EDITORIAL
Editor in Chief Ian Peate Editor/Associate Publisher Julie Smith [email protected]
We must not fail our veterans
Chief Subeditor Sarah Kahn [email protected] Subeditors Daniel Davies [email protected] Vicqui Stuart-Jones [email protected] Commissioning Editor Sue Woodward Group Classified Director Rachel McElhinney [email protected] Circulation Director Sally Boettcher [email protected] Associate Publisher Andrew Iafrati [email protected] MedEd Manager Tracy Cowan [email protected] Classified Sales Executive Harry Nolan Production Manager Jon Redmayne Production Assistant Larry Oakes Editorial Make-up Kyri Apostolou Publishing Director Anthony Kerr Managing Director Jon Benson Chief Executive Officer Ben Allen UK PERSONAL SUBSCRIPTION RATES
Quarterly Direct Debit Annual Direct Debit Annual Credit Card 2yr Annual Credit Card 3yr Annual Credit Card
£43 £169 £178 £303 £427
Subscribe online: www.magsubscriptions.com, Subscribe by phone: +44 (0) 1722 716997 Contact [email protected] for institutional pricing MA Healthcare Ltd is part of the Mark Allen Group
www.markallengroup.com The British Journal of Nursing is published by MA Healthcare Ltd, St Jude’s Church, Dulwich Road, London SE24 0PB Tel: 020 7738 5454 Editorial: 020 7501 6716 Sales: 020 7501 6726 Email: [email protected] Websites: www.britishjournalofnursing.com
© MA Healthcare Ltd, 2015. All rights reserved. No part of the British Journal of Nursing may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording, or otherwise without prior written permission of the Publishing Director. The British Journal of Nursing is a double-blind, peerreviewed journal. It is indexed on the main databases, including the International Nursing Index, Medline and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) The views expressed do not necessarily represent those of the editor or the British Journal of Nursing. Advertisements in the journal do not imply endorsement of the products or services advertised. ISSN 0966 – 0461 Print: Pensord Press Ltd, Blackwood, NP12 2YA Distribution: Comag Distribution, West Drayton, UB7 7QE Cover picture: iStockphoto.com The paper used within this publication has been sourced from Chain-of-Custody certified manufacturers, operating within international environmental standards, to ensure sustainable sourcing of the raw materials, sustainable production and to minimise our carbon footprint.
British Journal of Nursing, 2015, Vol 24, No 11
I
am very proud of, and grateful for, the commitment of all those who have served and are currently serving in our armed forces. I have immense respect and gratitude for them, and believe they deserve our support and fair treatment. The Armed Forces Covenant (Ministry of Defence (MOD), 2011), the main principles of which are enshrined in the Armed Forces Act 2011, is an enduring covenant between the people of the UK, Her Majesty’s Government and all those who serve or have served in the armed forces and their families. Defence of the realm is the first duty of Government and the armed forces fulfil that responsibility on behalf of the Government. In doing so, they sacrifice some civilian freedoms; they confront danger; and they may suffer serious injury or death as a consequence of their duty. Families also play a key role in supporting the operational efficiency of our armed forces. In return, the whole nation has a moral obligation to the armed forces and their families. Those who serve and have served in the armed forces, along with their families, should not be expected to face any disadvantage compared with other citizens in the provision of public and commercial services (including health services). The Covenant notes that special consideration, in some cases, is appropriate, particularly for those who have given most—for example, the injured and the bereaved. The whole of society is involved in this obligation to recognise those who have done their military duty, as we demonstrate that we value their contribution. With regard to health care, the armed-forces community should enjoy the same standard of, and access to, health care enjoyed by any other UK citizen, wherever they live. For serving personnel, secondary care is given by the local healthcare provider. Veterans—defined as those who have served for at least a day in Her Majesty’s Armed Forces, whether as a Regular or as a Reservist (MOD, 2011)—receive their health care from the NHS.They are expected to receive priority treatment where this is associated with a condition resulting from their service in the armed forces, subject to clinical need. Once a veteran leaves the armed forces, their health care is the responsibility of the NHS. Those injured in service, whether physically or psychologically, should be cared for in a way that reflects the nation’s moral obligation to them and at the same time respects the person’s wishes. For those with concerns about their mental health, where symptoms may not present for some time after leaving service, these people should be able to access services with health professionals who have an understanding of armed-forces culture. Support should be available for all service personnel to aid their transition from
service to civilian life. Provision should include appropriate healthcare referral. The level of support will depend on individual circumstances. Between 2008/9 and 2012/13, more than 4327 service personnel were medically discharged as a result of musculoskeletal disorders, lost limbs, and problems with ligaments and joints; 1007 were medically discharged as a result of poor mental health. Many of these people will require constant care for the rest of their lives (Ministry of Defence and British Orthopaedic Association, 2014). The Government has failed to honour its obligation in the Covenant to guarantee injured British soldiers priority for medical treatment in the years after their service. Systems need to be tightened up, and priority treatment offered, as agreed and promised. The Government must demonstrate its full commitment by sustaining and rewarding veterans. I think we can do better, and should do better, when it comes to the health care offered to our veterans as a result of the sacrifices that they have made in defence of the realm. The health service needs to help veterans more effectively in accessing specialist care and avoid cases where some fall through the net as a result of a system that is over-bureaucratic and difficult to navigate. When we provide veterans with the treatment that they have the right to receive, they can continue to be productive members of society. It is a sound investment to look after these people, and to provide them with the support and help that they need. Our moral obligation to treat veterans must not end when service ceases.They should receive priority health care from the NHS when being treated for a condition that has resulted from their time in the armed forces. Understanding the Covenant and the obligations in it can help nurses ensure that veteran care is as good as it should be. The Government needs to be more honest about what it is delivering under the Covenant, and what it should be delivering, as there seems to be some disparity. This is a serious indictment of a failure to respond to the needs of the most courageous people in our society. BJN
Ian Peate
Editor in Chief British Journal of Nursing
Ministry of Defence (2011) The Armed Forces Covenant. http:// tinyurl.com/kd9xr4h (accessed 7 May 2015) Ministry of Defence and British Orthopaedic Association (2014) The Chavasse Report:The Evidence. http://tinyurl.com/nqmsh7j (accessed 7 May 2015)
561
British Journal of Nursing. Downloaded from magonlinelibrary.com by 129.096.252.188 on December 6, 2015. For personal use only. No other uses without permission. . All rights reserved.
Editor in Chief Ian Peate Editor/Associate Publisher Julie Smith [email protected]
We must not fail our veterans
Chief Subeditor Sarah Kahn [email protected] Subeditors Daniel Davies [email protected] Vicqui Stuart-Jones [email protected] Commissioning Editor Sue Woodward Group Classified Director Rachel McElhinney [email protected] Circulation Director Sally Boettcher [email protected] Associate Publisher Andrew Iafrati [email protected] MedEd Manager Tracy Cowan [email protected] Classified Sales Executive Harry Nolan Production Manager Jon Redmayne Production Assistant Larry Oakes Editorial Make-up Kyri Apostolou Publishing Director Anthony Kerr Managing Director Jon Benson Chief Executive Officer Ben Allen UK PERSONAL SUBSCRIPTION RATES
Quarterly Direct Debit Annual Direct Debit Annual Credit Card 2yr Annual Credit Card 3yr Annual Credit Card
£43 £169 £178 £303 £427
Subscribe online: www.magsubscriptions.com, Subscribe by phone: +44 (0) 1722 716997 Contact [email protected] for institutional pricing MA Healthcare Ltd is part of the Mark Allen Group
www.markallengroup.com The British Journal of Nursing is published by MA Healthcare Ltd, St Jude’s Church, Dulwich Road, London SE24 0PB Tel: 020 7738 5454 Editorial: 020 7501 6716 Sales: 020 7501 6726 Email: [email protected] Websites: www.britishjournalofnursing.com
© MA Healthcare Ltd, 2015. All rights reserved. No part of the British Journal of Nursing may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording, or otherwise without prior written permission of the Publishing Director. The British Journal of Nursing is a double-blind, peerreviewed journal. It is indexed on the main databases, including the International Nursing Index, Medline and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) The views expressed do not necessarily represent those of the editor or the British Journal of Nursing. Advertisements in the journal do not imply endorsement of the products or services advertised. ISSN 0966 – 0461 Print: Pensord Press Ltd, Blackwood, NP12 2YA Distribution: Comag Distribution, West Drayton, UB7 7QE Cover picture: iStockphoto.com The paper used within this publication has been sourced from Chain-of-Custody certified manufacturers, operating within international environmental standards, to ensure sustainable sourcing of the raw materials, sustainable production and to minimise our carbon footprint.
British Journal of Nursing, 2015, Vol 24, No 11
I
am very proud of, and grateful for, the commitment of all those who have served and are currently serving in our armed forces. I have immense respect and gratitude for them, and believe they deserve our support and fair treatment. The Armed Forces Covenant (Ministry of Defence (MOD), 2011), the main principles of which are enshrined in the Armed Forces Act 2011, is an enduring covenant between the people of the UK, Her Majesty’s Government and all those who serve or have served in the armed forces and their families. Defence of the realm is the first duty of Government and the armed forces fulfil that responsibility on behalf of the Government. In doing so, they sacrifice some civilian freedoms; they confront danger; and they may suffer serious injury or death as a consequence of their duty. Families also play a key role in supporting the operational efficiency of our armed forces. In return, the whole nation has a moral obligation to the armed forces and their families. Those who serve and have served in the armed forces, along with their families, should not be expected to face any disadvantage compared with other citizens in the provision of public and commercial services (including health services). The Covenant notes that special consideration, in some cases, is appropriate, particularly for those who have given most—for example, the injured and the bereaved. The whole of society is involved in this obligation to recognise those who have done their military duty, as we demonstrate that we value their contribution. With regard to health care, the armed-forces community should enjoy the same standard of, and access to, health care enjoyed by any other UK citizen, wherever they live. For serving personnel, secondary care is given by the local healthcare provider. Veterans—defined as those who have served for at least a day in Her Majesty’s Armed Forces, whether as a Regular or as a Reservist (MOD, 2011)—receive their health care from the NHS.They are expected to receive priority treatment where this is associated with a condition resulting from their service in the armed forces, subject to clinical need. Once a veteran leaves the armed forces, their health care is the responsibility of the NHS. Those injured in service, whether physically or psychologically, should be cared for in a way that reflects the nation’s moral obligation to them and at the same time respects the person’s wishes. For those with concerns about their mental health, where symptoms may not present for some time after leaving service, these people should be able to access services with health professionals who have an understanding of armed-forces culture. Support should be available for all service personnel to aid their transition from
service to civilian life. Provision should include appropriate healthcare referral. The level of support will depend on individual circumstances. Between 2008/9 and 2012/13, more than 4327 service personnel were medically discharged as a result of musculoskeletal disorders, lost limbs, and problems with ligaments and joints; 1007 were medically discharged as a result of poor mental health. Many of these people will require constant care for the rest of their lives (Ministry of Defence and British Orthopaedic Association, 2014). The Government has failed to honour its obligation in the Covenant to guarantee injured British soldiers priority for medical treatment in the years after their service. Systems need to be tightened up, and priority treatment offered, as agreed and promised. The Government must demonstrate its full commitment by sustaining and rewarding veterans. I think we can do better, and should do better, when it comes to the health care offered to our veterans as a result of the sacrifices that they have made in defence of the realm. The health service needs to help veterans more effectively in accessing specialist care and avoid cases where some fall through the net as a result of a system that is over-bureaucratic and difficult to navigate. When we provide veterans with the treatment that they have the right to receive, they can continue to be productive members of society. It is a sound investment to look after these people, and to provide them with the support and help that they need. Our moral obligation to treat veterans must not end when service ceases.They should receive priority health care from the NHS when being treated for a condition that has resulted from their time in the armed forces. Understanding the Covenant and the obligations in it can help nurses ensure that veteran care is as good as it should be. The Government needs to be more honest about what it is delivering under the Covenant, and what it should be delivering, as there seems to be some disparity. This is a serious indictment of a failure to respond to the needs of the most courageous people in our society. BJN
Ian Peate
Editor in Chief British Journal of Nursing
Ministry of Defence (2011) The Armed Forces Covenant. http:// tinyurl.com/kd9xr4h (accessed 7 May 2015) Ministry of Defence and British Orthopaedic Association (2014) The Chavasse Report:The Evidence. http://tinyurl.com/nqmsh7j (accessed 7 May 2015)
561
British Journal of Nursing. Downloaded from magonlinelibrary.com by 129.096.252.188 on December 6, 2015. For personal use only. No other uses without permission. . All rights reserved.
