Adapting general practice nursing for the veteran population

To mark this year’s Remembrance Day, Madeleine Anderson spoke with veteran, specialist nurse practitioner and veteran lead at the Whittaker Lane Medical Centre, Debbie Howarth, about how general practice nurses (GPNs) can adapt their care for the veteran population, and the difference that being a ‘Veteran Friendly’ accredited practice can make to these often harder to reach patients.

Over 4,400 GP practices are Veteran Friendly accredited, a free programme by the Royal College of GPs and NHS England which aims to support practices to identify veteran patients, understand their health needs and to refer them to specialist NHS services where needed.

This week, the government began its new training programme to help NHS staff across England to provide personalised care for the armed forces community. As part of the scheme, all GP practices in England will receive training on how best to support veterans.

How did you first discover the Veteran Friendly accreditation scheme and what drew you to promoting the scheme in your own practice?

I was in the Reserves for the RAF quite a few years ago, and I was aware of the scheme then. One afternoon I decided to look into the scheme more and when I learnt that you didn’t have to be GP to do the course, I ran with it. I wanted to make my surgery was veteran friendly by being the nurse to do the accreditation.

Related Article: Practice nurses urged to lead on veteran care

What does the accreditation scheme involve?

It’s all online and there’s no set time that you have to complete it in. It’s in modules, so you don’t have to complete the scheme all at once. You can park it and go back to it whenever you choose to.

You get to know what services are available to veterans and develop the confidence to signpost those services to patients.

Those initial contacts with veterans are very important, as many feel they are being fobbed off, rushed out or not being listened to. If that’s the case, they may never go back to that practice which could put them in a very vulnerable position.

What can practice nurses bring to the scheme in comparison to other primary care professionals?

Practice nurses can make use of those long-term relationships with patients. As a nurse, I’m more on a level with patients and have more of a rapport one on one with them that they have with a GP. When they’re coming to see me, it’s usually for something chronic, even mental health issues. It’s well established in my role that I can support patients with long-term conditions.

How do you identify your patient population and adapt care for them?

I’ve worked there for 21 years. The patients know me and have known me throughout different levels at different stages of their lives; they’ve got quite a rapport with me anyway.

When they’re filling in a new patient form, there’s a box on there that says, ‘are you a veteran?’ So, once they’ve ticked that, that opens the pathway further conversation.

If they’re coming to see me, whether it’s for a flu injection, a blood test, or whatever it is, I can see that they’re a veteran. So, then I open that conversation and that helps in a lot of ways, because we’ve got that initial established way of finding whether they are a veteran or not.

What can nurses get out of working at an accredited practice?

It really depends on if it’s an interest to you and if it’s a passion for you. You don’t have to have the veteran link; you could be trying to improve your mental health nursing skills, for example. The scheme could then help you to develop the nursing role that you’re trying to establish for yourself.

Patients will then get to know you better and you build that confidence and that relationship with them. You can have conversations with patients that open up other avenues and conversations about the different things that they may need support with.

Building the trust of patients and developing those connections is very important, especially for those who are wary about speaking to a healthcare professional.

As a veteran myself, it’s offered a lot of avenues for me, and I’ve developed great friendships and lots of contacts.

That’s very significant in itself, especially in a primary care nursing career when you’re quite isolated. So, to have that camaraderie with other colleagues is really reassuring and a good support.

How does being an accredited practice improve patient’s quality of care access?

It’s knowing that they’re not getting passed from pillar to post, and that somebody is listening and trying to help them. This can be shown in a five-minute appointment of just listening, or when patients access longer-term support.

It’s not a complicated course to do, but it’s very worthwhile for patients. It does surprise me that more nurses have not got this under their belt.