South East Coast Armed Forces Forum 7 th February 2011 Dave Rutter

1. Military Health Programme South East Coast Armed Forces Forum 7th February 2011 Dave Rutter Head - Military Health & Veterans Department of Health

2. Government Military Health Priorities Rebuild the Armed Forces Covenant Effective Transition of the Seriously Injured to NHS Care Improve Veteran’s Mental Health services Ensure Military Health Priorities not lost during NHS Transition Support to NHS Reservists All of the above require strong local & regional leadership: Establish NHS Armed Forces Network

3. Statutory Initiatives • Armed Forces Act 2011: • Annual duty to report to progress against the Military Covenant to Parliament including Health. • Health & Social Care Bill 2011: • Includes duty of the NHS Commissioning Board to commission services on behalf of the Armed Forces (currently a PCT duty) • NHS Mental Health Strategy 2011 • Includes specific provision for veterans • NHS Operating Framework 2011/11 …

4. NHS Operating Framework Military and Veterans’ Health It is important that SHAs develop and maintain their Armed Forces Networks to ensure the implementation of the Ministry of Defence / NHS Transition Protocol for those who have been injured in the course of their duty, meeting veterans’ prosthetic needs and ensuring the implementation of the Murrison Report (Fighting Fit – A mental health plan for servicemen and veterans) to improve mental health services for veterans. SHAs must ensure continuity of this work during the NHS transition period. At the same time, there is an expectation that NHS employers should be supportive towards those staff who volunteer for reserve duties.

5. MoD / UK DH Partnership Governance MoD / UK DH Partnership Board Partnership Board: cross government level Working Groups – People & Services Joint Executive team NHS Armed Forces Network (England) DH England Strategic Partners Programme (3rd Sector) Regional Armed Forces Forums Joint Executive People Working Group Services Working Group NHS Armed Forces Network Regional Military Commands Regional Forums

6. Role of the NHS Armed Forces Network To provide regional NHS leadership, advocacy and points of liaison for Military Health & Veterans issues. To work with regional military, social services and third sector organisations to ensure deliver Armed Forces community programmes.

7. Future of the AF Networks The NHS and the Armed Forces are commencing a significant period of organisational change. Governance needs to be in place to deliver health services for the Armed Forces, their dependents and veterans. NHS Armed Forces Networks are vital to achieving this aim. Transition arrangements aligned to the NHS Commissioning arm are in planning.

8. NHS Armed Forces Network • Of the 10 SHA Areas: • 10 Armed Forces Leads identified • 7 Active AF Forums (incl. NHS SEC) • 3 Forum launches scheduled • NHS Armed Forces Conference, 07 March 2011, RBL London • Key current contribution • Local trouble shooting / sign posting / problem solving • Regional AF advocacy • Policy development & implementation

9. Veterans Health • The Military Covenant preserves the key principles of the Command Paper: • No disadvantage • Manage their lives as effortlessly as anyone else • Continuity of public services • Proper Return for Sacrifice • Key areas for the NHS • Transition to NHS care (joint responsibility with Armed Forces) • Prosthetics • Mental health services

10. Murrison Review: Fighting Fit There are four principal recommendations: • Incorporation of a structured mental health systems enquiry into existing medical examinations performed whilst serving. • An uplift in the number of mental health professionals conducting veterans outreach work from Mental Health Trusts in partnership with leading mental health charities. • A Veterans Information Service (VIS) to be deployed 12 months after a person leaves the Armed Forces. • Trial of an online early intervention service for serving personnel and veterans.

11. Veterans Mental Health Services • Phase 1: Initial Capability (Jan - Jun 11) • Interim & preparatory MH projects across all SHAs • Combat Stress 24 hr helpline (Jan 11) • Phase 2: Murrison Rollout (Mar – Dec 11) • Big White Wall online MH support (from Apr 11) • NHS National Veterans MH capability (from Apr 11) • Veterans Information Service (from Apr 12) • Phase 3: Service Evaluation & Improvement (2012-14) • Annual evaluation and reports to Prime Minister / Mil Covenant • Deeper integration with voluntary sector

12. Murrison Review: Fighting Fit The recommendations are based on the following propositions: • Established models of care should be used in designing the programme. • Any provider will be considered that can deliver against NICE guidelines and CQC standards in accordance with the precepts of the Big Society. • Follow-up and management should be as close to home as possible. • Stigma deters Service and Ex-service personnel from engaging with conventional mental health provision.

13. Next Steps Key areas to take forward: • Murrison implementation • Phase 1 in implementation • Phase 2 in planning • Embed Armed Forces Network in SHA Transition • Deliver on Armed Forces Covenant • Ensure seamless transition particularly for seriously injured • Continue to strengthen links with local Armed Forces • Service improvement – e.g. prosthetics provision • Support to NHS reservists

14. Further information: Contacts DH Military Health Programme:doh.armedforcesnetworks@nhs.net The Team Dave Rutter Caroline Pease Rob Moorhead