Stepping up clinical lead for veteran patients and their families in general practice can be a rewarding leadership opportunity, says advanced nurse practitioner Jordana Wright
As a military wife, and also an advanced nurse practitioner, I feel somewhat of an expert in the field of veterans’ healthcare – something that, as healthcare professionals, it is critical to have an awareness of. But why are veterans’ needs any different to other patients’ needs?
Until recently, it was difficult to identify the true number of veterans residing in the UK, and the figure was always estimated. This changed after the 2021 Census which specifically asked people to declare if they had ever served in the Armed Forces. The data revealed that 1,853,112 people in England and Wales reported that they had previously served in the UK armed forces. To put this into perspective, that’s 3.8% of the total residents aged 16 years and over.
My personal and professional experience has given me a great deal of insight into why veterans’ healthcare needs might be different to the general population.
First, veterans are often reluctant to seek help for their health, whether this is a physical or psychological problem. During intense and gruelling military training, they are instilled with a steely mindset like no other, which drives them to push through difficult situations and ‘get on with it’. This delay in seeking advice can lead to long term injury or disability, experienced by an estimated 52% of veterans in comparison to 36% of the general population (Royal British Legion, 2006).
The military lifestyle usually requires frequent travel, and therefore results in a disconnect from regular contact with healthcare services. Veterans are often unable (or reluctant) to access regular follow-up for health conditions or injuries, and family members may also lose their place on NHS waiting lists due to frequent relocations.
Specialised psychological support is also often required by veterans, due to exposure to trauma and highly stressful situations during deployments or training.
Research from King’s College London estimated the rate of PTSD amongst UK veterans to be 7.4% – for perspective, the PTSD rate amongst the general public is 4%. This figure is estimated to be even higher for veterans who served in Iraq or Afghanistan (9%), with 30% of this group predicted to develop a mental health condition at some point during their lives.
It’s important to note too that these are the cases we know about – sadly, underreported PTSD is all too common, with veterans and their families trying to deal with undiagnosed PTSD by themselves, which is immensely difficult.
This is where we can step in as nurses to learn how to support veterans and their families. GP practices are often the first point of contact for veterans, whether the contact is related to their service or not.
However, past research has shown that many practices are not aware of how many veteran patients they have, or indeed how to address their specific health needs.
Simply asking the question ‘Have you ever served in the Armed Forces?’ identifies this population, meaning that if veterans present with needs that may require specialist input, practices can signpost them to the best possible support as early as possible.
Could you become a veterans’ clinical lead?
The Royal College of General Practitioners (RCGP) has developed a veteran-friendly GP practice accreditation scheme, an evidence-based initiative that provides GP surgeries with the knowledge and resources they require to best support their veteran patients.
The scheme is completely free, and all it takes is simply for the practice to nominate a veterans’ clinical lead, ask their patients if they have ever served in the armed forces, and code them as ‘military veteran’.
General practice nurses wanting to take on the role of clinical lead, will receive easy-to-access online training and information about how to identify, support and, if necessary, refer veteran patients to specialist services.
Once they have received this training and information, they can take the lead on championing veterans’ care in their practice, sharing information and best practice with the wider practice team.
To date, the veteran friendly accreditation scheme has been found to be successful in enhancing care for veterans within GP surgeries, and a study by the University of Chester found that 99% of accredited practices recommended the scheme.
So, what’s stopping you from encouraging your practice to register with the scheme, and taking on the role of clinical lead? Not only will this be a rewarding leadership opportunity, most importantly, it will undoubtedly help support your veteran patients and their families.
Find out more about the RCGP’s veteran friendly GP practice accreditation scheme: rcgp.org.uk/veterans
Jordana Wright is an advanced nurse practitioner at Derbyshire Community Health Services NHS Foundation Trust.