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Nigel's surgery 93: Caring for veterans and their families
When we inspect general practices, we look at how they provide care to different groups of people.
One of these is ‘people whose circumstances may make them vulnerable’. This includes members of the armed forces community. This comprises serving personnel (regular and reserve), their families and veterans. There are about 2.4 million veterans in Great Britain, 5% of the population aged 16 and over. Almost two-thirds of veterans are 65 and over and the majority are male. Also, there are about 5.4 million adult spouses, partners, widowers (overall mainly female) and child dependants of veterans.
The healthcare needs of veterans can be different from other patients. They may:
- miss the structure, support and friendship of the forces
- find transition to life outside the military stressful.
Acknowledging this is a crucial first step in providing effective healthcare for veterans. Their treatment may need some understanding of military life.
Armed forces personnel
Veterans may have physical and mental health issues specific to their time in service.
There has been an emphasis on veterans with post-traumatic stress disorder (PTSD). For veterans who deployed when serving, rates of PTSD (9%) are higher than the incidence among civilians. This rises to 17% for those who deployed in a front-line, infantry combat role. Rates for veterans who have not been deployed (around 6.2%), are broadly equivalent to the incidence among civilians. More common issues for all veterans include other mental health difficulties, such as anxiety and depression, as well as problems related to alcohol.
There is growing evidence that a range of mental health conditions may appear (or patients may present) some years after leaving the armed forces. These conditions may relate to combat, training or other military experiences, transition out of service or pre-service vulnerabilities.
Service families often have extra pressures on family life and may be more vulnerable than the general population. These include:
- stress around deployment, concerns about injury or death
- extended, short-notice and repeated periods of separation
- social isolation from family and friends (based in remote locations and moved at short notice)
- additional and short notice caring responsibilities
- adapting to family life after enforced separation.
Service families tend to move every two to three years. They should not be disadvantaged by:
- losing their place on hospital waiting lists
- having their care interrupted
- needing to re-register with GP services.
GP care for veterans and their families
There are resources to support GP practices.
Veteran’s healthcare toolkit
The RCGP has produced guidance for GPs on how to deal with veterans’ healthcare needs. The veterans' healthcare toolkit advises how best to help those who may have been affected by their service careers. The toolkit includes:
- NHS duty to the armed forces community, including the Armed Forces Covenant
- services for veterans, provided by NHS and other groups
- how to request a patient’s service medical records.
Veteran friendly accredited practice
RCGP, NHS England and NHS Improvement are working together to accredit GP practices as ‘veteran friendly’.
Find out about veteran friendly GP practices, including:
- what accreditation involves
- how to take part.
- Last updated:
- 20 June 2019