Veterans, Reservists and Armed Forces Families Health Needs Assessment

Why Focus on the Military Community? Increasing public interest in Serving members since Iraq and Afghanistan but needs of veterans, reservists and families less well understood Appreciation that there are specific challenges of Service life Influence of national reports and strategies: Fighting Fit, a Mental Health Plan for Servicemen and Veterans 2010 (The Murrison Report) The Armed Forces Covenant 2011 The Chavasse Report 2014

Armed Forces Covenant The Armed Forces Covenant is a promise from the nation that those who serve or have served, and their families, are treated fairly. The covenant’s 2 principles are that: -the armed forces community should not face disadvantage compared to other citizens in the provision of public and commercial services - special consideration is appropriate in some cases, especially for those who have given most such as the injured and the bereaved.

Armed Forces Community Covenant The community covenant encourages local communities to support the armed forces community in their area and promote public understanding and awareness.

Health Needs Assessment A systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalities A Veteran: Anyone who has served in HM Armed Forces at any time, irrespective of length of service (Ministry of Defence) A Reservist: Anyone who is registered as a reserve in the Armed Forces, but is not currently on active duty Military Family: The spouse or partner of a serving person, plus any dependents. More broadly, any members of a family or household unit who experience the impact of Service life of a serving member of the Armed Forces

Veterans, Reservists and Armed Forces Families Health Needs Assessment Two key steps: Describing the veteran, reservist and Armed Forces families population Identifying their health and healthcare needs  Not straight forward due to lack of routinely collected data

Describing the Veteran, Reservist and Armed Forces Families Population Veterans: Extrapolations of national data Pension and Compensation scheme data Service leavers data Primary care records Reservists: Permanent home addresses Armed Forces Families: Service pupil premium Children’s Centres’ numbers Families Federation data

Veterans in Hampshire Extrapolations from national data: A total of nearly 60,000 veterans living in Hampshire Around 40,000 of these are likely to be over 65 years old Around 10:1 males to females Compensation and Pension Scheme data: Around 25,000 receive a pension (AFPS or WPS)

Number of Veterans Receiving Armed Forces Pensions by District District All Armed Forces Pension Scheme (AFPS) All War Pensions Scheme (WPS) All Armed Forces Compensation Scheme (AFCS) Basingstoke and Deane1, East Hampshire1, Eastleigh Fareham3, Gosport4, Hart1, Havant2, New Forest1, Rushmoor1, Test Valley2, Winchester1, All21,3704,9351,605

Veterans in Hampshire The population of veterans in Hampshire is mostly elderly and suffer with isolation and mobility problems Musculoskeletal problems are a common health issue and veterans are also more likely than the general population to have sensory problems The most common mental health problems are anxiety and depression, but some will suffer with complex problems that require specialised help Only a small proportion of general practices routinely ask patients about their veteran status when they register with a GP Many of the needs of the ex-Gurkha population will be similar to those of the general veteran population, but they have some specific issues often relating to difficulties accessing services

Reservists in Hampshire There are at least 1256 reservists with permanent home addresses in Hampshire Reservists tend to be older and have higher educational attainment than regular personnel The health needs of reservists are likely to very similar to the general population Deployments can result in a feeling of isolation sometimes resulting in risky behaviours

Armed Forces Families in Hampshire Very little data on numbers and locations of Armed Forces families National data: Suggests 32-70% Serving personnel are married Service Pupil Premium: Around 5,000 Service children in schools in Hampshire Survey of Children’s Centres: At least 1,000 families with children under 5 years old

Armed Forces Families in Hampshire The issues of deployment and mobility can result in: Isolation and mental health problems Relationship difficulties Psychological welfare of children Disruption to schooling Other issues of transition  Some of the potential disadvantage that Armed Forces families may experience as a result of their Service life has been mitigated by actions taken in response to the Armed Forces Covenant

Summary of recommendations Please note that the following slides are a only a summary of some of the recommendations. For a full copy please reference to the full Health Needs Assessment Document.

Recommendations: Mental Health Better identification of mental health problems related to Service, by increasing awareness of the ways in which they might present and ensure that veterans receive the treatment that is most appropriate for them and their mental health problems

Recommendations: General Practice Help GPs to better understand the communities they are serving and to recognise and identify veterans, reservists and Armed Forces families

Recommendations: Children & Families Raise awareness of the Service Pupil Premium in schools to that uptake of it increases Continue to work with Children’s Centres to support Armed Forces families

Recommendations: Gurkha Population Influence all partners to better understand the health needs of Gurkhas and some of the difficulties with accessing services

Recommendations: Transition Work with the CCGs and MOD to improve the transfer of notes so that continuity of care is maintained Work with employers to improve understanding of the needs of reservists

Recommendations: Armed Forces Covenant Fund Encourage partners to submit applications for the Armed Forces Covenant Fund for projects around 4 priorities: –Veterans’ Gateway –Families in Stress –Improving local covenant delivery (for Local Authorities) –Community integration / delivery of local services For more information about the grants: For more information and help with applications contact Hampshire Community Support Team

Summary The exact numbers and locations of veterans, reservists and military families is hard to estimate but there are a significant number in Hampshire, especially in Rushmoor Many of their health and healthcare needs will be the same as the civilian population but they do also face specific challenges The health and wellbeing of veterans, reservists and military families in Rushmoor and Hampshire can be improved by work in key areas: –Mental health –GP practices –Children and families –Gurkha population –Transition

Schools For further information - please access the PDL website to see past copies of Supporting Service children briefing sheets /pdl/understanding-pdl/supporting- service-children.htm

Schools Contacts:- Glyn Wright County Inspector/Advisor Personal Development Learning (PDL) Safeguarding E & I lead, Pupil Premium, Service Children support and CiC Inspector (East) HIAS, Education and Inclusion, Children's Services Department, Hampshire County Council

Contacts Hampshire Community Support Team Melissa Juniper – Team Jenny Wilford – Partnership Officer, Veterans, Military Families and Annette Lindsay – Partnership Officer, Gurkha/Nepali and Foreign &