A focus on the Armed Forces healthcare work at Somerset NHS Foundation Trust

The ethos of the Armed Forces Covenant and Veteran Aware status runs through the veins of Somerset NHS Foundation Trust.

The trust was among the first tranche to be accredited as Veteran Aware by the Veterans Covenant Healthcare Alliance, reflecting the Armed Forces’ make-up of the county.

It is home to 40 Commando Royal Marines and RNAS Yeovilton and the latest statistics suggest that about 55,000 armed forces veterans live in the county, while on its borders with Dorset and Wiltshire live many retired senior officers and their families. 

This means that at least 10 per cent of the Trust’s patient population is from the armed forces family. 

Professor Dave Thomas, the Trust’s Director of Nursing Strategy and Transformation & Chief Nursing Information Officer, heads up the Clinical Dyad; he is also a British Army Reservist. On 1 December, he takes command of 243 Field Hospital, a multi-role medical regiment so understands the needs of this population.

Prof Thomas had been involved with accreditation work in what was the Royal Devon and Exeter NHS Foundation Trust (now the Royal Devon University Healthcare NHS Foundation Trust) before moving on to his current role where he oversaw reaccreditation last year.

“I saw this work as a way of making a difference as I understand both sides of the fence,” he said.

What he brought in from Exeter was first-hand experience of the value of Defence Medical Welfare Service (DMWS) officers. Having seen the difference they made on the wards there, he put forward a successful business case for two DMWS officers in Somerset.

This helped tick many reaccreditation boxes. “They’ve been the game changer for us,” he said.

“This was the biggest practical initiative in Somerset because it has a direct impact to the patient. They are the conduit between health, veterans and the wider Armed Forces Community. They are just superb, and I love having them around.”

The DMWS officers are one part and possibly the most useful part, of the messaging to staff about the contract between the Armed Forces Community and the nation.

While the communications team drip-feeds messages about the role of staff relating to the Armed Forces Community on a regular basis throughout the year, reiterating the DMWS, VCHA and the Employer Recognition Scheme and Prof Thomas’ reservist role ensures a visual reminder, the DMWS officers are “in the face of our clinical teams all the time”.

Through their work, they cover all the access points into the Trust: the Emergency Department (ED), the Acute Unit and the Acute Surgical Decision Unit. In any meetings, they remind clinical teams of the importance of identifying members of the Armed Forces Community.

Among cases the DMWS officers have been involved with is that of an elderly veteran who had dependencies and was a regular attendee to the ED and being admitted six to eight times a year for at least four to five days each time.

His problems went beyond health but also encompassed housing. However, since the DMWS officer became involved – and with a huge amount of support from the Royal British Legion and Soldiers’, Sailors’, and Airmen’s Family Association (SSAFA), the Armed Forces charity, and some from the Trust’s Talking Therapies service – he has been non-dependent for about six months and has joined up with local sports initiatives.

“This case for me shows that if we are working in collaboration with housing, DMWS and we are sharing our knowledge to allow people to be seen and cared for out of hospital.”

“By combining the DMWS and our healthcare awareness it delivers some fantastic results,” he said.  

The Trust also has an Armed Forces Network, which meets virtually every other month. Currently membership stands at 84, which Prof Thomas hopes to double in the next year.

One aspect of the work underway at Somerset, which bodes well for the county’s Armed Forces Community, is its work with the Integrated Care Board (ICB), NHS Somerset. The Trust’s borders are co-terminus with the ICB’s, which helps in pushing forward with NHS England’s nine commitments to improve healthcare services for this community across the county.

Work is progressing with development of two Armed Forces Community Hubs in Somerset.

These hubs are open to all members of the Armed Forces Community; serving, families and veterans and are designed to help the community to navigate the system to find services to support their needs.

Future work at the Trust includes developing a new e-healthcare patient record by 2026 that will flag members of the Armed Forces family and should be able to send alerts to the admin lead teams, the booking teams and DMWS officers to let people know they are in the system; introducing bespoke training for the admin team relating to identification and getting the DMWS officers’ contracts extended.  

There are limitations in the work any one central team can do. The Trust is an integrated acute, community and mental health trust with 13,500 staff spread across 156 buildings and in the community settings across the county. This is acknowledged, but Prof Thomas believes that the Trust is heading in the right direction.

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