The UK’s defence capability relies increasingly on its reservists from the NHS, says Alison Moore Around 2,000 NHS staff already work as military reservists, combining their daily duties in hospitals and the community with part-time training. But over the next few years that number is expected to rise. The UK’s armed forces are becoming more reliant on reservists and are looking to increase numbers from around 23,000 to 35,000 over the next few years, with reservists making up 29 per cent of the defence capability. Clinical staff – doctors, nurses and physiotherapists – will make up 5,000 of these and already play a vital part in military medical services. The Ministry of Defence (MoD) says that it will be looking for about 600 extra nurse reservists across the army, navy and RAF reserve services.

Commitment

Nurse reservists working alongside colleagues from the military can be called on to take part in operations and training exercises around the world, and training in the UK. Their commitment is for between 12 and 27 days’ training a year and they are paid in line with their role, qualifications and rank. They also get a tax-free annual bonus and build up armed forces pension rights. Many NHS organisations support their nurse reservists – in some cases allowing additional paid leave to cover annual training commitments.

There is no nationally agreed level of support that English NHS organisations will provide to reservists. 5 Boroughs Partnership Foundation Trust in the north west offers up to 18 days’ paid leave for training. However, assistant director of human resources Charlotte Layton says few of the trust’s reservists take that much. She says that it is important the message about supporting reservists reaches managers and staff so that they understand the options available to them. NHS Scotland has a reservists policy that includes two weeks’ paid leave for annual camp and additional unpaid leave for training. It also has a commitment to try to roster staff so that they can attend training. NHS Employers director of employment services Sue Covill says there is a misconception that reservists will be required to deploy abroad at short notice. In fact, there is usually plenty of notice and the MoD will discuss cases

with employers if the absence of an employee is going to cause difficulties. The MoD will also help reservists to reintegrate after periods of deployment, she adds. Cost implications can also be a concern for employers. However, if a reservist is sent abroad his or her salary will be covered by the military and the employer will usually have had substantial notice to arrange cover. Employers can benefit from their workforce’s reservists involvement. Alan Tabener’s military experience, for example, has helped him take on a lead role dealing with veterans’ mental health issues at his trust. The primary care mental health nurse has combined working for the NHS and the military for more than 25 years. He works at 5 Boroughs Partnership Foundation Trust in Wigan on the Improving Access to Psychological Therapies service, using techniques such as cognitive behaviour therapy. Since 1987 he has been attached to 207 Manchester Field Hospital, committed to a 15-day training period each year and additional time at weekends and evenings. ‘You are a soldier before you are

GARRY PARSONS

From NHS to army – and back again

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SUMMARY

anything else,’ he says. ‘You have to be able to defend yourself and your casualties.’ Mr Tabener spent six months in Iraq in 2004, holding surgeries for soldiers. He also advised officers on how to help their soldiers cope with the stress of deployment. ‘It is a steep learning curve. You are briefing commanders and often fighting the stigma attached to soldiers seeking mental health services. You have to convince military leaders that mental health problems are normal,’ he says. ‘The ethos of military mental health is to keep the soldier fighting, not to pull them out. We are educating soldiers and commanders that it is okay to be anxious.’

Some NHS employers are reluctant to support staff who join the armed forces as reservists, fearing that the time spent on training and deployment will be costly and disruptive. In reality, the disruption is minimal and reservists’ skills and experience bring considerable strengths to their organisations. Author Alison Moore is a freelance journalist

Insight

His experience as a soldier gives him insight into veterans’ mental health issues – insights that a civilian nurse would be unlikely to have. ‘I understand their language; I know what they have been through,’ he says. Trauma nurse co-ordinator Laura Foster’s field hospital experience has also been valuable in her work at King’s College

Hospital, London. She saw some horrific casualties when deployed to Afghanistan in 2011, where she worked in intensive care at Camp Bastion. ‘I learned so much about really good team work at Camp Bastion. Just seeing how they work from a trauma point of view was fantastic,’ she says. Service personnel with severe injuries would sometimes require huge amounts of blood – 87 units in one case – yet the unit had an astonishing survival rate. Once service members were stable enough to be transferred, they would be flown via RAF Brize Norton to Birmingham. Feedback on their progress would be sent back to Camp Bastion, which helped keep morale high. Ms Foster could be deployed

abroad again potentially, although the end of hostilities in Iraq and Afghanistan make that less likely. She has recently signed up for another five years and is attached to RAF Brize Norton. She says the leadership courses she has been able to complete through her military training have been particularly valuable opportunities that might have been hard to access in the NHS. ‘The RAF was keen to see that I improved my skills and wanted me to progress in my career.’ Ms Covill says many skills are enhanced by military training and service – not only leadership and organisational expertise, but also clinical skills; the military’s trauma care is seen as groundbreaking, for example. Supporting Britain’s Reservists and Employers – an MoD-funded organisation – has calculated that employers would have to purchase £8,000 of training to match that provided by the military to an average reservist in a year NS For our resources collection on defence nursing see http://rcnpublishing.com/r/ defence-nursing

‘I TOOK MYSELF OUT OF MY COMFORT ZONE’ Associate nurse director at NHS Fife Pauline Small is senior officer for the Queen Alexandra’s Royal Naval Nursing Service reserves – one of the UK’s most senior nurse reservists. She was also instrumental in developing a Scotland-wide approach to reservists in the NHS, which individual organisations have adopted. She has been a reservist for more than 15 years and says she has received support from her NHS employers and the military. ‘It was an opportunity to do something different and take myself outside my comfort zone,’ she says. In 2006, she spent five months on full-time reserve service in Cyprus. ‘I was a practising midwife and the

military were having problems staffing and maintaining the service,’ she says. She has also visited Iraq for a short period. She has helped to promote reservists within the NHS and correct some of the misapprehensions about releasing staff for training and deployment. As well as speaking on the subject, she has accompanied a group of chief executives and chair to an RAF base in Cyprus to learn more about the reservists’ role. Ms Small has also been named on a list of the UK’s most influential nurse leaders. Now 55, she is passionate about the clinical and leadership skills reserve service can offer nurses.

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From NHS to army--and back again.

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