Renewing Our Commitments

Healthcare

Healthcare provision is a vital service both for wounded personnel returning from operational duty, and for personnel, veterans and families resident in Scotland.

Priority NHS treatment is provided for veterans with a service-related condition, based on clinical need. During active operations in Iraq and Afghanistan, injured personnel requiring urgent or complex treatment accessed the NHS in Scotland and third sector organisations more frequently. Now that operations have concluded, numbers of wounded personnel dealing with immediate trauma have fallen and there is greater emphasis on long-term clinical needs.

Scotland has made notable progress on specialist healthcare provision, with particular emphasis on mental healthcare.

Some progress included:

• Prosthetics: Scotland provides a state-of-the-art National Specialist Prosthetics (SOTA) Service. Announced in June 2013, the service became fully operational in April 2014. This is now well established and working well through a single multidisciplinary team approach across two specialist centres (Edinburgh and Glasgow) with links to all other limb-fitting centres in the country. The relationship with the Personnel Recovery Unit continues to be very positive. In the region of £5 million has been provided to the service since 2013, including funds for staff, facilities, training and new prosthetic limbs for 35 amputees. A top priority has been to ensure that Service personnel have full equity of access to the NHS in Scotland, putting systems in place to register them and share data safely and efficiently.
• Mental healthcare provision: In 2015, in partnership with NHSScotland and Combat Stress, the Scottish Government committed over £3.6 million funding over three years for specialist mental health services for veterans resident in Scotland at the Hollybush House Combat Stress facility in Ayr. This will fund a range of specialist clinical, rehabilitation, social and welfare support at the facility. Evidence-based treatment programmes include an intensive Post Traumatic Stress Disorder (PTSD) programme, trans-diagnostic programme, stabilisation and anger management programmes.
• Veterans First Point: The expertise and knowledge developed by Veterans First Point Lothian (a one-stop-shop drop-in centre for any veterans issue providing clinical, welfare, housing and other support) informed the Scottish Government’s mental health strategy commitment to explore the development of similar services in other areas of Scotland. The Scottish Government has provided £1.6 million to support this service to date and has now announced a further £200,000 for 2016/17. In recognition of the strengths of this model, NHS Lothian secured £2.5 million of Armed Forces Covenant funding to support the commitment and establish Veterans First Point Scotland to work with local partnerships to explore how the strengths of the Lothian service could be delivered in other localities with evaluation, training and other support from the national hub. Over the last year, work has been taken forward in 10 health board areas across Scotland to assist each local area establish key partnerships, identify premises, plan requirements and recruit and select staff. This work continues, with the service in Tayside operational at September 2015 with others to follow.
• Allocation of Community Health Index (CHI) numbers has been an essential element. Electronic synchronisation between the Joint Personnel Administration (JPA) system and the allocation of CHI has taken place, and the new system went live in September 2015. This is a one-way secure link to provide transfer of demographic information, and ensures that all Service personnel based in Scotland have access to NHS services in Scotland, on the same basis as members of the general population, including services such as bowel, breast, cervical and other screening programmes. Arrangements have also been put in place to provide and record screening data within Service health records.
• Scottish Care Information Gateway (SCI): Hardware has been installed to ensure that Military Health Centres have access to the same system as any Scottish GP and training to extend access is underway.

Looking ahead, we want to ensure that long-term clinical needs of Service personnel and veterans are better understood and supported within the NHS. Sharing patient data will remain a high priority - we want to streamline transfer of military health records to local GPs for Service leavers, working with the Ministry of Defence to improve transition plans and early GP registration.