Military Veterans and access to Health Services- Priority Treatment

The CMO has recently confirmed that successive NHS Operating frameworks includes the requirement that military veterans receive priority access to NHS secondary care for any conditions which are likely to be related to their service (subject to the clinical needs of all patients).

Where it is considered that priority treatment might be appropriate because the condition to which the referral relates is likely to be related to the patient's time in the services, GPs are asked to include details in the referral.

Where the patient is content for their veteran status to be included, GPs are asked to clearly state this when drafting referral letters including, in your clinical opinion, that the condition may be related to military service.

GPs, when making referrals relating to a military veteran for diagnosis or treatment, where they are aware of the patient's veteran status, should record that status as part of the referral. If the patient does not want the GP to record their veteran status then the information should not be included.

For Choose and Book, GPs are asked to refer normally and select the correct appointment priority based upon the patient's medical condition (routine / urgent or 2 week wait) including veteran details in the referral letter (refer: ttp://www.chooseandbook.nhs.uk/staff/communications/fact/Armed-Forces.pdf)

Where secondary care clinicians agree that a veteran's condition is likely to be service-related, they are asked to prioritise veterans over other patients with the same level of clinical need. However, and as set out in David Nicholson's letter of December 2007, it remains the case that veterans should not be given priority over other patients with more urgent clinical needs.

In order to ensure continuity of care, it is anticipated Defence Medical Services will commence direct transfer of medical records to GPs when individuals leave the Armed Forces. GPs and practice nurses are asked to include as a minimum the "History Relating to Military Service" code (Read: Code Xa8Da or SNoMed CT: 302121005) against all known veterans within the practice.

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There are about 5 million veterans in England (a veteran is defined as someone who has served at least one day in the UK Armed Forces). For the vast majority of veterans their time in the service will have been a positive experience but some will leave with medical conditions resulting from their time in service.

Given the ongoing nature of UK Armed Forces involvement in Afghanistan and the current and future needs of the veteran population, it is important that access to priority treatment is identified where appropriate.