Registering and Care of Military Personnel & Veterans
Page Contents
Registration Arrangements for Serving Personnel
Armed Forces Covenant and Legal Duties
Identifying Veterans in General Practice
Physical Health Considerations
Specialist NHS Services for Veterans
Introduction
This guidance supports GP practices in the registration and ongoing care of serving personnel, reservists, veterans and Armed Forces families. It reflects current NHS policy, the Armed Forces Covenant, the Armed Forces Act 2021, NHS England veteran pathways and Royal College of General Practitioners’ recommendations.
Practices should ensure that members of the Armed Forces community experience no disadvantage in accessing healthcare because of service-related circumstances and should be aware of specialist pathways available to veterans and their families.
Registration Arrangements for Serving Personnel
Eligible Armed Forces personnel may remain registered with a GP practice under specific contractual arrangements. Defence Medical Services retain responsibility for occupational health matters, while NHS primary care may be provided where authorised arrangements are in place.
Personnel and families returning from overseas postings may register with a previous practice subject to normal residency requirements and local registration policies.
See Section 13.5A Inclusion in list of patients: armed forces personnel of Standard General Medical Services Contract for full details.
Armed Forces Covenant and Legal Duties
The Armed Forces Covenant recognises the unique obligations and sacrifices made by serving personnel, veterans and their families.
Key healthcare principles include:
- No disadvantage in accessing healthcare because of service.
- Retention of NHS waiting-list position where appropriate following service-related moves.
- Priority treatment for service-attributable conditions, subject to clinical need.
- Awareness of Armed Forces culture among healthcare professionals.
Relevant NHS bodies are required to give due regard to Armed Forces Covenant principles when exercising specified healthcare functions.
See section 7.13B Duty to have regard to Armed Forces covenant of Standard General Medical Services Contract and the Armed Forces Covenant for full details.
Identifying Veterans in General Practice
A veteran is anyone who has served in the UK Armed Forces, Regular or Reserve, for at least one day.
Practices should routinely ask patients whether they have served in the Armed Forces and record this using appropriate SNOMED coding – 443668013 (History Relating to Military Service). Accurate coding improves access to specialist services, aids commissioning planning and referral quality.
See RCGP and NHSE urge practices to become veteran friendly accredited this Remembrance
Veteran Health Profile
Current census-based data indicates there are approximately 2.0 to 2.1 million veterans in Great Britain. Around sixty per cent are aged 65 years and over, although increasing numbers of younger veterans are accessing NHS services.
Many veterans enjoy health outcomes similar to the wider population. However, some experience health conditions associated with military service or the transition to civilian life.
Physical Health Considerations
Common service-related presentations include musculoskeletal disorders affecting the back, knees, hips and lower limbs, hearing problems, chronic pain, rehabilitation needs and conditions attributable to operational service.
When a condition may be attributable to military service, this should be clearly documented and communicated in referrals.
Mental Health Considerations
While PTSD remains an important condition, veterans more commonly present with anxiety, depression, alcohol-related difficulties, adjustment disorders, sleep disturbance and broader psychological wellbeing concerns.
Some mental health conditions may emerge many years after military service has ended. Practices should take a trauma-informed approach and consider service history whenever relevant symptoms arise.
Specialist NHS Services for Veterans
Op COURAGE provides specialist NHS mental health services for veterans, reservists, service leavers and eligible family members.
Op RESTORE provides assessment and support for veterans with service-attributable physical health conditions and injuries.
Veterans should also be directed to local integrated care pathways and Veterans Covenant Healthcare Alliance – Veterans Covenant Healthcare Alliance supported services where available.
Armed Forces Families
Service families may experience repeated relocation, deployment-related stress, periods of separation, social isolation, and unexpected caring responsibilities.
Practices should ensure that military families are not disadvantaged when moving between areas and are aware of available support services.
Practice Recommendations
- Ask all newly registering patients whether they or immediate family members have served in the Armed Forces.
- Apply veteran coding consistently.
- Include veteran status in referral letters where clinically relevant.
- Promote awareness of Op COURAGE and Op RESTORE.
- Nominate a Veterans Clinical Lead.
- Consider obtaining RCGP Veteran Friendly Accreditation (Veteran Friendly Practice Accreditation Form (ONE practice per application ONLY))
- Maintain links with regional Armed Forces healthcare networks (To find out more, email armedforceshealth@nhs.net.)
Suggested Referral Wording
As this patient is a military veteran, and the current condition may be related to military service, the referral should be considered in accordance with Armed Forces Covenant principles and relevant NHS guidance concerning service-attributable conditions.
Services Supporting Veterans
- Help for Heroes -“We provide recovery and support for the Armed Forces community whose lives are affected by their service, no matter when they served.”
- Forcesline – Free confidential helpline provides supportive, listening signposting service for serving personnel, Veterans and families.
- Combat Stress – Confidential and safe help and advice about Service-related mental health issues for the whole military community.
- Togetherall – Share what’s troubling you anonymously, 24 hours a day, 7 days a week. Free for serving personnel, veterans, family members and carers.
- Veterans Gateway – The first point of contact for veterans seeking support”
- Veterans UK – MoD/Government. Claims, pensions and service records
- Veterans Outreach Support– Drop In Centres
- Blesma – “Providing support to limbless and injured veterans for life”
- Blind Veterans UK – “Helping Ex-Service men and women of every generation rebuild their lives after sight loss. Since 1915 we’ve provided rehabilitation, training, practical advice and emotional support to tens of thousands of blind veterans.”
- NHS Veterans Mental Health Services
- Forces Online Veterans Directory – Additional local services
Services Supporting Family Members
Support for Family Members of Injured, Wounded & Sick Currently Serving, Reservist or Veterans
- The Ripple Pond– Free to adult family members of all military personnel
- Togetherall – Free to all military personnel & family members
- SSAFA– Families of Injured Service Personnel (FISP)
Support for Parents of Serving Military Personnel – NOT Injured
These organisations will give information to ALL adult family members (including parents) of those who are currently serving:
Support for Children of Serving & Ex-Serving Military Personnel
Sometimes the support is not because a parent has been injured, but perhaps a parent is deployed, or about to be deployed, and the child(ren) is anxious and in need of additional support.
- Little Troopers (formerly ‘My Daddy’s a Soldier’ – this organisation is only for children of serving personnel)
- Sailors’ Children’s Society
- HMS Heroes – HMS Heroes & Service Pupils Champions run groups through schools – for more info contact RBL)
- Other Young Carers groups: carersuk.org Children’s Society
- Books (Niamh Finley-Howe) – “Mummy Why Does Daddy Cry?” “So What, My Dad Has PTSD”