GP mythbuster 93: Caring for veterans and their families

Page last updated: 3 September 2024
Categories
Organisations we regulate

Incorporating the latest information on this subject, in particular:

  • reasons for medical discharge, specific needs and mental health conditions
  • the Armed Forces Covenant
  • what we consider when we inspect.

This box only lists significant updates, for example where we are updating the factual content of our guidance. We do not include minor changes, such as editorial corrections.

When we inspect general practices, we look at how they provide care to their local population.

This includes members of the armed forces community, which includes serving personnel (regular and reserve), service leavers, their families and veterans.

The healthcare needs of veterans can be different from other patients so clinicians may need some understanding of military life. While most veterans have similar levels of health to the general population, around 2,000 leave on medical grounds. The most common reasons for medical discharge are for issues relating to people’s:

  • back
  • knees
  • mental health
  • hearing

Veterans may miss the structure, support and friendship of the forces and find the transition to life outside the military stressful. Acknowledging this is a crucial first step in providing effective healthcare for veterans.

Armed forces personnel

Veterans may have physical and mental health issues specific to their time in service and additional specific needs. For example, there may be language barriers for Gurkha veterans and their families, who may have limited English language skills, particularly those who live within a community where English isn’t their first language..

There is growing evidence that a range of mental health conditions may appear some years after leaving the armed forces or patients may present with these conditions. These conditions may relate to combat, training or other military experiences, transition out of service or to pre-service health conditions.

Common issues for some veterans include mental health conditions such as anxiety and depression, as well as problems related to misuse of alcohol.

There has been an emphasis on veterans with post-traumatic stress disorder (PTSD). Rates of PTSD are higher for veterans who were deployed when serving than among civilians. The rate is higher for those who have been deployed in a front-line, infantry combat role. Rates of PTSD for veterans who have not been deployed are broadly equivalent to those among civilians.

Service families

Service families often have extra pressures on their daily family life than the general population. These include:

  • stress around deployment
  • concerns about injury or death
  • extended, short-notice and repeated periods of separation
  • social isolation from family and friends because of being based in remote locations and moved at short notice
  • additional and short notice caring responsibilities
  • adapting to family life after enforced separation.

Service families tend to move every two to three years. They should not be disadvantaged by:

  • losing their place on hospital waiting lists
  • having their care interrupted
  • needing to re-register with GP services.

The Armed Forces Covenant

The Armed Forces Covenant supports serving personnel, service leavers, veterans, and their families. It sets out a number of health commitments for the Armed Forces community and expects the same standard of, and access to healthcare as that received by any other UK citizen.

For example, family members should retain their place on any NHS waiting list if moved around the UK and veterans should receive priority treatment for a condition that relates to their service, subject to clinical need.

There are resources to support GP practices. See guidance on providing NHS care to veterans, service leavers, and non-mobilised reservists.

Veteran’s healthcare toolkit

The Royal College of General Practitioners (RCGP) has produced guidance for GPs on how to deal with veterans’ healthcare needs. The veterans' healthcare toolkit advises how best to help those who may have been affected by their service careers. The toolkit explains:

  • the NHS duty to the armed forces community
  • the services for veterans provided by NHS and other groups
  • how to request a patient’s service medical records.

Veteran friendly accredited practice

The RCGP and NHS England and NHS Improvement are working together to accredit GP practices as ‘veteran friendly’. 

Find out about Veteran friendly GP practice accreditation

When we inspect

We use these regulations when we review if the practice is safe, effective, responsive, caring and well-led:

We:

  • ask how providers understand the diverse health and care needs of people and their local communities, so that care is joined-up, flexible and supports choice and continuity.
  • assess the arrangements to identify and meet the needs of their local population
  • ask for evidence to show that care is provided to meet people’s needs

Further information

GP mythbusters