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A veteran is someone who has served in the armed forces for at least 1 day. There are around 2.6 million veterans in the UK.

The health needs of military veterans can differ significantly to those of other patients, it's highly important for continuing healthcare to tell your GP that you have served.

The NHS has a duty to deliver on a number of health commitments in relation to the Armed Forces community which are set out in the Armed Forces Covenant and the NHS Constitution.

The Armed Forces Covenant
  • The Armed Forces community should enjoy the same standard of, and access to healthcare as that received by any other UK citizen in the area they live.
  • Family members should retain their place on any NHS waiting list, if moved around the UK due to the service person being posted.
  • Veterans should receive priority treatment for a condition which relates to their service, subject to clinical need.
  • Those injured in service should be cared for in a way that reflects the nation's moral obligation to them, by healthcare professionals who understand the Armed Forces culture.
Visit the Armed Forces Covenant for more information.

The NHS Constitution states 'the NHS will ensure that in line with the Armed Forces Covenant, those in the Armed Forces, reservists, their families and veterans are not disadvantaged in accessing health services in the area they reside'.

Veterans' Mental Health Transition, Intervention and Liaison Service (TILS)
This is a dedicated out-patient service for serving personnel approaching discharge from the Armed Forces and veterans who are experiencing mental health difficulties. The TILS provides a range of treatment, from recognising the early signs of mental health problems and providing access to early support, to therapeutic treatment for complex mental health difficulties and psychological trauma. Help may also be provided with housing, employment, alcohol misuse and social support.

The service comprises three elements:
  1. Transition: service for those in transition, leaving the armed forces The service works with the Ministry of Defence (MOD) to offer mental health support for Armed Forces personnel approaching discharge.
  2. Intervention: service for veterans with complex presentation Service personnel approaching discharge and veterans will have an assessment within two weeks of a receipt of referral. Where appropriate, the TILS will aim to see patients two weeks after this. This will be with a clinician who has an expert understanding of Armed Forces life and culture. They may also be supported by a care coordinator who will liaise with other services and organisations to ensure a coordinated approach to their care.
  3. Liaison: general service for veterans Patients who do not have complex presentations, yet would benefit from NHS care, will be referred into local mainstream NHS mental health services where they will receive treatment and support.
If an assessment finds that an individual has significant mental health difficulties that are service related and have not improved with previous treatment, they will be referred to their local CTS.

Veterans' Mental Health Complex Treatment Service (CTS)
This is an enhanced out patient service for ex-forces who have military related complex mental health difficulties that have not improved with previous treatment. The service provides a range of intensive care and treatment that may include (but is not limited to) support for drug and alcohol misuse, physical health, employment, housing, relationships and finances, as well as occupational and trauma focused therapies.

Access to the CTS is via the TILS. This ensures that any previous treatment and support has been considered. Once referred to the CTS, the service aims to see patients for their first appointment two weeks after this. They will be supported by a military aware team who will develop a personalised care plan with them, which will include arrangements for crisis care.

Access to both of these services is through the TILS. GPs and patients can contact the service direct for a referral: Veterans Trauma Network (VTN)
Following feedback from veterans, their families and GPs, NHS England has worked with the MOD and key military charities to launch the Veterans Trauma Network, which provides care and treatment to those who have been injured during their time in service.

Located in ten major trauma centres across England (Plymouth, Oxford, London (three centres), Birmingham, Nottingham, Liverpool, Leeds and Middlesborough), the network links with the TILS, CTS and key military charities to provide a complete package of care.

Veterans can be referred to the service by their GP, Blesma, Blind Veterans UK or Style for Soldiers, where they will benefit from specialist care by military and civilian experts in trauma.

Patients using the service will have a personalised treatment plan that links to other services where required, such as rehabilitation and mental health, whilst families and carers will be supported to access services they may benefit from.

For more information or to refer a patient, email england.veteranstraumanetwork@nhs.net
 
Prosthetics
A veterans' prosthetics programme was put into place to implement the key findings of A better deal for military amputees report by Dr Andrew Murrison MP.

Dr Murrison recommended that a small number of NHS disablement centres should provide specialist prosthetic and rehabilitation support to veterans to ensure that they continue to have access to high quality care similar to that which was provided to them whilst they were in the Armed Forces. The following nine Disablement Service Centres (DSCs) were selected to provide this support although veterans are free to attend the NHS DSC of their choice:
  • Bristol – Bristol Centre for Enablement, North Bristol NHS Trust
  • Leicester – Leicester Specialist Mobility Centre, provided by Blatchford Clinical Services on behalf of clinical commissioning groups (CCGs)
  • Sheffield – Mobility and Specialised Rehabilitation Centre, Northern General Hospital
  • Carlisle – Disablement Services Centre, Cumberland Infirmary, North Cumbria University Hospitals NHS Trust
  • Preston – Specialist Mobility & Rehabilitation Centre, Lancashire Teaching Hospitals NHS Foundation Trust
  • Stanmore – Stanmore Prosthetic Rehabilitation Unit, Royal National Orthopaedic Hospital Trust
  • Portsmouth – Prosthetic Regional Rehabilitation Department, Portsmouth Hospitals NHS Trust
  • Birmingham – West Midlands Rehabilitation Centre, Birmingham Community Healthcare NHS Trust
  • Cambridge – Addenbrooke's Rehabilitation Clinic, Cambridge University Hospitals NHS Foundation Trust
Mobility equipment support
The Royal British Legion has a Veterans' Mobility Fund, which provides specialist wheelchairs, orthotic equipment and other mobility related items for veterans who have a service related serious physical injury and whose needs cannot be met through statutory services. Eligibility for the fund requires the condition to be attributable to service and typically applicants will be in receipt of a War Pension or relevant award under the Armed Forces Compensation Scheme. To find out more, visit the British Legion website.

The Armed Forces Healthcare Navigator Service
The Defence Medical Welfare Service (DMWS) provides emotional and practical support to the Armed Forces community when they are on a health care pathway, receiving treatment in hospital, community based health care, or at home. 

Assessing, identifying, and addressing welfare and wellbeing issues that are a barrier to recovery or good health and wellbeing, DMWS work with the individual, their family, carers, and health and social care partners, to find solutions and provide onward supported referrals to other organisations for services beyond the scope of DMWS intervention. 

DMWS' professional and expert medical welfare service evidences reduction in delayed transfers of care, reduction in frequent attendance at A&E, enables independent living, reduces social isolation, improves wellbeing, and provides a coordinated, holistic approach to accessing the right support, in the right place, at the right time

Veterans can be referred to DMWS or can contact DMWS directly. For more information, visit Defence Medical Welfare Service website.

More information
Further information on NHS services for veterans can be found on the NHS website.
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