Armed Forces Personnel and Veterans Health Joint Group’s Implementation Group: progress update letter – November 2019

Letter to the Strategic Oversight Group detail progress made by the Implementation Group towards Strategic Oversight Group priorities for 2019 to 2020.

I refer to your letter of 25 May 2019 where you set out the priority areas that members of the Armed Forces Personnel and Veterans Health Joint Group’s Strategic Oversight Group (SOG) had selected for progression by the Implementation Group (IG). 

The IG has met twice since its inception and I am pleased with the dynamics of the group, the level of experience and knowledge its membership brings and their enthusiasm for effecting positive change for the Armed Forces and Veterans community. To enhance the experience, we have added to the membership with the recent inclusion of Sharon Callaghan, Operations Manager within the MOD’s Defence Primary Healthcare for Scotland.

I am pleased to report progress against the priority areas set out in your letter:

Wheelchairs – national guidance

The IG tasked Dr Mike Dolan, Head of SMART Services at the Astley Ainslie Hospital, to set up a “task and finish” group on reviewing national guidance, working in partnership with Steve Burton of BLESMA, to achieve parity in service provision, comparable with other technology such a prosthetics.  Mike provided recommendations to the IG’s October 2019 meeting, which were agreed.

Mike will establish a short life working group to:

  • commission a review of the eligibility criteria, funding arrangements, performance and quality ambitions and criteria, and remit of the NHS Wheelchair & Seating Services in Scotland by end December 2019, to report back to the IG in June 2020
  • oversee the widening of the Specialist Prosthetic Service remit to include wheelchairs for veterans, by December 2019
  • ensure that the recommendations of the short life working group are implemented in sufficient time to allow access to funding for the provision of wheelchairs by the start of the 2020/21 financial year and report back to the IG by June 2021

In addition to asking Mike to proceed with these recommendations, members have fed back to him that they would like wellbeing to be taken into account, in acknowledgement of the mental health impact of loss of mobility and limb loss. In the longer term, members will be interested to see an independent impact assessment with service users.

Managed Clinical Network

Following the necessary approvals process, the National Veterans Care Network (“the Network”) gained formal approval in September 2019.  NHS National Services Division resource is in place and the team are actively working on the structure and remit of the Network, engaging with stakeholders to ensure it reflects the diverse nature and needs of the veterans population.  I have met Kate Burley of NHS NSD who is leading the development and officials are working closely with Kate and her team.

The Network will be a National Strategic Network, ensuring it considers the breadth of veterans healthcare needs both clinical and non-clinical, with a wide pool of statutory and non-statutory providers.

NHS NSD recently presented to the NHS Armed Forces and Veterans Champions Network on their work to date and to invite Champions to work collaboratively on the structure and remit of the Veterans Network.

Kate Burley will present progress to the IG in January 2020 and it is intended that the Network will be formally launched in April 2020.  In the longer term, we are considering whether the Veterans Network should have permanent representation on the SOG or IG.

Hearing Aids

You will recall the issue that veterans were encountering when receiving replacement hearing aids when their MOD aids had expired.  A letter was sent out jointly from Adrian Carragher, Head of Audiology Services, University Hospital Ayr and myself, to all Audiology departments in Scotland, setting out the expectation that Boards take a “like for like” approach to the replacement of veterans hearing aids, and affirming the service and support they are expected to provide for veterans. No issues have been raised so far but Adrian is seeking feedback from a Head of Service Group, and IG members have agreed to seek feedback from service users to measure whether the letter has been effective.

Priority Treatment definition

Following our discussion at the SOG about the definition of Priority Treatment within the Armed Forces Covenant the Department of Health and Social Care have convened a pan-UK working group on the subject. The group has met twice and Scottish representatives are David McArthur, NHS Armed Forces and Veterans Champion for Orkney; Neil Morrison, Executive Secretary of the Veterans Scotland Health Pillar Group and Karen Stock, patient representative.  SG officials have also participated.

Scotland is actively involved in this working group, most recently taking a proactively directive approach to outcomes.  A recommendations paper will be put to the MOD / DHSC / Devolved Administrations Health Partnership Board on 19 November 2019.

Although the work of this group satisfies the direction from the Strategic Oversight Group, members are mindful that there will be implications for them with regard to messaging and communication, and are keen to begin this once a Partnership Board decision has been reached.

Veterans First Point – future of service

Funding continues until March 2020 and officials are pursuing funding options beyond that.

Developing a Champions Network

Since May 2019, we have provided two network events to provide NHS Armed Forces and Veterans Champions with information and development on areas of mutual interest, encouraging the sharing of good practice and providing the opportunity to make and build connections within the cohort.  We have conducted two surveys of the Network to measure success and feedback has been very positive. We will continue to engage in this way to ensure future events meet Champions’ needs and the SG is able to tap in to the valuable local knowledge they hold, enabling us to better understand the healthcare experience of veterans on the ground.

Veterans Aware Hospital Accreditation

We have made use of the Champions as an expert group and Ian Donnelly of the Veterans Covenant Healthcare Alliance recently presented to the Network on the Veterans Aware Hospitals accreditation programme, seeking views on our ambition for every NHS Board to buy in to the programme in the next 12-18 months.  Accreditation would mean Hospitals meeting and maintaining standards such as staff being educated in veteran’s needs, the hospital identifying veterans to ensure they receive appropriate care and making links to local veteran’s services.  Champions see the benefit of accreditation and have asked to see some case studies from accredited hospitals in NHS England before committing to progress.  We will bring this back to the Network shortly.

The IG will next meet in January 2020 where further progress will be made.  I look forward to presenting this to the SOG in May 2020 and to working together on new priorities.

Jason Leitch

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