Health and Wellbeing Stakeholder Insights – Armed Forces Personnel and Veterans Joint Health Group

Professor Jason Leitch is the National Clinical Director of the Scottish Government and chairs the Implementation Group of the Armed Forces Personnel and Veterans Joint Health Group, which includes representatives from a wide range of stakeholders, including the armed forces, veterans’ organisations and charities, NHS Scotland, NHS and Local Authority Armed Forces and Veterans Champions, and the Scottish Government.

A number of years ago I was approached to take on the role of the Scottish Government’s Armed Forces and veteran’s champion in the health directorate. I was delighted to do so. It’s been a fascinating few years as I’ve learned about the broad work underway and met with those affected by their service and the work going on across sectors to assist.

I now Chair the Implementation Group, part of the Armed Forces Personnel and Veterans Joint Health Group. The Joint Group, which is Chaired by the Chief Medical Officer, Gregor Smith, drives progress towards delivery of commitments relating to the health of the Armed Forces and veterans community here in Scotland.

We are a ‘committee’ which I think it’s fair to say has two uniquely non-committee functions; it’s fun and it gets stuff done. We’ve worked together across the NHS, the third sector, the Commissioner’s office and with those with lived experience on subjects as broad as access, hearing aids, employability, medical records and, of course, mental health. We’ve made progress but there is more to do. With the help of the Veteran’s Commissioner’s reports we have a clear set of priorities and we will endeavour to continue to push the rock up the hill.

Change is not straightforward. A mentor of mine taught me that ‘every system is perfectly designed to get the results it gets’. If you want change, you have to change the system. Everyone I have met in this field is keen to do exactly that. The Scottish Government can convene and help but the real work happens in the frontline services.

The Scottish Government is fully committed to ensuring that all Armed Forces personnel who serve in Scotland, veterans who live in Scotland and their families are able to access the best possible care and support, including safe, effective and person-centred healthcare. It is through collaboration and connecting with the subject matter experts that we can achieve this.  We engage with colleagues on a 4 nation basis.  While the Armed Forces Covenant is reserved, the application of health is devolved, all of which adds to the complexity, it is also truly helpful in shaping learning. 

The Group’s broad membership harnesses a range of experts who work together on priority areas and recommendations driving progress towards our commitments of meeting the health needs of Armed Forces personnel and veterans in Scotland.   We are aware that many of the recommendations are interlinked and addressing some of the inequalities that veterans face sits at the heart of the Joint Group’s varied priorities.  I am hopeful for the future and I look forward to playing a small role in helping.

Health and Wellbeing Stakeholder Insights – Scottish Veterans Care Network

Dr Lucy Abraham is a consultant Clinical Psychologist and in 2020 she was appointed Clinical Lead for the Scottish Veterans Care Network (SVCN), a National Strategic Network which aims to deliver an integrated, person-centred care pathway across the health and social care system for Scotland’s veterans. Here, she shares the ethos behind SVCN’s approach.

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Commissioner calls for early implementation of the Veterans Mental Health and Wellbeing Plan in his third and final report on getting transition right in Scotland

A report published today by the Scottish Veterans Commissioner says that the healthcare needs of those transitioning from the armed forces must not be neglected as the NHS struggles to recover from the Pandemic. The report examines provision of healthcare for veterans in Scotland and makes four recommendations to enable a more seamless transition to the civilian world.

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Veterans Commissioner reports on progress against recommendations put forward to improve Veterans’ services and support in Scotland

Charlie Wallace, Scotland’s Veterans Commissioner today published his third annual assessment of progress made against recommendations put forward by his office for improving services and support for veterans and their families living in Scotland.

His assessment found that despite the Pandemic, progress continues to be made on Veterans’ issues raised in a series of reports put forward by his office.  A key success is the recommended Veterans Mental Health Action Plan, which after extensive consultation, is about to be published and with it should come better mental health and wellbeing services, delivered in a way that best suits Veterans’ needs.

Overall, there has been greatest change around delivery of the Commissioner’s 2018 Health and Wellbeing recommendations:

– with a number of measures put in place to help identify and register Veterans accessing NHS care, giving health professionals the information they need to better understand and support Veterans

– work proceeding on ‘Veteran friendly’ GP practice accreditation, to promote and consolidate good practice amongst GPs

– further alignment of the Defence Medical Services and NHS IT systems, through Programme Cortisone, which will allow quicker electronic transfer of medical records

– improved support for Veterans who suffer chronic pain, through the Pain Association Scotland

– the launch of DAISy, the Drug and Alcohol Information Service, which will work to better understand the issues related to alcohol and drug harms, including where problematic use is causing damage to Veterans lives and those of their families

The Scottish Veterans Commissioner, Charlie Wallace, said:  

“I am particularly pleased and hopeful to see the major step forward that the new Veterans’ Mental Health Action Plan and care pathway represents and the broader progress that has been made in health and wellbeing. 

“Providing scrutiny and supportive challenge to policy makers and those delivering services to the Veterans’ community is an important part of my role, and assessing progress annually tells us whether current actions are effective in driving delivery and leading to positive change – but also crucially, where greater attention is needed.”

“Overall, the report tells a story of sustained effort across government and partner organisations, large and small, to address the issues highlighted in my reports and make long-term sustainable changes to policy and practice.  However, there remain some stubborn challenges here that government and its partners cannot afford to let up on now.”

Last year the Scottish Veterans Commissioner identified 20 recommendations in need of more attention to drive change and highlighted his concerns around employment and skills development and health and mental health services in particular.  These were areas where, among other things, the Commissioner felt the on-going Pandemic posed an increased risk to Service Leavers and Veterans, who often already face additional challenges when seeking civilian employment or health or mental health care services.

Charlie Wallace, continued:  “As the challenges of the Pandemic continue, we have seen more people suffer from increased anxiety, isolation and job losses, and services which are slower to respond to need.  

“These are still areas where a strong focus and emphasis on support and early intervention needs to be maintained.  There is evidence of that in this year’s report, but going forward I want to see the strengthened strategic leadership we have seen in these areas continue and stronger partnership working, even when those partners do not always make easy bed-fellows.

“In the area of employment, skills and learning, there is evidence that high-level leadership and co-ordination through the Veterans Employability Strategic Group is starting to have a real impact.  The Group is working effectively, developing its long-term vision and action plan and bringing new strategic partners to the table.”

The Veterans Employability Strategic Group has initiated work aimed at:  maximising Service Leavers’ and their families’ access to impartial and on-going advice and guidance to support careers choices and access to training and up-skilling opportunities; better understanding the baseline employment situation for the Veterans community through better data; and identifying ways in which the NHS in Scotland can fully utilise the talents of the Veterans community to fill vacancies in the NHS, including in the new National Treatment Centres currently being created.” 

Charlie Wallace, added:  “However, I now need to see further progress on issues I flagged previously.  These include:  the lack of recognition of Service Leavers’ and Veterans’ qualifications, skills and experience which prevents them competing for employment opportunities; efforts to better align Veterans’ skills and abilities with known skills gaps in key sectors of the Scottish economy and where there are labour shortages; and ensuring we get the levels of support right for Early Service Leavers, who can often be vulnerable to poor transition back into civilian society.”

Background

The progress report, introduced in June 2019, is a tool used by the Scottish Veterans Commissioner (SVC) to capture, track and report on action taken in response to his recommendations made to the Scottish Government to help improve support and services for Scotland’s Veteran’s community.  There were originally 63 recommendations in total, taken from four in-depth reports published since the first Commissioner took up appointment in 2014.

A standard RAG (red, amber, green) rating, based on facts supplied by Scottish Government officials and the Commissioner’s own knowledge of developments, has been applied to each recommendation to indicate the progress that has been made towards meeting it.

The Veterans Commissioner will continue to monitor the effect of the implemented changes and the status of the remaining recommendations that will bring positive results for veterans.  Early next year he will also report for the first time on the 14 new outcome-focussed recommendations made in his latest reports which looked specifically at getting transition from the Armed Forces right in Scotland.  A number of older recommendations will now be pursued through recommendations made in the Positive Futures Employment, Skills and Learning and Housing Reports of December 2020 and June 2021.

The full SVC 2021 progress report can be viewed here.

Quick facts

  • A Veteran is anyone age 16 and over who has served at least one day in the Armed Forces (Regular or Reserve).  Increasingly our Veterans are of working age, with up to 1,800 individuals a year plus their families leaving the Armed Forces and choosing to settle in Scotland.
  • There are currently around 250,000 Veterans living in Scotland.  That’s around 5% of the population, plus their partners and families. 
  • The Commissioner is currently working on the third in a series of papers on getting transition from the Armed Forces right, the overview for which was set in his ‘Positive Futures’ paper of November 2019.   Positive Futures – Employment, Skills and Learning published in December 2020; Positive Futures – Housing: Making a Home in Civilian Society published in June 2021; and the final report Positive Futures – Health and Wellbeing will publish early next year.