Health and Wellbeing Progress – Recommendation 15

Tackling health inequalities

The Scottish Government, NHS(S) and partners should identify veterans as a distinct group in their work to tackle health inequalities. In doing so they should produce proposals for preventing or mitigating inequalities as they apply to this group, with the ultimate aim of improving health outcomes for all.

2019 SVC evaluation of status:

Partially implemented

2019 update provided by the Scottish Government:

Officials have been engaging with colleagues on the Step Into Health programme to hear more about how their programme works. The programme is a NHS Employers initiative to promote and encourage members of the Armed Forces on leaving service to join the NHS. There is an opportunity to maximise this initiative across NHS Scotland. Officials have also had discussions with the Veterans Commissioner and NHS Boards to look at challenges and opportunities to determine if further work is required around veterans’ employability within NHS Scotland. This initiative will tackle health inequalities by increasing the number of NHS staff who are veterans themselves and have a shared vocabulary and experience with veteran patients, enabling improved health outcomes for veterans. The current position is that Step Into Health was discussed at the HR Directors Scotland meeting on 30 January 2019 where the HR lead stepped down from this work. A new HR lead will be identified to drive forward the programme, so work is on ice until then.

We have worked with NHS24 to improve accessibility to online information for veterans on NHS Inform. An evaluation study has taken place and improvements will be implemented at the end of March 2019. Improved accessibility and quality of information will tackle health inequalities and improve health outcomes for veterans.

NHS24 are currently leading a project to allow the development of a standardised website for each GP practice across Scotland, which will encourage dissemination of health information, as well as promote self-management and signpost to available local services. “Early Adopter” pilot areas are NHS Highland, Western Isles, Lanarkshire, Forth Valley and Lothian. The early adopter practices will use the site in a ‘live’ environment throughout April and May 2019 for the back end/administration of the site, before testing with patients and public within a live environment, before a phased approach to rolling out to a larger number of practices throughout 2019. Uptake should increase through each rollout phase and, in turn, this will increase the accessibility of health information and improved outcomes for all.

The ALLIANCE is funded by the Scottish Government to deliver A Local Information System for Scotland (ALISS). This web-based resource continues to map community assets and to connect people – including veterans – with local sources of support that will enable them to manage their own health conditions more effectively. ALISS was co-produced by working with disabled people, people living with long term conditions, unpaid carers, health and social care professionals and technology professionals. In 2017/18, the ALLIANCE developed a new version of the website to make it easier to keep information content up-to-date and to improve the relevance and accuracy of searches. In 2017/18 the number of users who accessed ALISS totalled 164,851 and 3,777 services were added to the system.

2020 SVC evaluation of status:

Partially implemented

2020 update provided by the Scottish Government:

NHS Inform has pages dedicated to veterans’ health and rights, with links to other services. The information in those pages is replicated in the “Welcome to Scotland” document for serving personnel and their families who are posted in Scotland. Part of the work towards developing the Mental Health Action Plan and the proforma to gather intelligence around this is to identify where current inequalities may lie in terms of access to mental health services for veterans, and also aims to identify unmet need for specific groups within the veterans’ community (that may be associated with ethnic group, gender, sexuality, age, nature of their difficulties, type or length of military service, or method of discharge).

2021 SVC evaluation of status:

Partially implemented

2021 update provided by the Scottish Government:

Awareness of the interlinked nature of the inequalities that veterans may face sits at the heart of the Joint Group’s varied priority work areas. In taking forward work to reduce and mitigate these inequalities, our approach has focused on identifying veterans as a distinct group.

Over the last year, the following work, which includes identifying veterans as a distinct group, has progressed:

  • On wellbeing, wider socio-economic and related health inequalities,  we have worked with partners to develop resources to support veterans gain employment within the NHS and promote the NHS as a post-service career.
  • To reduce inequalities veterans may face in accessing healthcare, we contribute to four-nation work on reviewing ‘priority treatment’ terminology and, at the correct time, will expand on this work by communicating the conclusions across the Scottish health landscape.
  • The Mental Health Action Plan will contain recommendations on veteran wellbeing services, including drug and alcohol services.
  • We are exploring the set-up of a veteran-specific trauma network/pathway.
  • Through written instruction to health boards, we have sought to ensure that veterans’ MOD-issued wheelchair and hearing aid devices are maintained and replaced to at least a level commensurate with devices received at time of discharge.

We continue to keep online information updated to ensure appropriate sign-posting to veteran-specific information and services through NHS Inform.

2022 SVC evaluation of status:

Partially implemented

2022 update provided by the Scottish Government:

Identifying who and where our veterans are is a key to understanding what health inequalities they face. The inclusion of the question on veterans in the Census and the Scottish Health Survey will assist further with this. The current priorities, as set by the Strategic Oversight Group, allow us to focus on specific areas where we can improve health outcomes for veterans. 

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