1. MEDICALLY ASSESSING THE ROYAL FLEET AUXILIARY SEAFARER
3/28/2017
MEDICALLY ASSESSING THE ROYAL FLEET AUXILIARY SEAFARER
GRAEME NICHOLSON
Cons OM Navy Command HQ
SHARON KITWOOD
Occupational Health Nurse RFA
Sharon intro

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This presentation expresses the views of the speakers and not necessarily the policy or views of the MoD
And we must say this

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Sharon structure and who the 2 ‘idiots’ in bold are

4. Who are we? 16 ships (11 post SDSR) 2,300 personnel
3/28/2017
Who are we?
16 ships (11 post SDSR)
From 10,000 to 41,000 tonnes
2,300 personnel
Medical Technicians on all ships
RN MOs when deployed or on long passages
RFA ARGUS (dormant hospital) – RN MO plus RN Medical Assistant
Sharon on who we are
Stress that post SDSR there will still be a very large requirement for RFA to support a potentially even more widely dispersed RN
Medical Technicians allow us to cover for emergency medicine, Occ health and the military aspects of the role - damage control, fire-fighting and casualty handling
Background of the medical technicians – mix of military and civilian personnel

5. Personnel MOD civilians 2300 unionised employees
3/28/2017
Personnel
MOD civilians
2300 unionised employees
Deck, supply, engineers, communicators, force protection
Average age 42 (officers) 39 (ratings)
107 females (4.6%)
Average length service 10 years
Home base worldwide
Sharon on numbers
Still have comms personnel due to the requirements of military signal traffic
They need to have their eyesight standards assessed on the same basis as engineers (discussion with Dr Carter for the summer MCA newsletter in 2009)
Force protection teams go onto ships deployed into certain areas e.g. Gulf and Somali basin to provide close in weapons support for self defence. Mostly drawn from RNR
Personnel with mixed civilian and service backgrounds
Some of our seafarers live in Thailand, Australia, America, You can be assured that when something catastrophic happens, the individual will reside thousands of miles away.

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What do we do?
Keep the RN at sea by supplying fuel, spares, food, equipment e.t.c
Vert-rep and helicopter operations
Counter-piracy operations
Disaster relief
Boarding operations (drug-busting)
Support Mine-counter measures vessels & submarines
Land Royal Marines to a hostile beach
Self-defence and damage control
Graeme on what and how

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Graeme

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Graeme

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Graeme

10. Why are we different? Deploy to conflict areas and disaster zones
3/28/2017
Why are we different?
Deploy to conflict areas and disaster zones
Fire-fighting roles and training
Damage control and CBRN
Aviation operations
Must be able to operate like the RN as well as with the RN
Graeme

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Fitness for Sea
Fitness standards based on holding an in-date, unrestricted ENG1 medical certificate
Restricted certificates can be tolerated for limited periods.
May use any appropriate AD.
In house ADs post illness / injury and for problematic cases
Primary care from civilian GPs
Emergency and urgent care as well as OH from RFA and RN
Sharon
Can you discuss how limited ENGs cause personnel difficulties
Also where our in house Ads are and when / why we would use them instead of a seafarer returning to their previous AD.
Raise GPs and medication supply problems and see if we can get any good ideas from the floor on how others resolve this problem

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Fitness for Sea
If landed then can be medically evacuated back to UK via RAF system
Med Techs produce letters for GP
Plans to produce end of tour GP note
RFA OH Nurse follows up those landed or reporting illness with GP / Specialist
Sharon

13. Working Patterns 4 months at sea, 2 months leave
3/28/2017
Working Patterns
4 months at sea, 2 months leave
Then either back to sea or courses
Shift patterns at sea are different for different ranks and trades
Sharon
Can you stress that we effectively lose medical control of the seafarers for the 2 months away and that they may have health problems, operations e.t.c. without our knowledge and often without teling us.
Can you give some examples of courses and of the shift patterns at sea, indicating that there are some evolutions that may need off shift personnel stood to.

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Graeme

15. Joining OH Screen Every time seafarer joins a ship.
3/28/2017
Joining OH Screen
Every time seafarer joins a ship.
Height, weight, bp, urinalysis, ENG1, PMH, medications', allergies and lifestyle.
If considered unfit after medical advice, landed from the ship
Total medical discharges in 2009 – 132
Aero-medivac 32
Own way passage 90
Graeme

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Joining OH Screen
Failures at OH screen reported to RFA OHN and Navy Command Medical HQ
Problems with ENG1 also reported
Discrepancies between ENG1 and seafarer’s medical state reported to MCA.
Graeme

17. Common Problems Reported
3/28/2017
Common Problems Reported
Untreated hypertension
Urinalysis – blood, protein and sugar
Unresolved illnesses / injuries
Obesity (and unfitness)
Inadequate medication supplies
Graeme

18. Fitness Testing The RN fitness test:
3/28/2017
Fitness Testing
The RN fitness test:
Timed 1½ mile run (age & gender related pass times)
Shuttle run (Multi-stage fitness test)
1 mile walk with time, weight and heart rate changes fed into a VO2 max calculation
Consideration given to whether RFA should introduce these test.
Graeme to lead into Sharon

19. Healthy Living Campaign
3/28/2017
Healthy Living Campaign
Introduction on 1 Jan 11.
Menus marked with fat, sugar and calorie content
Encouragement to exercise and lose weight (ship-board gyms and PT)
Sharon – background to Campaign the details of plan
Ship-board provision of exercise equipment

20. Healthy Living Campaign
3/28/2017
Healthy Living Campaign
BMI and waist circumference at OH screen.
Cardiac risk calculated against NICE guidance
Those at v high risk considered for landing by CO (until lose weight)
Sharon continued
Can you say something about the support we might be able to offer for personnel who are landed?

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Any questions?