1. Scotland’s Health Commitment to the Armed Forces, Their Families and Veterans 4 th October 2011 Sir Andrew Cash Co-Chair MoD/UK Departments of Health Partnership Board Military Health & Veterans

2. MoD/UK Departments of Health Partnership Board Priorities for the Partnership Board Governance Armed Forces Covenant Transition to NHS Care Veterans Mental Health Murrison Prosthetics Review Support to NHS Reservists

3. Military Health & Veterans MoD / UK DH Partnership Governance 1. Partnership Board: cross government & administrations 2. Working Groups – People & Services (incl. DAs) 3. Joint Executive team 4. NHS Armed Forces Network (England & DAs) 5. DH England Strategic Partners Programme (3 rd Sector) 6. Regional Armed Forces Forums (England & DAs) MoD / UK DH Partnership Board NHS Armed Forces Network Regional Military Commands Services Working Group People Working Group Joint Executive Regional Forums

4. Military Health & Veterans Armed Forces Covenant: Key Principles The Armed Forces Covenant preserves and extends the key principles of the Service Personnel Command Paper: No disadvantage in the provision and continuity of public services Minimise the social and economic impact of military life Positive measures to enable equality of outcome Special treatment for the injured & bereaved as a proper return for sacrifice

5. Military Health & Veterans Armed Forces Covenant: Health Commitments The Armed Forces Covenant announcement including Health recommendations for Armed Forces community: – Same standard of / & access to healthcare – Maintenance of NHS waiting list place when moved – Care of those injured in service – Access to Mental Health professionals with Armed Forces awareness

6. Military Health & Veterans Transition to NHS Care Transition to NHS Care for Seriously Injured - Essential steps to ensure continuity of care MOD Team need to identify receiving health authority at least 3 to 6 months prior to medical discharge MOD Case Coordinator must establish contact with case manager for receiving authority A Joint Care Plan drawn together by Defence Medical Services and NHS providers together with the 3 rd Sector, Veterans Welfare Services and Local Authorities as appropriate to the case. We need to avoid this…………

7. Military Health & Veterans Transition to NHS Care The Cliff-Edge Concern Level of Care In - Service Discharge Post - Service

8. Military Health & Veterans Veterans & Families Mental Health NHS England Progress Feb 2011: Mental Health Strategy: “No Health without Mental Health” including commitment on veterans Mar 2011: Combat Stress 24hr mental health helpline (operated by Rethink) for veterans and families launched: – Over 3,000 calls to date Jun 2011: NHS Veterans’ Mental Health Capability: An uplift in the number of mental health professionals conducting veterans outreach, assessment and referral work in partnership with leading charities: – e.g. in support of Tedworth House veterans hub from 29 June with Combat Stress & H4H

9. Military Health & Veterans Veterans & Families Mental Health NHS England Next Steps Sept 2011:Trial of the Big White Wall online early intervention service for serving personnel, veterans and families (including RBL bereavement advice) – www.bigwhitewall.com – Note: free access already in place for the Armed Forces, families and veterans, 200 AF community users to date Sept 2011: Launch of E-Learning package for GPs in partnership with the RCGP Nov 2011: National Veterans Mental Health Clinical Network in partnership with the MoD & leading charities – open to professionals from the Devolved Administrations

10. Military Health & Veterans Veterans & Families Mental Health NHS Services Next Steps Nov 2011: Dr Murrison MP - first evaluation against the Fighting Fit recommendations & report to Ministers April 2012: A Veterans Information Service (VIS) to be deployed 12 months after a person leaves the Armed Forces 2012: Annual Armed Forces Covenant report to Parliament – subject to Armed Forces Bill

11. Military Health & Veterans The Armed Forces Covenant Veterans Health Veterans Prosthetic Services – Murrison Review The review gathered evidence on the current and future needs of veterans for prosthetics services, and on the provision and cost of services. It also looked at: – the future funding of high specification, evidence-based prosthetics services within the NHS and the possible contribution of personal health budgets and the inclusion of these in continuing healthcare arrangement – how regional variations in service can be minimised; – how the transition from the armed forces’ prosthetics care to the NHS can be improved; and – the role of service charities in helping to meet the realistic needs of individuals over and above that which the NHS can provide.

12. Military Health & Veterans The Armed Forces Covenant Veterans Health Veterans Prosthetic Services – Murrison Review The review was delivered to SoS Health, SoS MoD & Prime Minister on 30 June 2011 Estimated cost of around £15M over next 4 years Ambition to develop a series of specialist prosthetics centres across England and the Devolved Administrations – Import key intensive rehabilitation lessons from Headley Court – Develop close clinical and professional links – Backed up by evaluation and standards development work There are challenges: – The money / consistent service / overseas care / equalities

13. Military Health & Veterans Support to NHS Reservists Government has identified need to increase number of reservists NHS reservists provide vital services to the Armed Forces In return, the NHS gain staff with broader skills and wider experience It is essential that reservists are treated consistently by the NHS – despite the pressures on resources

14. Military Health & Veterans Military and NHS Care – challenges for all Ongoing Issues Quality & availability of receiving services – Social care – Continuing healthcare – Prosthetics – Mental Health services – Medical records / registration Establishing responsible commissioner Expectations management – difficult for individuals and families Confusion of clinical responsibility / temporary registration

15. Military Health & Veterans Working with Key Delivery Partners and many others….

16. Military Health & Veterans Further information: Contacts DH Military Health Programme: doh.armedforcesnetworks@nhs.net www.armedforceshealthparthership.org.uk The Team Dave RutterJane Bracey Caroline Pease Rob Moorhead