Embedding Veteran Aware work to the extent that it has become ‘Business as Usual’ is the ultimate aim of any organisation. This is when the work ceases to be led by a small team or one individual and is the responsibility of all.
One organisation that appears to be close to this state is Great Western Hospitals NHS Foundation Trust, which was accredited as Veteran Aware in September 2021.
Tania Currie, its Head of Patient Experience and Engagement, took on the work of Armed Forces Lead about two years ago. It was a logical fit, though as Tania observes, it was a steep learning curve given she has no Armed Forces experience and is a challenge given that she works three days a week and the work is compressed alongside her other roles.
But, she says, it feels now as though much of the work surrounding policy and processes has become business as usual, leaving the team to concentrate more on awareness raising and training issues. To reach this state meant working methodically working through the VCHA standards, and by setting up a working group containing people who do have military experience as well as people with an interest in this area, it has been able to progress quite far, helped by having full executive backing.
Every six months an updated report is compiled for the Trust’s Equality, Diversity and Inclusion Group. The latest demonstrates the progress made. Among highlights it has recently signed up to the Pride in Veterans Standard, which is part of the Fighting with Pride campaign aimed at raising awareness and providing support to LGBT+ Veterans, serving personnel and their families, particularly those discriminated by the previous ban on homosexuality in the military.
When Tania started on the Veterans work, she didn’t understand why anyone from the Armed Forces would be disadvantaged. This is understandable. She says: “I was thinking, ‘Wow, why would they be disadvantaged?’ “Because literally, you know, that was sort of my level of knowledge at the time, but obviously quite quickly I understood that much better and it’s been, it has been really, really interesting.
“It was a completely new sort of thing for me and in some ways maybe that was good because if you come at it and you’ve got that military experience already, you’re obviously perhaps got your own ideas, whereas I was coming with literally no preconceived ideas or no understanding.
“So I had to learn everything and understand it and then be able to convey that to others so that bit was quite beneficial because lots of our staff would be in the same position as me.”
The first practicality was to think through whom she needed to be on the team with her. She met up with a member of staff who’s a reservist and who now leads on armed forces staff engagement. Between them, they worked out from which parts of the Trust they would need staff representation. This included from recruitment, HR, communications and admin support and for some staff to have military experience.
At the same time, Tania looked to see what the Trust could already demonstrate. She realised the first thing for the Trust was to get the Armed Forces Covenant signed, followed by working through the Veterans Covenant Healthcare Alliance’s (VCHA) standards with VCHA Regional Lead Bernadette Knight.
“Bernadette was really supportive in helping me to understand what was required for each of the standards. Although that took a bit of time, and it was about obviously gathering the evidence and getting the team together and making sure that we could demonstrate that we’ve met each of the standards.
“That took a few months and obviously I was really pleased the Trust achieved Veteran Aware status.”
Part of this process included working closely with an HR colleague who sits on the working group to progress from bronze Defence Employer Recognition Scheme status to silver and then gold, which it was awarded recently.
An ongoing challenge that all trusts will relate to is raising staff awareness. Tania and the team focussed on aware-raising, through social media, its staff intranet page and its website and training with core groups such as booking clerks or staff at the Emergency Department.
What has proved their worth are two Defence Medical Welfare Service Officers – two former members of staff who used to work at the Trust. The Trust agreed to match-fund the DMWS and the pair have been in post for about a year.
“They know the wards and they know the staff and you know they know lots of the consultants and things they’ve been able to just freely go around the Trust and raise that awareness, about their role, and more generally about the Armed Forces Covenant and about why we’re doing this. That’s worked really, really well,” she says, adding that they also go out into the community to raise links with local groups.
Training is still an issue. The aim would be to get it within induction, but the amount of mandatory training now required for clinical and non-clinical staff has meant that Armed Forces awareness training is not yet recognised as mandatory within the Trust. What has been incorporated at induction is information about the Covenant and whom to contact within the Trust, as well as an information leaflet containing more information about Veterans work within the organisation, including about the staff Armed Forces Network. The team has also uploaded an Armed Forces Covenant slide deck on to its intranet along with links to other external training.
Where the team feels it’s done really well is on work on its main patient administration system, Careflow. When Tania started the Trust already had a flag on the system that said, ‘Are you a Veteran?’ She changed the wording so it reflected the whole of the Armed Forces Community – capturing those serving, veterans, reservists or close family members. More than 10,000 patients have now been logged on this as part of the Armed Forces Community.
One slight issue – and one most clinicians will be familiar with – is that the main system doesn’t ‘talk’ with the assessment system used by staff who provide the bedside care. This is the system generally looked at every day. To overcome this, Tania and the team had the same question inserted on to this system – Nervecentre – and a note to refer to the DMWS officers if the patient is part of the Armed Forces Community. This isn’t yet on the system used by the community health teams, though it is Tania’s ambition for this to eventually happen.
One interesting finding in Tania’s work relates to the concept of staff champions. She initially went down the route of having ‘a champion everywhere’ but realised there was a danger of the Trust being championed out, given the numbers of champions across other service lines. She may revisit this given recent level of interest from staff keen to be involved in some way, partly caused by increased awareness within the Trust and also due to the more embedded nature of the Armed Forces staff network.