Veterans and the Armed Forces community - support: 2020 report

Healthcare Including Mental Health

Achievements

Scottish Veterans Care Network

The Scottish Government has established the Scottish Veterans Care Network (SVCN) which will help to support Veterans with issues accessing care and health inequalities. The Network will be formally launched in November 2020. Engagement with a broad range of stakeholders has enabled the Network to create a delivery strategy, setting out immediate priorities and a plan for their implementation. One of the first priorities of the Veterans Care Network will be the creation of a Veterans Mental Health Action Plan.

The SVCN has started work to map the range of existing health and care services available for Veterans across Scotland. This will include services provided by NHS Boards, Health and Social Care Partnerships (HSCPs), Integrated Joint Boards (IJBs), Third Sector and Councils. This will be compiled along with existing published data on Veterans health, in order to develop a Mental Health Action Plan which will inform the planning of services for the future. A working group within the SVCN on data and information is in the development stages and the proforma around the Mental Health Action Plan will also go out to HSCPs and IJBs to gather intelligence around strategic planning for Veterans services, which will likely inform the planning of future services.

Identifying Veterans

It has been a core part of the curriculum for new GPs since 2019 to undertake training and demonstrate awareness of Veterans and their specific issues. GPs should therefore be better prepared to initiate a conversation with patients on their Service career history and any resulting medical need(s). In addition, the Scottish Government is working with NHS Scotland to ensure declared Veteran status on a patient's medical record, so that this is immediately visible to the GP during each consultation. This work is being taken forward by the Implementation Group.

The Armed Forces and Veterans Health Joint Group

The Armed Forces Personnel & Veterans Health Joint Group (AFPVH JG) brings together NHS Champions, representatives of the Service community, Veterans organisations, Scottish Government officials and other stakeholders.

The Implementation Group provided a progress update to the Strategic Oversight Group in November 2019 and the National Clinical Director wrote to the Chief Medical Officer in September 2020 setting out progress against priority areas of work and other work that has been taken forward in relation to improving the health of Armed Forces personnel and Veterans working and living in Scotland. The Strategic Oversight Group has agreed three priorities for 2020-21: priority treatment; employment of Veterans in the NHS; and mental health. These groups remain pivotal in driving forward progress and although work has paused for much of this year we are pleased to be able to reignite it and rebuild momentum.

NHS Champions

The NHS Champions Network has been established and three events have been run, all of which have received positive feedback. We have surveyed Champions about next steps to ensure the content of future events remains fresh, interesting and relevant. Through this group we have been able to disseminate information and gauge views on new Scottish Government work, such as Veterans Aware Hospitals. We have also approached Champions on an individual basis so that their local knowledge can enhance decision making. The Champions Network was unable to meet in April and much of the work was paused due to COVID-19 but the Network will meet virtually before the end of 2020.

Champions are also represented on both elements of our Armed Forces Personnel and Veterans Health Joint Group, which is critical to the strategic oversight and governance of policy development.

Hearing Aid Replacements

In late August 2020, a letter was sent from the Scottish Government's National Clinical Director and Healthcare Science National Lead to all Audiology departments across Scotland. This set out the expectation that Veterans should receive like-for-like replacements of hearing aids. Previously, some personnel transitioning out of the Services had been given less effective hearing aids than those given during their Service.

A Veteran's son told Action on Hearing Loss that his father was "delighted with the quick service" and that things at home had improved so much and that "it is a great relief" for the family.

Drug and Alcohol Information System (DAISy)

DAISy will be implemented before the end of 2020 and will record details of individuals receiving treatment for alcohol and drug problems with the facility to highlight Veteran status so that the scale and nature of those receiving treatment can be measured. After implementation, the first quarter of data collection will allow us to construct metrics around alcohol and drug treatment in the Veterans population.

The Scottish Government has established a Short Life Working Group on Prescription Medicine Dependence and Withdrawal. Its remit is to consider, in a Scottish context, the recommendations made in the Public Health England Prescribed Medicines review (of the evidence for the dependence on, and withdrawal from, prescribed medicines). The group has met virtually several times during the COVID period and after presenting its draft recommendations to the Cabinet Secretary for Health and Sport will run a public consultation between November 2020 and January 2021.

Chronic Pain Management

The Pain Association Scotland (PAS) ran a very successful pilot from 2018 to 2019 on chronic pain self-management for 41 Veterans. This was in the format of group meetings at Erskine House and through one-to-one sessions with 11 Veterans. The pilot received excellent feedback from participants, with some describing the course as "informative, educational and interesting", and commenting that the course has "taught me to accept, manage and deal with" pain. Following the pilot, a group was established which met monthly and in March 2020, PAS secured a further 18 months of funding and will put the pilot findings before the National Advisory Committee for Chronic Pain with the aim of embedding the services going forward.

Veterans First Point & Combat Stress

In 2020-21, the Scottish Government will invest £1.4m in a range of specialist and community-based services for Veterans in Scotland, commissioned by NHS Ayrshire and Arran on behalf of NHS Scotland and provided by Combat Stress, and provided joint funding with six local health boards for the Veterans First Point Network. The Scottish Government has provided nearly £3 million to support the network of Veterans' First Point Services since 2017-2018, including £664,383 in the 2020-21 financial year.

During 2020, Combat Stress have undergone an operational and clinical redesign and will focus their Scottish services exclusively on Scottish Veterans. This will better reflect the current need in Scotland and enable more Veterans to get the right help within their community, including by accessing digital services.

Mental Health First Aid and Befriending

In 2020-21, the Scottish Government provided £3,000 of funding to hold two one-day Befriending training sessions for up to 25 individuals as well as four two-day Mental Health First Aid training sessions per up to 12 individuals from the Veterans community. It is anticipated that they will now take place in spring 2021 following postponement due to COVID-19.

Support During COVID-19

During the COVID-19 response the Scottish Government worked closely with Veterans Scotland and its Health Pillar Group to ensure that up-to-date advice was shared quickly, that the Scottish Government understood what support was being provided by third sector organisations to Veterans and to offer support.

NHS Inform has pages dedicated to Veterans' health and their rights and during the COVID-19 pandemic this information was maintained with advice so that the website remained the definitive information source for Veterans healthcare.

Early in the pandemic, the Scottish Government worked with Veterans Scotland to provide simplified and consolidated advice and help the third sector better understand the available funding packages. We developed guidance and signposting for organisations to identify quickly the different types of available support and where to go for more information.