Social prescribing is widely recognised as a valuable and cost-effective intervention that can significantly reduce workload in primary care. Most recently, the move to allow NHS social prescribers to prescribe heating to patients with long-term conditions that get worse in the cold, was welcomed by many frontline staff. Something to consider when considering social prescribing, is the importance of meaningful employment in a patient's recovery.
For many people who leave the Forces, the transition to civilian life is smooth and successful. But for some, the outcome is not quite as positive. Alongside physical challenges such as musculoskeletal and hearing problems, veterans may have an increased risk of experiencing anxiety and depression, alcohol and substance misuse, gambling problems and post-traumatic stress disorder (PTSD), making it difficult to gain and keep meaningful employment.
Employment can have a very positive effect on mental health and wellbeing
At The Poppy Factory, our employment consultants have expertise working with ex-Forces personnel with mild, moderate and complex mental and physical health conditions. We know employment can have a very positive effect on mental health and wellbeing and offer our employment services to veterans who have served in the Armed Forces or Reserves -often for many years, or in some cases, just a few days or weeks. While employment is always the end goal, support may include help accessing training or education; health and wellbeing services; or volunteering opportunities.
Veterans can struggle to engage with health services
In July 2021 we launched a pilot programme, backed by NHS England, to embed employment consultants within local primary care networks, health centres and mental health teams, taking referrals from general practice nurses, GPs, mental health practitioners and others who come into contact with veterans. An evaluation of one of the pilots in the Wirral in Cheshire, by the University of Nottingham's Institute of Mental Health (IMH, 2022), has shown a positive impact for the veterans.
Veterans can struggle to engage with health services and some of them felt more comfortable dealing with the employment consultant, who works exclusively with ex-Forces patients, who could then update clinical colleagues.
Last year, nearly 200 ex-Forces patients came to our employment service through the NHS, representing 35% of all referrals. Regular assessments showed that 64% reported increased health and wellbeing.
Feedback from clinical teams about our NHS pilots was overwhelmingly positive. Comments included: ‘There are no long waiting lists, the referral process is easy to follow, and information is shared between services.’
The role of general practice nurses
One important recommendation from the IMH was that the Poppy Factory's service ‘should accept referrals from a wide range of sources including primary and secondary care, to ensure employment support can be used as an early intervention before health conditions escalate or can be used as part of a veteran's recovery plan from more serious conditions’.
We are strong supporters of the Military Veteran Aware Accreditation programme Veterans’ healthcare toolkit: Veteran friendly GP practice accreditation (rcgp.org.uk) and know that general practice nurses work hard to identify ex-Forces patients. We hope the opportunity to refer directly to our employment service will be a useful approach and one that ultimately leads to successful outcomes and reduced reliance on the NHS.