Armed Forces Personnel and Veterans Health Joint Group’s Implementation Group minutes: June 2021

Attendees and apologies

Attendees

• Jason Leitch, Scottish Government Clinical Director of Healthcare Quality and Improvement (Chair)
• Neil Morrison , Veterans Scotland – Health representative
• Ian Cumming, Third sector representative: Erskine
• Mairi McKinley, NHS Fife Armed Forces and Veterans Champion
• Craig Cunningham, NHS Lanarkshire Armed Forces and Veterans Champion
• Sharon Callaghan, Regional Clinical Directors Operations Manager, MOD
• Martin Bell , NHS Champion, NHS National Services Scotland
• Hannah Cornish, Scottish Veterans Care Network
• Michael Ross, Armed Forces and Veterans Healthcare policy team, Scottish Government (Secretariat)
• Alex Dunn, Unit Head, Person Centred Healthcare and Participation Unit, Scottish Government
• Fiona Cameron, St. John & Red Cross Defence Medical Welfare Service
• Ally Forrester, Armed Forces Personnel and Veterans Unit, Scottish Government

Apologies 

• Andrew Carter, NHS Borders Armed Forces and Veterans Champion
• Claire Wood, NHS Highland Armed Forces and Veterans Champion
• Lucy Abraham, Scottish Veterans Care Network
• Annalena Winslow, Armed Forces and Veterans Healthcare policy team, Scottish Government

Items and actions

1. Welcome, introductions and apologies

Jason Leitch, Chair, welcomed members to the meeting. Members introduced themselves as some present were new to the group.

The apologies, as reflected above, were noted.

2. Scottish Government Update: 2021-22 Strategic Oversight Group Priorities & Discussion

Michael provided an update on the group’s priorities, that had been progressing since October 2020, and other related work.

Priority Treatment

The four-nation work on reviewing and revising the Priority Treatment terminology has been pushed back due to UK Department of Health Senior Leadership Team and Ministerial interest in the topic. We have heard that it is positive interest and have been informed we will hear more shortly when the Priority Treatment Working Group reconvenes.

Neil Morrison added that he welcomed the reference to Priority Treatment in the draft statutory guidance to the UK Covenant Legislation currently going through UK Parliament, as it resembled the suggestion previously offered by Scottish representatives in the Priority Treatment Working Group.

UK Armed Forces Covenant Legislation

Ministry of Defence (MOD) are in the process of running engagement sessions centred on the UK Armed Forces Covenant Legislation statutory guidance.

A request for volunteers to attend the MOD sessions was distributed to Armed Forces and Veterans Champions. The first Scottish cross-sectoral session took place on 24 June. A further session for Scottish Government (SG) officials will take place on 2 July.

The draft statutory guidance was also distributed to members of this group and NHS Armed Forces & Veterans Champions, with an optional request for feedback to be returned to Michael.

Craig Cunningham added that when the is bill passed, it may be worthwhile to contact NHS Boards notifying them of the new duty. Jason agreed, and suggested that a Cabinet Secretary letter could accompany passing of the legislation and distribution of the guidance.

Employability with NHS

The veterans webpage on the NHS Careers website, offering a range of support and information for careers in the NHS, went live last week. The launch aligned with Armed Forces week. There was a series of social media activity and publication of the career case studies to promote the NHS as a post-service career. It has involved positive collaborative work from our colleague at NHS Education Scotland, Careers Transition Partnership (CTP), the SG Health Workforce team, and others.

SG colleagues in the Health Workforce team have completed and collated the outcomes of the survey on veterans’ thoughts and perceptions of NHS jobs. This has already and will continue to inform their strategy moving forward. If useful, the paper featuring the survey results can be shared with the group.

NHS Fife Pilot Project

The pilot project centres on improving primary care clinical coding of veterans in NHS Fife. During the planning stage, the project team encountered difficulty with clinical coding for veterans. There is conflicting advice and potential IT issues with some codes. The project team are taking a paper to the MOD, Department of Health and Devolved Administration Partnership Board on 6th July which requests a cross-nation agreement and approach to reviewing the coding to gain clarity.

The project team are eager for a cross-nation approach as this aligns with other IT projects in this sphere. Officials have heard that there is cross-organisation interest in such a review. Once we have clarity on which code to use, planning for the pilot will re-commence.

Jason questioned whether these developments will impact the timescales of the project. Mairi Mckinley responded that it may be a long process, but clarity on coding is necessary if the project is to avoid issues further down the line. Michael added that at every opportunity he has been raising the prospective review and need for clarification with cross-nation colleagues and they have been receptive to it. It is hoped that any review will be straightforward and quick.

2021-22 New Priorities

Discussion then turned to new priorities and work areas set by the Strategic Oversight Group (SOG) in May.

Veteran Friendly GP Accreditation

Jason suggested a sub-group could be set up to take the Veteran Friendly GP Accreditation work forward, as had been previously suggested at the April Implementation Group. Neil Morrison, representatives from the Royal College of General Practitioners, and Martin Bell could be involved in the group. Mairi advised she is unable to take on further work, but will remain on the periphery of this work due to the links with the NHS Fife project. Alex Dunn and Michael will progress setting up the group.

Action: Secretariat to set up a sub-group to take forward the GP Accreditation work and provide an update at the next meeting

Scottish Veterans Trauma Network

There was a presentation on NHS England’s Veteran Trauma Network at the SOG. It had been agreed to explore setting up a similar network in Scotland, with the Scottish Veterans Care Network (SVCN) playing a key role, given their previous experience and links.

Jason suggested that SG officials and Scottish Veterans Network colleagues will have to work on the detail and logistics of this offline.

Hannah Cornish agreed that Kate Burley had attended the SOG and there had been agreement for SVCN to work on this.

Action: SG officials and SVCN to discuss the logistics of setting up a Scottish Veterans Trauma Network

Consideration of Scottish Veterans Commissioner’s focus on transition in upcoming reports

At the SOG in May, Charlie Wallace, Scottish Veteran Commissioner (SVC), had noted that transition would be central to his upcoming reports. The group discussed the relevance of this in relation to its work and priorities.

The group recognised that transition spans beyond health, into other policy areas, but key areas of the group’s work – such as the transfer of medical records from Defence Medical Service to NHS GPs – are linked to transition.

Mairi noted that Transition Officers had previously been in place, but was unsure if they were still active. Ian Cumming added that their work had paused, but had now resumed. Mairi added that there is also a Joint Service Publication on transition, which includes health.

Hannah added that SVCN also have a role to play as transition falls between many agencies.

Jason suggested that it had been a while since he had met up with the SVC, so he will meet with him to discuss his reports.

Action: Secretariat to arrange meeting between Jason and SVC.

3. Andrew Selous MP Report, Living in our Shoes

Ally Forrester gave a presentation that provided background and an overview of the Living in our Shoes report (also referred to as the “Selous report”). The report provides a review of services and support for Armed Forces and veterans’ families. Some of the recommendations focus on health. Ally’s presentation ended with a question on whether these health recommendations are best progressed by the Implementation Group. Jason thanked Ally for the presentation.

Jason questioned the relevance of this work for the group.

Martin Bell stated that, given delays in implementation, he felt the timescale of 5-10 years for delivery of project CORTISONE, which seeks to align UK cross-border IT systems, was accurate.

Neil said he had previously read the Selous report, but it had been some time ago, and he was not sure the report was relevant to this group.

Michael explained that the background to this item is that SG Armed Forces and Veterans Personnel Unit colleagues had approached the team to ask if the SOG was an appropriate forum for the recommendations to be progressed. There are already 18/19 health-related SVC recommendations, which the Joint Group report on, so adding more centred on families – which already align with the SVC recommendations – does not appear desirable.

Michael said he believes that if we broaden our approach to closer incorporate consideration of families when taking forward work on our current priorities, we will deliver on the Selous recommendations in addition to progressing the group’s priorities.

Jason asked if Michael could map out how the report links into the work of this group.

Action: Michael to map out how the Living in our Shoes report aligns with the group’s current priorities and work

4. Scottish Veterans Care Network Update

Hannah provided an updated on the SVCN’s work. Draft recommendations have been developed based on a number of work strands, including focus groups with veterans, literature and policy reviews, and analysis of the service mapping questionnaires that were issued to Integration Joint Boards, NHS Boards and service providers. Engagement activity continues with a focus group to gain veterans input and a focus group on families upcoming.

There are challenging discussions around scope, given the broader social policy impacts on mental health and wellbeing. With regard to veteran-specific mental health services, there are questions and discussion required on the appropriateness of devolving to Third Sector.

5. Next meeting

The group will reconvene at the beginning of September.