Armed Forces Personnel and Veterans Health Joint Group's Implementation Group minutes: September 2024

Attendees and apologies

• John Harden (Chair), National Clinical Lead for Quality and Safety, Scottish Government
• Sharon Findlay, Regional Clinical Director, Defence Primary Healthcare (Scotland and Northern Ireland)
• Robert Reid, Regional Manager Scotland and Overseas, Defence Medical Welfare Service (DMWS)
• Jo McBain, NHS Highland Armed Forces and Veterans Champion 
• Craig Cunningham, NHS Lanarkshire Armed Forces and Veterans Champion
• Dr Rakesh Bhabutta, Regional Clinical Director, Defence Primary Healthcare Scotland
• Craig Murney, NHS National Services Scotland Armed Forces and Veterans Champion

Official support

• Gary Cocker, Geonomics, Diagnostics and Participation Unit, Scottish Government
• Stephanie Johnstone, Geonomics, Diagnostics and Participation Unit, Scottish Government

Apologies

• Sharon Callaghan, Operations Manager Scotland, Defence Primary Healthcare (Scotland and North)
• Andrew Carter, NHS Borders Armed Forces and Veterans Champion
• Ian Cumming, Third Sector Representative, Erskine
• Mairi McKinley, NHS Fife Armed Forces and Veterans Champion
• Neil Morrison, Health Representative, Veterans Scotland

Items and actions

Welcome and apologies – Chair

John welcomed all to the group and noted the apologies as above. 

Brief roundtable catch up – Chair, all

John invited the group to share any issues they were facing. 

Craig C highlighted an issue with a request for the supply of Optometry funding. Requests coming to him to provide funding for glasses. Whilst Craig knew this was not the case, he queried whether Optometry issues were included.

Bob had shared information regarding a Greater Glasgow and Clyde NHS Armed Forces and Veterans event on 3 October. 

Sharon presented an issue following her meeting with SG on 29 August regarding prescriptions. Prescriptions are being logged on SCI Store and patients are unable to pick up from there. Sharon wants to find out where and who they should go to. 

Update on IG priorities – Gary Cocker

Gary gave the progress update on current priorities. 

The General Practice Armed Forces and Veterans’ Recognition Scheme

Gary re-affirmed that the General Practice AF and V Recognition Scheme had launched and noted that SG are continuing to promote and plan to move it into secondary care as well. 

Gary also gave an update on the GP scheme participation numbers and locations in which SG are currently gathering data. Gary noted that there was a consistent geographical spread. 

Gary noted that he had met with NHS Borders and has plans to meet with the GP sub-committee in Lanarkshire in October. 

Scottish Veterans Treatment Pathway (SVTP)

Gary noted that funding for the pathway had been signed over to the host board, NHS Highland, to progress. He explained that the pathway had not launched as SG/NHS Highland are still identifying members of the multidisciplinary team but noted that there are already one or two cases which seem appropriate to move on to the pathway.

Visit to Redford Barracks

Gary gave an update on his visit to Redford Barracks meeting with Defence Primary Healthcare in which John also attended. The visit was to establish what work SG can do around the interfaces between NHS and MOD. 

Update on MOD/NHS Interfaces – presentation from Dr Rakesh Bhabutta

Ricky presented his paper entitled ‘Review of the effectiveness of the interface between Defence Primary Healthcare medical centres and NHS Scotland’

Craig M - Agreed with recommendations of the report. Noted that his team would be the project team to contact to progress. 

John noted there was a realisation something had to be done and the paper hints that it is not as complicated. He agreed it would come to Craig M’s team but noted that SG had reached out the E Health team. 

Jo McBain noted that there were similar issues regarding GP referrals to NHS Highland for the SVTP project. She was glad to see in the paper what the clinical governance is and that some of the report had reinforced the message that this is for people who are serving and not just the veterans. 

Sharon F – agreed with Jo and the suggestion that having the clinical governance at the higher level would be really helpful. 

Sharon and Ricky have raised with Digital directors that a short life working group may be required to drive it forward however they are having difficulties with the capacity. 

Craig C noted that GPs are frustrated with specialist pathways and patients are being sent back as GP’s have not done what is required according to those pathways.  He mentioned that there may be work arounds/solutions e.g. access can be granted to volunteers to obtain an NHS email address, and he will be able to share that process. He also suggested that it might be more useful to concentrate this work around the areas of Barracks instead of Scotland wide noting its practicality and noted a data protection factor, patients may not want the military to know of certain procedures they have had. 

Sharon F noted that there were seven barrack facilities in six health boards.

Jo agreed with Craig C regarding work arounds and mentioned that community link workers (third sector) had access to NHS systems through an SLA which could be an easy solution. However, she noted that we need to clear that we are/are not commissioning the MOD to do services for the NHS. She also agreed with the data sharing issue but noted the dangers of not sharing all information. 

Ricky noted that there are issues with Accident and Emergency emails and noted there is a lot that needs to be done on both sides to set the tone.

Craig C asked if there was a plan for the 'Right Decisions Platform' to be NHS Scotland wide. If so, suggested we move to having this for all as that would also support regional services as opposed to individual Board referral protocols and all the different access routes.

Jo suspected that some of these solutions we may come up with may solve some of NHS Highlands current internal data sharing issues with GP practices and indeed internally across integration authorities.

John Harden noted that SG have access to some NHS services as he can access via his SG email account. As long as the system/mechanism to you use to log is recognised by the system it will be validated. He agreed with the suggestion that this be a dedicated piece of work but keen that it’s not only this group that has ownership. He noted that a working group should be set up to look at the issues in Ricky's paper but realised that it may need separate groups and they all should report to the IG. He also noted that it should be done in partnership with DMS and NHS.  John also noted that the group should include planning and delivery colleagues from NHS for consistency/whole system view and a ‘Once for Scotland’ approach. 

Any other business - Chair/all

No other business was discussed. 

Date of next meeting – Chair

The next meeting will be arranged for three months’ time (possibly 17 December). Scottish Government officials will send out a placeholder for the next meeting in due course. 

John thanked everyone for their attendance and thanked Ricky for his work/input to the group and wished him well in his retirement. 

Action 1: John and Gary to look into Optometry issue. 

Action 2: Gary to share invite for Greater Glasgow and Clyde NHS Armed Forces and Veterans Event 3 Oct with appropriate staff/members.

Action 3: Gary and John taking the action to progress issue around prescriptions being logged on SCI. 

Action 4: Gary to follow up with DPC on issues raised during Redford Barracks visit.

Action 5: John and Gary to work with Sharon and Ricky on this and to establish a working group for MOD/NHS Interfaces.