Support for veterans and the armed forces community: 2019

Update: Healthcare Including Mental Health

Achievements

Scottish Veterans Commissioner Report

The Scottish Veterans Commissioner’s (SVC) report ‘Veterans Health and Wellbeing – A distinctive Scottish Approach’ has been the focus of our policy delivery since it was published in April 2018. The Commissioner’s progress report in May 2019 shared our view that good overall progress is being made and provided further impetus as we head towards implementation of the more complex recommendations.

The Commissioner’s reports are our main drivers to delivering better health outcomes for veterans and armed forces families ensuring they do not experience disadvantage when accessing health services in Scotland. The recommendations help us to deliver what is important to individuals and their families, and to foster continuous improvement.

We are working with stakeholders, NHS Armed Forces and Veterans Champions and through the refreshed Armed Forces Personnel and Veterans Health Joint Group to ensure we create the conditions for achieving the ‘Distinctive Scottish Approach to Veterans Health’. 

Collaborative Working

We actively participated in cross-border networks through the MOD/Department of Health (DH) Partnership Board and a number of sub-groups. A meeting of the MOD/DH Partnership Board was held in Scotland in November 2019. We have strengthened relationships with UK Government counterparts at policy level and we have used these links to engage with the Welsh Government on their priority care media campaign. In 2019 we have been key in the inception of a cross border working group on the definition of priority care. 

The Armed Forces and Veterans Health Joint Group also includes a Local Authority Champion and a third sector representative to help strengthen cross-agency links in health.

The Armed Forces and Veterans Health Joint Group 

The Armed Forces Personnel & Veterans Health Joint Group (AFPVH JG) brings together NHS Champions, representatives of the Service community, veterans organisations, Scottish Government officials and other stakeholders. Refreshing the structure, role and remit of the Joint Group has been a priority over the last year, as it is central to delivering a number of the SVC’s recommendations. In December 2018, the Chief Executive of the NHS approved a new structure for the Joint Group, consisting of a Strategic Oversight Group and an Implementation Group. The Strategic Oversight Group met for the first time in May 2019 with the Implementation Group meeting in June 2019. The Strategic Oversight Group set priorities for the Implementation Group, such as hearing aid provision and to review the guidance on wheelchairs.  These groups will drive progress forwards on our commitments to meeting the health needs of Armed Forces personnel, veterans and their families.

Scottish Veterans Care Network

The Scottish Veterans Care Network was approved in September 2019 by NHS National Services Scotland. It will be a National Strategic Network which will address a number of current issues, including access to specialist services such as Veterans First Point and mainstream services, awareness of veterans needs amongst health professionals and veterans data, with an expectation that it will allow sharing of good practice and expertise, as well as adding to the resilience of existing services. A key objective and early priority for the network will be the development of a Veterans Mental Health Action Plan, ensuring it complements Scotland’s 10 year Mental Health Strategy and veterans have parity of care, no matter where they live in Scotland. Additionally the Action Plan will link to key strands of the Mental Health Strategy including work on suicide prevention.  

NHS Inform

Ensuring that Veterans have sufficient information on where to access support, the Scottish Government has worked with Veterans Scotland and NHS24 to update online information about veterans health services on NHS Inform. In March 2019 NHS Inform, based on feedback, made comprehensive adaptions to the content and the way it was presented, to ensure that the information is as helpful as possible to veterans.  A toolkit to complement the updated information has been produced for organisations who support veterans, and was distributed to all organisations who gave feedback.  

Certificate of Vision Impairment 

The Scottish Government has worked with Scottish War Blinded (SWB), Veterans Scotland and other relevant sight loss and veterans charities, to update the guidance for practitioners responsible for certifying people as sight impaired or severely sight impaired, to ask if the patient has ever served in the Armed Forces. If so, to direct the veteran to the free services and support provided by Scottish War Blinded. The patient information leaflet that accompanies the Certificate of Vision Impairment (CVI) Scotland form, also includes contact details for SWB.

NHS Champions

Two network events were held in 2019 for NHS Armed Forces and Veterans Champions, encouraging the sharing of good practice and providing the opportunity to make and build connections within the cohort. We will continue to provide these events on a regular basis, evolving the content to meet Scottish Government and Champions’ priorities. Champions are also represented on both elements of our Armed Forces Personnel and Veterans Health Joint Group, which is critical to the strategic oversight and governance of policy development. 

Veterans First Point Network 

The Scottish Government and six local health boards continue to fund jointly the Veterans First Point Network which offers a one stop shop for Veterans no matter their need. The Scottish Government has provided £1.6 million over 2018–19 and 2019-20. Discussions around funding beyond 2019-20 are ongoing.

Specialist Mental Health Services

The Scottish Government in partnership with NHS Scotland and Combat Stress are committed to provide funding of £1.4 million per year until 2021 for the provision of a range of specialist and community based services for Veterans resident in Scotland. 

Veterans Health Data

NHS Information Services Division (ISD) Scotland have been tasked by Scottish Government to establish routine data transfer of information about veterans from MOD to ISD so that these can be linked and compared to health and social care datasets held by ISD Scotland such as mental health, social care data, hospital waiting times, A&E, drugs and alcohol. These linked datasets can then be used to evidence and inform services on improvements and outcomes for veterans living in Scotland; and to ensure that veterans access to services and health inequalities do not differ in comparison to the general population.

Case Study

Veterans First Point 

Bill engaged with V1P as he was struggling with his mental health and felt overwhelmed by circumstantial and past issues both related to his military career and personal life.  

He found himself ruminating whether his life had any sense and feeling crippled by guilt and depression. He decided to ask for help through a friend who found V1P services beneficial and agreed to be assessed and then seen by the clinical team; his peer support worker also helped him to access different services (Citizens Advice Bureau, Scottish Association for Mental Health etc.). He underwent psychological therapy where he focused on regaining motivation and kick starting a new career as he chose to think about the future rather than the past. 

He decided to get back into study and applied for a course through the Open University which offered funding for veterans, he also engaged with a V1P psychiatrist who reviewed his mental health and medication regime liaising with his GP to best attend his needs. Bill helped V1P in interviewing candidates as part of a service users panel and at the end of the treatment/engagement with V1P he reported feeling his situation is much improved and found motivation and meaning to get involved in his own development as a professional. 

Case Study

Scottish War Blinded

Royal Air Force veteran Del Tulloch survived a life-threatening stroke in January 2018, which left him in a wheelchair and with significant sight loss. Del, 75, of Inverness, was told he would not survive the night when his stroke hit – but after eight months in hospital the determined veteran is fighting back.

The grandfather-of-three became a member of Scottish War Blinded – a charity who support veterans in Scotland with sight loss, no matter the cause – while he was still in hospital. A Scottish War Blinded Outreach Worker and the charity’s expert rehabilitation team worked closely with Del to establish what kind of support he and his wife Phyllis needed.

When he returned home, various specialist equipment – from talking clocks to magnifiers – was already there waiting for him, all provided by the charity free of charge. One particular electronic magnifier – a CCTV reader which magnifies onto a large screen – is helping the determined veteran to tie flies again on the road to regaining his life-long fishing hobby. He now also regularly attends Scottish War Blinded’s monthly Inverness lunch group with fellow veterans with sight loss and continues to receive regular home visits and support from the outreach and rehabilitation teams. 

Del said: “It makes me feel tremendous. It’s brilliant, the support I’ve had. It makes me feel like I’ve got somebody there if I need it.”