Scottish Government Armed Forces Personnel and Veterans Health Joint Group Strategic Oversight Group 15 May 2024

Attendees and apologies

• Gregor Smith, Chief Medical Officer, Scottish Government (SG)
• John Harden, Deputy National Clinical Director, Scottish Government (SG) 
• Jim Wilson, Veterans Scotland
• Ian Cumming, CEO Erskine
• Jo McBain, NHS Highland AF and V Champion
• Craig Cunningham, NHS Lanarkshire AF and V Champion
• Karen Ross, Army Families Federation (AFF)
• Susie Hamilton, Scottish Veterans Commissioner (SVC)
• Sharon Callaghan, Regional Clinical Director Operations Manager 
• Julie McIllroy, Head of Strategy, SVC office
• John Mooney, Head of Veterans Unit, SG
• Paul Hood, Deputy Head of Veterans Unit, SG
• Lesley McDowall, Head of Survivors Support and Veterans’ Mental Health, SG
• Lynne Taylor, Chair Veterans Mental Health Advisory Group
• Lindsey Restrick, Armed Forces and Veterans Health Policy, SG
• Stephanie Johnstone, Healthcare Quality Participation Team, SG

Items and actions

Welcome 

Gregor welcomed everyone to the meeting and apologies received were noted.  

Brief roundtable catch up 

Gregor asked the group to share any reflections of how things have been since last meeting. 

Susie acknowledged the hard work and progress that has been made in many areas including the roll out of the GP scheme.  However, mental health is the area that seems to raise the greatest concern among both service users and those providing support.  The perception is that there is a better service elsewhere in the UK.  

Craig advised that there are a growing number of veterans with an expectation of a cure for a condition (particularly service related) that simply isn’t there.  

Jim concurred and advised that managing expectations is key and gave the example of Op Courage, which gives the impression of it being a locally delivered national service.  

Gregor highlighted that his upcoming annual report covers the theme of care and what is meant by that; care and cure are hugely different.

Ian shared his reflections, and that his organisation strives to support veterans in care live well. Operating costs have increased significantly, and this has resulted in reducing the rooms available at the Erskine estate.  However, against a challenging background Erskine is continuing to provide support and has recently purchased a hotel to help veterans to live well in the community, with Erskine type care.  

Karen thanked members for the support they are giving to forces families.  There are still issues where families move between the devolved administrations, but the NHS Champions have been very helpful and the consideration of families in the development of initiatives and priorities is very welcome.  

IT connectivity 

Sharon gave an overview of some of the risks and challenges that are a result of poor IT connectivity between NHS and MOD systems. These include an inability to send electronic referrals and receive data ‘pushed’ to medical centres. Sharon highlighted that connectivity does vary between health boards.  Planned mitigation includes reaching medical director, digital directors and individual Board engagement.  

There is a longer-term solution via the portal and integration strand within Med IS Evolve.  

Gregor offered to support this work, including reaching medical directors if needed. 

TOR & membership of Joint Group 

The group considered the TOR and membership of the Joint Group.

Re representation of the NHS Champions – Jo suggested that the NHS Champions Network were approached to confirm that they are happy with the current representatives.

Susie suggested that reference to SVC progress reports and recommendations are generalised.

Ian offered that social care should be represented. 

Implementation Group Report to SOG on IG priorities 

Gregor acknowledged and thanked Jason for his dedication and the contribution he has made to this work.  As Jason has stepped away from Government there is a new chair of the Implementation Group.

John as new Chair of the Implementation Group introduced himself and gave an overview of the progress report that has been sent to the SOG from the IG including suggested priorities for the next year.

Gregor acknowledged progress in the GP scheme and understands why take up may be relatively slow.  Gregor is keen that the IG uses the next 12 months to promote, and increase take up of the scheme including the launch of training for Secondary care.

Susie asked that bereaved families are explicitly considered in any families work.

Veterans Mental Health Advisory Group 

Lynne, as Chair of the Veterans Mental Health Advisory Group, was invited to give an overview of the work. 

Lynne highlighted that the aim of the group is to develop tangible deliverables that enable veterans and their families to have equitable access to Mental Health Services.  Lynne recognises the work that has taken place with the previous Implementation Board and the intention is that this Group will build on this previous work, including in the original plan.

Jim and Gregor asked about the Governance structure of the group and mental health policy officials advised that they would welcome a dotted line between the Joint Group and the Advisory group.

John supported this and advised that where possible we should take forward joint actions.  Sharon also indicated her support as signposting to help when in service, can make the transition to civilian life easier.  Susie also welcomed this.

Agreement of priorities for 2024/2025 

The Group agreed that the priorities for 2024/2025 are:

•    To continue to promote the GP recognition scheme and the training for Secondary care 
•    Consider what more can be done to improve the identification of veterans throughout healthcare, particularly on referrals from Primary to Secondary Care
•    Once finance approved, oversee the implementation of the SVTP 
•    Develop a Covenant Standards Framework
•    Explore how forces families are considered in policy delivery and decision making.   

Any other business

Karen highlighted issues relating to a case where the mechanisms for referrals are different between devolved administrations.  Gregor recognised that this can be a challenge and as the NHS is distinct across the 4 nations, a solution cannot be found within this group. 

Gregor raised that he has received his service number and has formally been signed off by the King to be an Air Commodore in the RAF Medical reservists and asked the Group if they thought that this represented a conflict of interest.

No such conflict was raised.

Date of next meeting

Gregor thank all for their time and advised that the next meeting will be in May 2025 with officials sending out invitations nearer the time.

Actions

Lindsey to make the changes to the TOR as discussed and re-circulate to the group for approval.