Armed Forces Personnel and Veterans Health Joint Group’s Implementation Group minutes: January 2022

Attendees and apologies

Attendees

• Jason Leitch, National Clinical Director, Scottish Government (Chair)
• Neil Morrison, Veterans Scotland, Health representative
• Ian Cumming, Third sector representative, Erskine
• Andrew Carter, NHS Borders Armed Forces and Veterans Champion
• Craig Cunningham, NHS Lanarkshire Armed Forces and Veterans Champion
• Lucy Abraham, Scottish Veterans Care Network
• Jo McBain, NHS Highland Armed Forces and Veterans Champion
• Alex Dunn, Person Centred Healthcare and Participation Unit, Scottish Government
• Annalena Winslow, Armed Forces and Veterans Healthcare policy team, Scottish Government
• Fiona Cameron, St. John and Red Cross Defence Medical Welfare Service
• Sharon Callaghan, Regional Clinical Director’s Operations Manager, MOD
• Maura Lynch, Trauma, Adverse Childhood Experiences (ACEs) and Resilience Team, Scottish Government
• Lindsey Restrick, Armed Forces and Veterans Healthcare policy team, Scottish Government (Secretariat)

Apologies

• Mairi McKinley, NHS Fife Armed Forces and Veterans Champion
• Martin Bell NHS Champion, NHS National Services Scotland, NSS

Items and actions

Welcome and apologies

Jason Leitch, Chair, welcomed members to the meeting. Apologies, as reflected above, were noted.

Scottish Government update

Lindsey Restrick provided an update on progress of the group’s priorities.

Jobs within the NHS

SG officials have recently re-engaged with SG Health Workforce colleagues and reconvened the employability sub group. This engagement was largely to take stock of what has been achieved under this priority and to explore what more could be done to embed this work, as there are separate but interlinked strands to this recommendation and it’s important that we ensure that the appropriate connections are being made and maintained. For example, the skills mapping tool that SCQF are working on will feed into the expansion of the veterans landing page on the NHS recruitment website and Health Workforce colleagues have a direct interest in the work that NHS Highland are exploring on an internship project for veterans. We are also engaging with the work that the NHS Academy is looking to develop with regard to the training and supporting veterans with employment into the NHS. 

NHS Fife pilot project

The paper that was taken to the Partnership board in July, around the proposal of code to be used, was accepted and there has been cross nation agreement on the use of this code. This means that the next steps in the planned pilot to a cluster of GP practices within NHS Fife can proceed. These are working with the project team and key stakeholders to understand the current processes in coding veteran patients. This process will help us to identify process improvements and address any challenges which may impede or improve the scalability the project to other Health Board areas when applying the agreed code. 

GP veteran accreditation

We have had constructive meetings with the accreditation scheme sub group and the Royal College of General Practitioners (RCGP) Scotland with regard to what would be required to develop user friendly, Scotland-specific content for this scheme. RCGP are due to produce a project proposal paper which will outline what will be required to develop and implement a Scottish scheme. Due to the differences in the healthcare landscape between Scotland and England, there will need to be changes to the accreditation process in operation in the English version of the scheme. Once this paper has been received, we will consult with the sub group. We have challenged the RCGP with developing metrics that balance demonstrating the success and value of the scheme and encourages practices to participate, while ensuring the certification process does not place a disproportionate burden on already stretched primary care services. 

Scottish Veterans Trauma Network (SVTN)

SG officials have begun to reach out to key partners and stakeholders to better understand and scope the Scottish health landscape and how a SVTN might operate within this. This includes extensive discussions with colleagues in NHS England to understand how the Veteran Trauma Network operates in other parts of the UK. A particular focus has been on the nature and volume of referrals and how these link with third sector and wrap around holistic services including mental health. Officials are conscious of ensuring that, where appropriate, this work aligns with and where possible integrates with ongoing projects such as the Scottish Veterans Care Network’s (SVCN) Mental Health Action Plan and its implementation and other existing or emerging networks and pathways. As such it may be worth noting that at this stage we are exploring what a wider Scottish Veterans Treatment Pathway might look like. 

Priority treatment

There is no update to this priority at this time. As a recap on the current status, the priority treatment terminology has not moved forward. UK colleagues require agreement from the Secretary of State for Health and Social Care to progress this and due to demands around the pandemic, to date it has been a challenge to find time to provide an update on the veterans’ health portfolio. The next meeting of the priority Treatment working group is scheduled for March 2022.

Discussion

Lindsey opened for questions. Jason commented that he thought that the group had achieved a lot, this sentiment was echoed by Neil. Craig suggested that the GP accreditation project link in with the Scottish General Practioners Committee (SGPC). Regarding jobs within the NHS, Jason mentioned that linking in with the Academy was a good idea. Discussion took place around the SVTN priority. Lucy advised that there have been meetings between the Scottish Trauma Network (STN) and the SVCN to discuss a way forward. Annalena commented that the provision that is developed to meet this priority should be holistic. Fiona concurred, that the service should be about integration rather than setting up parallel groups and adding additional layers.

It was agreed that the Scottish Veterans Trauma Network be an agenda item at the next meeting.

SVC report on annual evaluation of progress against recommendations

Annual progress against SVC recommendations

Jason highlighted the updates on the report and where positive progress had been made but where improvement could be made.

Ian queried how to achieve the implementation of some of the recommendations. Under the recommendation of ‘Access to life-long services’ he highlighted a current case that is extremely complex and issues around care costs and funding present a real challenge to providing progressive support. 

Members were asked to review the recommendations that were given the RAG status of amber to consider what more could be done to change the status.

Mental health and wellbeing action plan 

Lucy provided an update on the Mental Health and Wellbeing Action plan and advised that it has been published on the SVCN website. There has been positive endorsement of the principles behind the plan from veterans’ groups. The next phase is the implementation of the plan and this will involve ensuring that pathways will build on existing services and will aim to ensure an equity of access to services. 

From a Scottish Government perspective, Maura advised that the Minister for Mental Wellbeing and Social Care is taking an active role in this plan and is taking a debate in February, the date is still to be confirmed. There is an expectation that the debate will include a funding announcement. The plan represents an inclusive piece of work and has a focus on living well. The implementation of the plan will touch on Scottish Government wide policies. Annalena, on behalf of the Scottish Government, thanked all involved in the production for their contribution to the plan. 

AOB and date of next meeting

Neil raised a particularly sensitive and complex case that has been brought to the attention of Veterans Scotland. It was agreed that Veterans Scotland and the Armed Forces and Veterans Healthcare policy unit consider what support can be offered.

As the current SVC is leaving post in March, it was considered that the next meeting should be arranged to coincide with the new SVC coming into post for an introduction to the group, around Easter. Jason will meet the new SVC separately ahead of the next scheduled meeting of the Implementation Group.