During my career as an advanced nurse practitioner, I have experience of our Armed Forces community from two perspectives; clinically, and as a military spouse. It is a community that often goes unnoticed, and so it is critical that health professionals are able to help and support them. That is where the Royal College of General Practitioners' (RCGP) free veteran friendly GP practice accreditation programme can help, by equipping practice staff with the training, information and resources to identify and then support their veteran patients.
A group with complex needs
There are an estimated 2.4 million veterans living in England, and taking into account their families too, there is a considerable Armed Forces community living under our care. The healthcare needs of veterans are often complex, related to both their experiences as serving members and the unique psychosocial issues associated with transitioning to civilian life (Oster et al, 2017). The complex needs of some veterans can be related to the intensive physical demands associated with military service, and lifestyle factors such as physical and psychological trauma, exposure to harmful/toxic substances, and alcohol consumption (Beard and Kamel, 2015).
The Armed Forces encourages its personnel to be self-sufficient and to get on with the job in hand and, culturally, there is often a misconception that asking for help is a sign of weakness (Fulton et al, 2018). Sadly, it is this very same mindset that often discourages them from reaching out for help and support from a health professional. As identification of veteran patients remains challenging and veterans are generally unlikely to identify their veteran status, providing this community with the healthcare that they deserve remains complex.
RCGP Veteran Friendly Accreditation Programme
The RCGP has worked with NHS England to develop the RCGP Veteran Friendly Accreditation Programme. It aims to equip GP practices to address this problem by understanding the specific needs of veterans and their families and prompting staff to ask patients if they have ever served in the Armed Forces. Accreditation is very simple and includes coding the veteran on the GP computer system and having a clinical lead for veterans within the surgery – who can be a nurse of course. Once accredited, practices receive an information pack to help with veterans' healthcare, along with some training. The programme also aims to help the NHS better uphold the health commitments of the Armed Forces Covenant, which states that the armed forces community, including veterans, should face no disadvantage in accessing health services, and receive priority care for military attributable conditions, subject to the clinical needs of others.
However, this referral fast-tracking can only occur if healthcare staff and other external organisations are aware of their patients' veteran status. This is where practices can step in, with the Veteran Friendly Accreditation Programme giving them the tools and support to do so. A recent evaluation study by the University of Chester found that the programme is having a successful impact. Data from accredited practices found that 99% of respondents would recommend the program and 84% report a better understanding of veteran needs (Finnegan et al, 2022).
Reducing health inequalities
Identifying and acknowledging veterans' specific health needs will help to improve health outcomes and reduce health inequalities within our Armed Forces communities. Health professionals can play a key role in addressing this by signposting appropriately and ensuring veterans have the correct support, and the RCGP Veteran Friendly Accreditation Programme is well placed to facilitate this.
‘The healthcare needs of veterans are often complex, related to both their experiences as serving members and the unique psychosocial issues associated with transitioning to civilian life.’