The GP and the Veteran

military veteran with family

27 September 2019

Brigadier Robin Simpson RCGP Veterans Champion

Have you ever asked yourself how many veterans are part of your GP practice? Are military veterans a special patient group? Through toolkits and an accreditation scheme the RCGP is working to address issues related to specific health needs of ex-military patients.

A veteran is anyone who has served who has served for at least one day in the Armed Forces (Regular or Reserve). There are 2.4 million UK veterans in Great Britain, making up 5% of the population (about the same number as diabetics). 89% of veterans are male and 60% are aged 65 and over.

Veterans are often associated with post-traumatic stress disorder (PTSD). While those who have been deployed are slightly more likely to have PTSD, overall the incidence is broadly equivalent to that of the general population. More common issues for all veterans include other mental health problems, such as anxiety and depression, and problems related to alcohol. Divorced and separated veterans are significantly more likely to report suffering from depression and anxiety related disorders.

Ex-military personnel should face no disadvantage when accessing health services

Serving in the armed forces is an overwhelmingly positive influence for most military personnel. They learn many skills that allow easy transition back into civilian life. However, while serving, they may develop physical and mental health problems, subsequently requiring help from a health professional. Knowing that a patient is a veteran will help doctors meet the health commitments of the Armed Forces Covenant, which means ex-military personnel should face no disadvantage when accessing health services and should receive priority care for military attributable conditions.

Recognising that veterans have specific medical needs is the first step to providing healthcare to this group of patients. The RCGP has produced a Veterans' Healthcare Toolkit containing guidance on how to manage veterans’ healthcare needs as well as advice on how to care for patients who may have been affected by their service careers.

The toolkit covers:

  • the duty of the NHS to the armed forces community, including the Armed Forces Covenant
  • services for veterans, provided by NHS and other groups
  • how to request a patient’s service medical records.

Veteran Friendly accreditation being rolled out across England

The RCGP is working alongside NHS England to accredit practices as ‘Veteran Friendly’. This is a simple process where practices are required to meet specified criteria and provide evidence that they are supportive of veterans’ healthcare.

To receive accreditation a practice is required to:

  1. Ask patients registering with a surgery if they have ever served in the British Armed Forces.
  2. Code it on the GP computer system, using the term ‘Military Veteran’.
  3. Have a clinical lead for veterans in the surgery. This should be a registered healthcare professional but could be a nurse or paramedic instead of a GP.
  4. Eligible practices should normally have a CQC ‘good’ rating or higher.

After a successful pilot in the RCGP Midland Faculty, the programme is being rolled out nationally across England. This work is fully supported by the Government and the Defence Select Committee. There are now more than 300 accredited GP Veteran Friendly Surgeries across England, and the RCGP is also working with the devolved nations to extend the programme. This is a voluntary initiative; but the College encourages practices to sign up as a veteran friendly practice.  

Now that you are more aware of the health needs of veterans, how about including in your consultation the question “have you ever served in the Armed Forces?” This one question is likely to link the patient’s symptoms with the underlying aetiology.

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