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:
- Prosthetics (as highlighted in the
Murrison report) which is the responsibility of NHS England and
over which there is little local influence
- 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
- 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).
- 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.