Hertfordshire Council commissioned a study to understand whether veterans are accessing NHS services in accordance with its commitment.
The NHS has committed to ensuring that: “all veterans are entitled to priority access to NHS care (including hospital, primary or community care) for conditions associated with their time in the Armed Forces (service-related)…subject to clinical need.”
The Health sub-group of the Hertfordshire Armed Forces Covenant Board commissioned Healthwatch Hertfordshire to conduct a study to better understand the healthcare needs and experiences of veterans living in Hertfordshire. Funding for the study was secured from Public Health Hertfordshire.
87 veterans completed a questionnaire, 7 veterans took part in an online focus group and 1:1 in-depth interviews. 8 local NHS organisations were interviewed, including Hospital Trusts, Clinical Commissioning Groups and “Veteran Friendly” GP practices.
The study reports the importance of identifying veterans, the need to increase access to priority treatment for veterans, and the need to raise awareness among both the veteran community and NHS professionals about veteran entitlement.
Veterans also raised concerns that the majority of NHS services are not aware of the Armed Forces Covenant. Veterans felt this lack of knowledge hindered them in accessing services they are entitled to – priority treatment based on clinical need, and being signposted or referred to specialist services, charities or support groups.
Veterans noted that information about the healthcare services available to veterans, would have been helpful when transitioning into civilian life and would have encouraged them to access this support.
The findings showed that veterans tend to face the same delays and barriers as the general population, particularly regarding waiting times.
As with the civilian population, 25% (17) of veterans struggled to access NHS services in the last 12 months, specifically mental health services, dentistry, opticians and audiologists.
Delays were largely as a result of the COVID-19 pandemic, restricting access to services and the level of care and support patients could receive.
However, the greatest barrier cited was that veterans often do not know what mental health services are available to them, and do not know how to access support for their mental health.
For example, of the 24 veterans with a mental health condition, 83% (20) of veterans had not accessed the Veteran Transition, Intervention and Liaison Service (TILS) and 96% (23) had not accessed the Veteran Complex Treatment Service (CTS).
Almost all veterans said this was because they had never heard of these services and were not aware they existed.
The Hospital Trusts and CCGs each had different interpretations of what priority treatment is, and what it means for veterans in practice, while some were not aware of priority treatment at all.
The same issues were found in terms of the Armed Forces Covenant, with Hospital Trusts, CCGs and GP practices having different interpretations of the Armed Forces Covenant and what it means in practice for veterans.
The questionnaire found that 60% (59) of veterans did not mention their military service to their GP, for a variety of reasons cited in the report.
Although the findings indicate a number of barriers to address, it is very positive that all NHS services involved in this project confirmed their commitment to working with the Health Subgroup, as well as other NHS and care partners across the system to improve experiences for veterans.
The recommendations that the Health Subgroup will propose to the Hertfordshire Armed Forces Covenant Board will be reviewed for approval in March 2021. Cllr Terry Douris, Chairman of the Hertfordshire Armed Forces Covenant Board, said: “I look forward to using this evidence to strengthen our work supporting the Armed Forces community in Hertfordshire.”
Healthwatch Hertfordshire’s report, “Improving Healthcare Access for Veterans” is accessible here in full.