Peter Collins (Chief Medical Officer, NHS Devon) introduced the Armed Forces Care report and discussed:

a)     The item focused on primary care support for veterans and the General Practice Armed Forces?friendly accreditation scheme;

b)    The accreditation scheme represented a positive initiative, supporting more tailored and informed care for veterans within primary care;

c)     All local GP practices had signed up to the scheme, demonstrating strong engagement from primary care colleagues;

d)    The scheme aimed to provide more bespoke and focused care to veterans, recognising the debt owed to those who had served in the armed forces;

e)     The work illustrated how local services were seeking to make a tangible difference for the armed forces community.

In response to questions, the Panel discussed:

a)     Whether NHS organisations had signed up to the Armed Forces Covenant using national pledges or organisation?specific pledges;

b)    Clarification that individual NHS organisations chose to sign up to the Covenant and set out how they would deliver commitments in practice, rather than the NHS signing as a single body;

c)     The principle of clinical prioritisation, with officers explaining that veterans did not “jump the queue”, but where two patients had the same clinical need, veterans should be prioritised in organisations that had adopted Covenant commitments;

d)    Concerns raised by Members regarding feedback suggesting veterans and serving personnel were not consistently receiving appropriate priority in practice;

e)     The distinction between veterans and serving personnel within current policy, and the perception that guidance was applied more consistently for veterans than for those currently serving.

Allison Treadgold (Head of Armed Forces Health, NHS England) provided clarification on national policy and statutory duties, and discussed:

f)      The Armed Forces Covenant comprised two elements: the original voluntary Covenant and the statutory duty introduced under the Armed Forces Act 2021, which came into force in 2022;

g)     The statutory duty applied to specific public bodies and functions, including health, housing and education, and required organisations to give “due regard” to the needs of the armed forces community;

h)    The statutory guidance required NHS organisations to ensure veterans with conditions attributable to their service received priority treatment, subject to clinical need;

i)      Priority treatment applied where two patients had the same clinical condition and level of need, with the veteran being prioritised;

j)      This principle had existed for many years within NHS access policies, historically referenced as “war pensioner” prioritisation;

k)     No equivalent national policy currently existed requiring prioritisation of serving personnel, with current expectations focused on ensuring no disadvantage rather than creating advantage;

l)      Local arrangements and Armed Forces?friendly accreditation encouraged trusts to consider what additional support could be offered to serving personnel, but this was not mandated nationally.

In response to questions, the Panel discussed:

m)   Differences between policy intent and lived experience reported by members of the armed forces community locally;

n)    Ambiguity within published reports referring to the “armed forces community” without clearly distinguishing between veterans and serving personnel;

o)    The need for greater clarity on how national policy translated into local operational practice, particularly at hospital trust level;

p)    The Chair thanked officers for the detailed clarification and reiterated the Panel’s commitment to ensuring members of the armed forces community were not disadvantaged in accessing healthcare.

Action: NHS Devon ICB, working with NHS England Armed Forces Health leads, to provide a future update outlining local application of Armed Forces Covenant commitments, including differences between policy and practice and support for both veterans and serving personnel.

The Panel agreed:

1.     To note the Armed Forces Care update.