National Heroes Service: GPs told ‘our veterans need you’

NHS chiefs have urged family doctors to enlist in a scheme improving care for thousands of armed forces veterans and their families.

GPs and their teams have been sent a comprehensive package of resources covering how to identify veterans and make sure their service is recognised by hospitals and other services, as well as how to access mental and physical health care tailored to their needs.

Those who support these important actions can become accredited as part of a growing network of Veteran Friendly GP practices.

The NHS Long Term Plan, published in January, will help to deliver a ‘National Heroes Service’ for veterans.

As the bed rock of the NHS, GPs will play a leading role in the expansion of new and current services to help armed services personnel transition back into civilian life.

Dr Jonathan Leach, NHS England Medical Director for Armed Forces and Veterans Health, said:“The NHS is committed to providing our veterans with the specialist care that they need, including high quality mental health support.

“GPs play a key part in helping us to support veterans adapt to civilian life, and it is therefore vital that they understand their particular health needs in order to ensure that they get the right treatment and care.”

The NHS Long Term Plan has a particular focus on improving NHS England’s mental health services for former armed forces members.

At the centre of the plans is a programme through which GPs and their teams can sign up to become a ‘veteran-friendly’ practice. Backed by NHS England and the Royal College of GPs, the Veteran Aware Accreditation scheme has already seen over 150 practices in the West Midlands become accredited, with hundreds more from across the country expressing interest in signing up over the next year.

The NHS’ aim is that every practice across England joins the scheme over the next five years.

The scheme enables practices to qualify to become an accredited GP practice if they meet the following criteria:

  • Have a lead for veteran’s issues within the surgery;
  • Identity and flag veterans on their computer system;
  • Undertake dedicated training and attend armed forces healthcare meetings, and;
  • Increase understanding of the health needs of veterans amongst both clinical and administrative staff.

The scheme seeks to ensure that every veteran receives the best possible care from their GP, regardless of where they live, and to support GPs and practice teams to ensure that ex-forces are fully aware of the dedicated help available to them.

Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: “Our patients who are veterans often have complex physical and mental health requirements, and their families may also need support with their own health.

I’m delighted to see so many GP practices already signing up to become ‘veteran friendly’, and making sure that those needs are properly flagged, considered, and accommodated as veterans readjust to and manage ongoing civilian life.

“A lot of the work to set up the scheme originated in the College’s Midland Faculty, of which I am a member, and I’m so proud of my GP colleagues for identifying such a good idea, turning it into a reality, and getting other practices involved on a national level.”

As well as improving the care offered by GPs, NHS England is expanding the Veterans’ Mental Health Transition, Intervention and Liaison Service (TILS), which launched in April 2017.

Serving personnel approaching discharge can now receive dedicated care and treatment for mental health difficulties before they leave the Armed Forces, with this continuing, where needed, as they transition to civilian life and beyond.

TILS is a dedicated community-based service designed to recognise the early signs of mental health difficulties.  It also includes help with alcohol and drug misuse, along with social support, such as advice on employment, housing, relationships and finance.

The service has already received over 6,780 referrals with work in progress to increase its capacity as part of the commitments of the NHS Long Term Plan.

Kate Davies, Director of Armed Forces Health at NHS England, said: “Local GPs have a vital role to play in improving healthcare for former armed forces members – from identifying and recording veterans, understanding their particular health needs, and knowing where they can turn for additional care and support.

“While the vast majority of veterans have similar levels of mental health to the general population, and as Mental Health Awareness Week draws to an end, it provides a timely opportunity to highlight the dedicated NHS services available for those ex-forces with mental health difficulties.”

Enhancements are also being made to the Veterans’ Mental Health Complex Treatment Service (CTS), which was launched in April 2018 for veterans who have military attributable complex mental health conditions. Available across England, the CTS provides an enhanced service for veterans whose mental health problems have not been resolved through earlier care, with over 640 referrals already received. Those accessing the service benefit from a range of mental health and social interventions, which may include (but is not limited to) support for substance misuse, physical health, employment, accommodation, relationships, finances, as well as occupational and trauma focused therapies.

Both the TILS and CTS have  made it easier for veterans to receive mental health care, as after engaging with ex-personnel and their families, these services focus on helping former service personnel closer to home, rather than requiring them to travel to centres for weeks at a time.

As families and carers can be impacted when their loved ones are unwell, the TILS and CTS support them to access support and treatment for themselves if needed ,as well as involving them, where appropriate, in care planning arrangements.

The vast majority of veterans have similar levels of heath to the general population.

However, the most frequent reasons to be discharged on medical grounds from the Armed Forces include health issues relating to back, knees, mental health and hearing.

Around 6.2% of veterans will suffer from post-traumatic stress disorder (PTSD), which is broadly equivalent to the incidence rate amongst civilians.

However, for those individuals who deployed when serving, rates of PTSD are higher at 9%, and up to 17% for those who deployed in a front-line, infantry combat role.

Other mental health issues include anxiety, depression and problems related to alcohol.