people who probably won't survive to role 1 med support ie ur R.A.P.  It was also shown in trials that attacks grind to a halt because soldiers try to do first aid at the sharp end with bullets still flying.
It gets very funny watching medical and nursing types doing BFAT as they will  argue with the instructors and try to go into BATLS/BARTS(British army tramua life support) mode .
As to scaling way above my pay scale to comment but as a gunner in a TA unit I did RMA3 even though there was no scaling for it at battery level and used the qual when not doing my primary job. As to team medic that was a very NI thing. The major problem now is becoming the medical/legal thing with the army medical directorate not wanting to be sued and I'm sorry to say a lack of trust that our superiors have in the abilities of the Team medics and non AMS medics.
They won't even train the CMT'S up to paramedic level which I think is ridiculous


BFAT is the natural progression by the AMS, in respect to medical training. I beleive its all to do with clinical governance- or who can do what to who medically. It's all about insurance and litigation- Doctors and Nurses are coverved by a civilian governing body who will say in court a Nurse or MO can do such and such and what standard.

Unfortunatley there isn't a Royal College of RegimentaL Medical Assistants and Combat Medical Technicians- or ever will be. And they cannot guarentee the treatment an individual casualty will recieve. So they downgrade the treatment to a flip-chart that is so basic; a black bin liner could carry out the task. Also the DMS still insist on having trades involved in steering policies who have little or no idea what RMA's or CMT's even do. And because of this the trades have been diluted to a point there is no point even being one- either be a MO or RGN- the world famous healthcare proffessionals! The AMS care about them but not the CMT or even less the RMA.

I have worked with RMA's who are an integral part of Battalion Medical Sp, in fact RMA's made better medics than the medics half the time.

May I just add in the next GW2, it will be the CMT and RMAs that will win the medical battle not some RGN who's bought a pair of Danners and thinks he or she is in Bravo 2 Zero.
have to agree with you in the first few minites after wounding is when the life will be saved.
Comming from an RMA background and now being a registered practioner I know only to well what the downgrading is all about.
But how can clinical governence be applied to a battlefield. I was ment to provide quality assurance and accountability in NHS hospitals.Its a bit like the health and safety legislation we will be expected to comply with.
But here is were the army will breach clinical governance and standard practice in that the first medical personnell on seen be that CMT or RMA will not be paramedic's.
Qman then maybe soldiers should now carry a st jhons ambulance or red cross public certificate or first aid at work certificate.
The only medical professionals that AMS care about are Doctors and Dentists.


For fcuk sake will you people just shut-up and stop making all medics appear to be a bunch of moaning wnakers.  Useless tossers exist in all trades and professions within the AMS, my experience is that it’s about pretty well equal between doctors, nurses CMT’s, MSO’s and uncle ‘Tom Cobbley and all.’  No one group is going to win the ‘medical battle’ whatever the fcuk that is.  Get something straight we are medics, we are not winning ‘battles’ that’s what our friends in the combat arms do, and very good they are at it too.  If you,…I… we… want some respect from the rest of the army (and by the way respect is something that brings some money and influence) lets all stop trying to pretend we are something that we are not and start to impress the rest of the Army by the high standard of professional care that we can provide.

PS. ‘Nurse’, for God sake will you learn some of the basic rules of English grammar and punctuation.  You don’t just embarrass the AMS but the whole of your profession.


I am not a moaning w*&nker, I have an opinion, and that is like an ar$ehole, we all have one. I make the point as a CMT who has seen the last 23 years that has seen the MA, CMT and RMA steadliy downgraded and eroded to a point of RGN's starting to being placed in Armoured Sections attached to Battlegroups. Nurses have a job to do and I am sure if you asked 80% of them, they would rather leave a 6 week depoyment in BATUS to the CMT who rather enjoys it.

Glue ear- If you READ  my post, I said the MEDICAL BATTLE- the treatment and evacuation, or return to the frontline of battle casualties. I am completely aware the Medics do not FIGHT! It's not our job! We have an Infantry for that!

Health and Safety requiremnts are repealled to a degree , by the Secretary of State for Defence in
Sect 20 of the HASAW Act 1974- i.e He signs to say the Armed Forces are exempt certain parts of the Act due the nature of conflict. The same should go with Clinical Governance- I am sure an Infantryman would rather be surviving to a Fd Hosp; than dying in a RAP because a RMA isnt allowed to carry out a life saving procedure.

Oh we would not get more money from 'The Army' if we were more respected, its not a popularity contest. We dont use Saachi and Saachi, to advertise us!We are not wearing shirts sponsored by The Sun.
Deploying QA's further forward I think is a great Idea.
IMHO they should be as far forward as the RAP working with the M.O. in an R.N.O capicity. It also means the QA's are forced to work with the big army.
Obviously glue ear you are in a field unit and not in DSCA or what ever its called now(something like dementia which it is) a whole orginisation designed to train Doctors.

As to my spelling and grammar this is a news goup its ment to be relaxed and fun.
Glue ear 'what is the medical battle?'

the phrases 'golden hour and platinum 15 minites' mean anything to you.

It will take longer than 15 minites for a casualty to get to role 1. So having Team Medics, RMA'S & CMT's who are well trained and should be BATLS/BARTS qualified in my opinion is essential. Good effective first aid by buddies near to point of wounding will also keep casualities alive long enough to reach role 1. Once into the chain it is a team effort between AMS and various agencies to keep them alive. The medical battle starts at point of wounding.


I sought to provoke a response and I'm glad that it has.  A few points of clarification:

1.        The concept of the medical battle.  Yes I do understand what you are getting at by using the phrase the 'medical battle'.  And I am very familiar with the time frames to treatment.  The point I am making is that the majority of those who are in the Combat and Combat Support arms find it silly when we use phrases like these.  To them its trying to imbue ourselves in some form warrior status that we do not have.  The respect people who know their job, do it professionally and don't try to bluff.

2.        My point about money is to do with funding of the AMS and the DMS more widely.  We have to fight our corner for the limited resources available within the defence budget and frankly we don't always do a very good job of it. This is in part due to the poor preparation medical service officers get for higher command and staff appointments.  But it also occurs because of a general lack of respect or perhaps more accurately the lack of value placed on the medical services.  This lack of respect is often stems from our being perceived as an organisation striven by internal.  

3.      As to the point on the status of CMT’s.  I quite agree that the status of the CMT has been eroded (whilst strangely range of skills has increased) and that this must be addressed.  One would hope that the proposed changes to the CEG would go some way towards this.  The issue is not should nurses or any other group be in the RAP or DS (now more correctly called the UAP and the CCS) but what should they be doing once they are there.  They ought to be adding value (which I believe they can do) not just taking over the job of the CMT.

4.      Clinical governance does not stop anyone doing anything.  What it does is stop people who do not have training in a particular skill from getting in over their head.  The reality is that audits carried out under the auspices of the various clinical governance processes are revealing that people simply don’t have the training to carry out many clinical tasks safely.  The issue then is to decide what to do about it.  Either we give more training or put in individuals who have the necessary wherewithal.  I agree that too often we have gone for the second option rather than upgrading those whoa are already there.

5.      Finally, I have served in field units, HQ’s, the DSCA (quite demented) and with the big army (doing non-medic jobs) well away from the AMS.  I have a fairly good idea how what the big army thinks of us right now and I’m afraid most of it is not good and they see it primarily as our own fault.  So are we going to stop infighting and put them straight?  The state of the medical services is as much the fault of the big army as the AMS.

One final point (and a bloody good argument I hope)….. could we go some way to stopping all this infighting by amalgamating the current 4 AMS corps into a Royal Corps of Army Health?


Glue Ear,

You must be the DGAMS, advocating the amalgamation of all the AMS Corps.

What a money saver that will be, all those RSMs and COs being cut- hey you should get an OBE- Other Buggers Efforts. No wonder, you worked with the grown up Army! Your expertise is sorely needed in our flagging DMS. (This is sarcasm- by the way)

The steering groups within the AMS at Camberley, are at present staffed with a QA HCA on the CMT steering committee and that doea not give me a warm fuzzy feeling- does it you?

At the end of the day clinical governance will control what a CMT and RMA will do, and we will have Armd Sect QA Sgts very soon. Rest in Peace the humble RMA! You will be sorely missed.



No it doesn't give me a warm fuzzy feeling especially.  But the point is does it matter who is heading the team.  What matters is:

1.  Do they have a thorough knowledge and wide experience of the AMS?

2.  Do they have a wide knowledge of the Army as a whole?

3.  Do they know who the subject matter experts are and are thy taking their advice.

The latest recruiting literature for the army states that we have some 143 CEG's.  I don’t think the CGS has trained in all 143, yet he is the man who heads up the organisation.

My main point is that in an organisation such as the AMS there are a lot of different trade groups with widely varying standards of trade training, practical skills and trade training.  There is considerable overlap; we all bring something to the party.  Why shouldn’t a nurse or a Dental Technician command a Sect within a Med Regt if they have the experience.  And this is the point, as you say most of them don’t and should not be appointed to section command.  I agree that CMT’s and RMA’s in particular are being pushed out, but why is this happening?  Its because of a lack of credibility when it come to clinical skills.  Don’t see clinical governance as a threat, something to beat you with, see it as an opportunity.  Use it as a tool to justify extra training and resources.  If clinical audits indicate that RMA’s or CMT’s don’t have a particular skill use this as you justification to get extra training.  Don’t sit back as so many CMT’s have done and assume it’s an argument you are always going to lose.  This goes back to my point about how the rest of the army sees you.  The truth is your average infantry CO will give you more respect if you are just an average (or even slightly below average) ‘soldier’ but a fcuking good asset as a clinician.  Yes, many of the QA’s and other non-CMT’s who may be attached to combat units are frankly poor ‘soldiers’ but they have more clinical skills than you applicable across a wider spectrum of operations.  The United States Marine Corps (USMC) went through similar arguments 25 years ago.  Their team medics won by becoming better soldiers, better commanders and but most importantly better clinicians.  In my earlier missive I mentioned how this can bring funding and influence.  Every USMC infantry section now has a team medic.  The latest tracked amphibious assault vehicle they have under development (entering service very soon) was built with space for the team medics kit and built into the chassis of each section vehicle from the design stage, not some afterthought after the assault sections kit had been put in.  The design allows him to treat casualties in the vehicle.  Can you imagine anyone on the IPT that is going to replace Warrior or the team working on FRES even giving this a first never mind a second thought?  This did not happen because the Americans are a bunch of casualty averse twats, or because they have got more cash than sense.  It’s because their medical services and in particular their Team Medics are respected for their professionalism and are seen as valued members of the team.  They did this by taking hold of their own CEG, getting better educated and raising the standard of people who became medics.  In particular they got away from the idea that some bloke who wasn’t quite making the grade as an Infantryman could be hived off to become the unit postie or the RMA.

Finally, rolling the AMS into one cap-badge would see very few jobs except for those who’s only real justification is that we have separate professionally based corps.  Do we need a matron in most units?  Provided there is a senior nurse who can provide professional advice isn’t that sufficient.  Of course this nurse could be the CO, Admin Officer, QM etc
Well glue ear I agree with alot of your points to the future.
first post:
1. the phrase 'medical battle' i think is quite consice and covers what its about.
2. Poor  funding will always be an issue and with the head of the service comming form 1 corps background then the funding will always go one way. As to staff officer development well who has time to do all the relevant courses not clinicians who are struggling to do what their respective professional bodies want. So are you arguing that it should be M.S.O's who command the corps? Or should we clinicians be allowed to go for staff courses and develop along a staff line? or are you an MSO who feels PQO's comissions aren't worth the paper they are written on(quote from a keogh instructor to a PQO course.)? I personally would like the opportunity to leave tha wards behind and go into an MSO type job.
The respect for the medical services has been declining for years and I have to say the MDHU debacle had exacerbated this. It is down right embarassing to constantly have to explain to soldiers that they're op has been cancelled because an NHS bed manager says we can't put him in one of our ward beds because there is a 90yo Psychogeriatric patient booked to goto theatre and the NHS side don't have a bed to put him in and because he's NHS he gets priority an will probably be in that bed 6 months later.
Medical services are like all logistic services who fade into the back ground in peace but come to the fore in war. There is nothing sexy and PR friendly about us except when we do disaster relief. We don't have the impact of say a new Tank. but when it goes wrong the army are screaming for us.
I would also say that the loss of military ethos in AMS hasn't helped. With quite senior officers putting forward the view that we should amalgamate with the NHS and forget about the deployment side of things.
3. The CMT is an area we need to sort out maybe we need to look at what the other services are doing the Naval Medical assistant has to operate to a much higher and more independent level than a CMT does. The CMT should be given a recognised qualification like Paramedic but should be able to work like a naval MA.
R.M.A's need to be saved and nurtured it is a very hit and miss job as it usually is a second qualification that the parent unit finds desireable not essential and would prefer the holder to concentrate on his primary trade eg rifleman etc.
Team medics or platoon level medics might be a way forward like the team medics they used in NI.
I remember a string on here looking at the RMA being rebadged RAMC and becoming a CMT if that was seriously talked about no wonder RMA 's are being looked at suspiciously by the big army and AMS.
The CMT/RMA should carry similar weight and both should be to naval Medcal assistant+paramedic levels with a BATLS/BARTS qualification as well.

4. Clinical governance is now the basis for most policies and standing orders in MDHU hospitals. Unfortunatley our needs differ from the NHS in some aspects we need staff to be able to preform certain tasks and procedureds. EG our HCA's canulate on exercise/deployment but are forbidden from doing it in MDHU's where they work most of the time. So staff in MDHU's are de skilling because of governance and NHS policy.

5. Army Medical services as 1 corps yes please should have happened at options for change. But it would need a clinical director and a personnell director well much like now. Over all It should be commanded by a staff trianed officer and a staff career pathway should be oen to all officers not just long coursers RMAS.
BTW can the beret be Grey with a cherry badge backing ;D and ROYAL ARMY HEALTH CORPS no  ARMY MEDICAL SERVICE would be fine.



First, an apology.  I was being a pedantic knob when I complained about your spelling and grammar.  Sorry.  And as I have discovered this application does some times change what you write.

Secondly, with regard to limiting what our HCA’s do.  This is essentially not a clinical governance matter, but one of perception and training.  Trust managers are afraid of the lawyers on this one.  Many hospitals employ phlebotomists and some even have cannulation teams who routinely change cannulae after a set time.  Many of those so employed are trained specifically in this task, with no previous medical training.  They receive specific training for the task in hand.  We need to be more robust in dealing with the trusts when we negotiate contracts.  By the way I have seen your comments elsewhere on the abuse of DMS staff by NHS Trusts.

Finally, don’t despair about staff training.  It is quite wrong to say that such training is open only to those who have attended RMAS.  MSO’s, MO, DO’s Vets and Nurses have all attended the Advanced Command and Staff Course.  


GE: Sorry a nurse could never be a QM, they aren't crusty enough, and  they come from a caring background! All my QM's have come from Belzebubs last fart gas!!! No disrespect to QMs whom I have served with as my Boss!

Nurse: You can forget the Grey beret for the AMSC as well!
NP glue ear.

As to HCA thing yep totally agree and having given top cover to HCA's in my ward to do bloods canula I think they are much better than the civvy teams who moan at what we do.
As to MDHU's we now have an excellent opportunity to pull the plug on them with most of AMS going to bucket and spade land why not close  them now.
Yes the clinical skills thing would work if we could release staff regularly to train and keep them current. but yet again demands of NHS mean MDHU oc's are reluctent to do this and juniors career development is being comprimised. The same is also true of the limited military  role we need to be able to carry out eg low level infantry work, living in the field, ITD's  and things to build unit cohesion and fittness like sport all sacrificed because of demands of NHS. By OC' s at all levels who don't want to upset the civvies and who just do as they're told by the NHS manager. Things like canceling post op tour leave because the NHS side is short staffed and the military have to cover the shortfall.
About the point of putting a nurse into an RAP as well as the full staff complement I think both sides would benefit.  I also think there is a great case for physios to be allocated to each regiment to work with MO and PTI to help rehabilitate injured soldiers.
The CMT/RMA issue will have to be looked at as to how it goes forward yes clinical skills need to be sharpened and having CMT's in field units constantly painting and packing boxes etc is a gross waste of training time. Maybe a look at providing BLUE light services with an ambulance service or covering a stretch of major motorway like the M25.
As to staff things giving Junior officers opportunities to develop as Junior officers as well as clinicians need to be looked at the EOC from what is being said by those on it the Sandhurst phase needs to be lengthened and the Keogh phase cut. As they are learning more at Sandhurst and more relevent things to.
Finally RMA's need to be encouraged not only with worthwhile qualifications but also with better support when they return to parent units with possibly more courses made available to them and opportuties to develop skills under supervision and with good consistant support.


I know of at least 2 nurses who went on to become QM's.  Neither liked to admit it too loudly, but yes they were cursty old Bastadrs!



I understand your frustration with having to work within the NHS.  But the reality is that we have to have some form of symbiotic relationship with them.  The real problem is the one size fits all solutions that we attempt to apply.

The Medical Officers have to train within the NHS and must, to retain their clinical skills, spend much of their career there.  But there is a problem with other healthcare professionals who cannot accept the order of magnitude step change between their training and that of doctors.  Put simply, doctors (as a collective group) have to be more intelligent and better educated than any other health care profession and must undertake a prolonged and arduous training.  For most hospital specialists this will last from the age of 18, when they enter medical school, to 36, the average age at appointment to consultant (the point at which they are deemed to be fully independent practitioners).  Please note that I am not a doctor but I can accept this reality for what it is, and I don’t feel belittled by this  

There is an important point here, all of the other health professionals within the DMS (yes including A&E and ITU nurses) could actually afford to spend a lot less time at the coal face in the NHS and yet still retain an acceptable level of skill to work with the field army on deployment.  Many non-doctors are horrified when it is suggested that they need less time in the diverse clinical environment of the NHS.  They want it both ways, to be in the Army full time yet not have to look after the decrepitly old.  And they want it both ways because then they don’t have to face the reality of the vast difference between doctors and the rest.  It insults both their professional and personal pride.

We have to accept that there is a difference and realise that what is best for the doctors is not necessarily best for the rest of us.  Then we must identify some way of decoupling the doctors from the rest of the AMS, allowing them to spend a far greater proportion of their career within the NHS without making them feel rejected by the rest of us who could afford to spend more time with the field army or in quiet ‘military hospitals.’ MO’s are key players; no doctors = no AMS.  

There are no cadres within the AMS which are fully manned and with a queue to get in, that is with one glaring exception; Physiotherapists.  Why is this cadre well recruited?  Simple, because they can expect to spend very large chunks of their career with soldiers - a young client group.  This may not provide the most diverse patient group to look after, but it is why they join and why they stay!  It’s because they don’t have to spend the majority of their career looking after the 75-year old plus patients like their colleagues working in the NHS.  So lets all swallow our pride and admit that for most of us we don’t need to spend every day in the NHS and accept admit publicly that this is because we are not in the same skill league as our MO colleagues.

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