The armed forces community is close to my heart as an advanced nurse practitioner and also as a military spouse.
It’s a community that often goes quietly unnoticed, yet it is estimated that there are around 2 million veterans living in the UK and, with an estimated 5.4 million adult spouses, partners, widowers and child dependents too, that’s a significant number of the population.
Around 18,000 service people move back into civilian life every year, including around 2,000 who leave the services on medical grounds. This is a huge lifestyle change and, as healthcare practitioners, we have a duty to access the tools and training that’s freely available to ensure we can provide this group with the support they need.
“Often, the healthcare needs of veterans can be quite different to the general population”
So how is this community any different to the general population, and why should we treat them any differently? The Armed Forces Covenant does not stipulate that veterans should be treated any differently, but that they should not face any disadvantage, which can happen for several reasons.
Often, the healthcare needs of veterans can be quite different to the general population. This can be related to the intense physical demands of the military, lifestyle factors (such as physical and psychological trauma), and exposure to harmful/toxic substances.
Some sources also suggest that 52% of veterans have a long-term illness or disability, compared to 36% of the general population. The military lifestyle usually requires frequent travel and a disconnect from regular contact with healthcare services. Families may lose their place on NHS waiting lists due to frequent relocations. There is also the major issue of stigma, which may prevent many veterans from accessing healthcare services.
Unfortunately, this is compounded by a lack of understanding of the armed forces culture among civilian healthcare staff, further disadvantaging them.
Often the front door to the NHS, GP surgeries can play an integral role in addressing this, by supporting veterans and their families. Military veterans have a higher prevalence of anxiety, depression, post-traumatic stress disorder (PTSD) and alcohol misuse than the general population, and these rates are higher for those with combat experience.
There is also evidence that PTSD has underlying biological and neurological effects that produce biological markers consistent with a broad range of inflammatory disorders, including cardiovascular and autoimmune diseases. This means that veterans suffering from these conditions are highly likely to present to GP surgeries, but do not always identify themselves as veterans, thus denying themselves access to specialist services.
“As nurses, we can champion best practice for our armed forces community”
This is where we can step in to help. The RCGP veteran friendly accreditation scheme gives GP practices the training, information, and resources to identify and support their veteran patients. It starts with simply asking: “Have you ever served?”.
By joining the RCGP veteran friendly accreditation scheme and appointing a clinical lead for veteran health care, GP practices can support the commitments of the Armed Forces Covenant and the NHS constitution.
As nurses, we can champion best practice for our armed forces community by stepping into these rewarding clinical lead roles. This simply involves staying up to date with the latest training, which is delivered online via email by the RCGP as part of the free programme. The veteran leads should also be available to provide advice to colleagues and to support veterans directly when needed.
To date, the programme is proving to be hugely valuable, with an evaluation study by the University of Chester revealing that 99% of respondents from accredited practices would recommend the practice, and 84% reported a better understanding of veterans’ needs.
With a friendly face and a listening ear, nurses can play an integral role in the drive to first identify our veterans and then support them.
Please, check whether your surgery is accredited and consider volunteering to be clinical lead for veterans. You might just be the knight in shining armour for your local armed forces community.
Find out more about the RCGP veteran accreditation programme scheme here.
Jordana Wright is an advanced nurse practitioner at Derbyshire Community Health Services NHS Foundation Trust