Agenda item

Armed Forces Strategy consultation

Feedback has been requested from the Health and Wellbeing Board by NHS England in relation to the draft Armed Forces Strategy.  The report is now attached.

Minutes:

Discussion:

 

The Acting Area Director, NHS England, Kent and Medway, gave a brief introduction to the report on the Armed Forces Strategy consultation which had been declared as urgent to enable comments to be given to NHS England, Kent and Medway by its extended deadline of 20 June 2014.

 

He explained that the Bath, Gloucestershire, Swindon and Wiltshire Area Team commissioned armed forces health on behalf of the south and said he would welcome the Board’s views on the draft Armed Forces Strategy.

 

The following comments and suggestions were put forward:

 

  • Healthwatch Medway comments are as circulated prior to the meeting

 

  • Comments from the Kent and Medway Military Partnership Board, relayed at the Health and Wellbeing Board meeting, were as follows:

 

The K&M Military Partnership Board would like NHS England to take into account the following specific issues as part of the strategy, particular concern was the wellbeing of veterans and their families/carers:

 

  1. Prosthetics (as highlighted in the Murrison report) which is the responsibility of NHS England and over which there is little local influence
  2. Mental health – the main issues for veterans are around alcohol and drug misuse and low level depression associated with difficulties in transition from military to civilian life.  Work is still needed to ensure excellent access to services provided by the local substance misuse providers
  3. Access to GPs (many veterans do not register with GPs) as part of the transition to civilian life people need to be encouraged to register with GPs.  Access to other parts of the NHS also can be an issue for families of serving personnel who move to Kent from elsewhere and find themselves at the bottom of the waiting list again.  A system is needed that fast-tracks people, where appropriate, in order to ensure the Covenant principle of ‘no detriment’ for families of serving personnel is followed. (Please note: the reference to the Covenant refers to the Armed Forces Covenant signed by the Council and partners – also attached).
  4. Reservists – Due to strategic changes in the armed forces towards much greater use of reservists this could impact on demands for services.  It is suggested that reservists were more likely to suffer from Post Traumatic Stress Disorder for example.  It is important that trends are monitored closely to ensure sufficient support is put in place.

 

The following additional comments were made during the meeting:

 

  • The CCG representatives at the meeting endorsed the issue relating to access to GPs and suggested that more needed to be done to encourage GPs to find out which of their patients were members or former members of the armed forces

 

  • Consideration should be given to including within the strategy a reflection of the fact that some former service personnel get involved in violent crime and are imprisoned due to mental health issues so preventative support should be made available to avoid this

 

  • Connected with the above, reference was made to the need to have a holistic approach to addressing mental health issues for armed service personnel to avoid safeguarding concerns and domestic abuse

 

  • In support of the submission by Healthwatch Medway it was acknowledged by other Board members that it would be helpful to reduce the jargon within the strategy to make it more easily accessible

 

  • Concern was expressed about the step down from specialist services provided in Birmingham, which were world class, to more local services, which were often inconsistent.  It was felt that more should be done to increase the quality and level of support outside of that specialist service

 

  • Support for partners of service personnel, and their children and carers was crucial

 

  • It was felt that an opportunity for working more seamlessly had been missed as the strategy focussed solely on health provision for the armed forces.  It was felt that the strategy could have been a much stronger document if it had been possible to demonstrate a close link with social care, (including the support that can be found in the voluntary sector), particularly in relation to after care (section 117 cases).  This could have clarified who was responsible at each stage of care/support.  This contribution could have been enhanced by discussing the issue with the Association of Social Services, particularly regarding mental health services, and was an opportunity to make clear who could provide support in the most acceptable way.  It was suggested that if this were to be added the strategy would have a more rounded and comprehensive approach.

 

  • The Director of Public Health stated that it was unclear how NHS England would engage with the Council to ensure a joined up approach to health improvement, as she was not linked to the armed forces network. (The Interim Area Director, NHS England, Kent and Medway suggested that she could discuss this matter with colleagues in the West Country who are the commissioners.  The Director of Public Health, however, felt that this would not be very helpful as it did not address the need for specific local information).

 

The general comment was made at the end of the discussion that it would have been very helpful if the strategy had been shared with the Health and Wellbeing Board at a much earlier stage as the deadline for comments was unrealistic and required the report to be circulated as a late item for the agenda.

 

Decision: 

 

The HWB requested the Democratic Services Officer to share the above comments with all Board members following which the HWB agreed   the above comments should be submitted to NHS England, Kent and Medway.

Supporting documents: