Veterans Rehabilitation Project

Project overview

The Veterans Rehabilitation Project was established in 2021 to undertake a review of musculoskeletal (MSK) rehabilitation services currently available to veterans across England.

Its aim was to identify gaps and variations in provision, highlight best practice, and develop recommendations for improvement. 

This is because of the significant variation and disadvantage in the diagnosis, treatment and rehabilitation services for veterans with MSK disorders.

The most common reason for medical discharge from the Armed Forces is related to MSK injuries.

Project background

The team is led by Professor Tim Briggs CBE, National Clinical Improvement Director for NHS England, GIRFT Chair, and Chair of the Veterans Covenant Healthcare Alliance.

The review is being carried out by our Physio and Rehab Lead, Linus Cosgrove. Linus has a passion for improving people’s access to healthcare, particularly good quality rehabilitation and has worked on several service development projects across these roles, gaining the skills to effectively assess and implement change where necessary.  He has now created an Armed Forces Community Rehabilitation Pack as part of a best practice pilot.

Recommendations

  • All trusts should become Veteran Aware.
  • All NHS staff (from GPs to hospital ward clerks or receptionists) should undertake basic veteran awareness training, which should be included in the induction package for new staff and then form part of mandatory training requirements.
  • Dedicated Armed Forces champions should be appointed in each health service.
  • Veterans with complex and enduring physical and/or mental health conditions should have a designated key worker as a single point of contact in primary care.
  • NHS service providers should encourage veterans to use the national digital Summary Care Record and Patient Health Record. The record summarises their health history, which they can hand over at each new appointment.
  • A minimum of two outcome measures should be used for MSK rehabilitation, chosen to meet and reflect patient goals and needs. Services should regularly review performance against these measures and make improvements as needed.
  • MSK rehabilitation services for veterans should aim for full vocational rehabilitation rather than limited reablement, with clearly defined goals and expectations set out in a rehabilitation plan agreed with each patient.
  • Veterans presenting with MSK injuries in primary care should be referred to the VTN for a MDT personalised and holistic rehabilitation needs assessment, including physical, cognitive and psychological functioning.
  • Rehabilitation for veterans with chronic, but not acute, MSK conditions should be managed in the community, with access to multidisciplinary care and a variety of services, such as gyms, classes and social prescribing, and the freedom to access rehabilitation services when needed without another referral.
  • Veterans with complex and disabling conditions should have their ongoing care managed by MDTs, in line with NICE recommendations. MDTs should include physiotherapy, occupational therapy, psychology and conditioning specialists. MDTs should consider involving MSK rehabilitation centres who have a reputation for specialised rehabilitation services.
  • NHS trusts should look to attract a wider range of allied health professionals to join MSK rehabilitation MDTs and make more allocated time for CPD and training. Staff should be involved in quality improvement processes so they can help deliver changes within the service that they work in.

Resources