FACTSHEET: Medical Support to Personnel Injured or Sick on Operations
23 Mar 07
Information on the medical support provided to Service personnel who are injured or fall ill on military operations.
Camp Bastion's CT (computerised tomography) scanner, Afghanistan
[Picture: Andrew Linnett, Crown Copyright/MOD 2007]
MOD recognises the importance of providing our people with a high standard of medical and health support. That is why we continue to invest in clinical improvements. The map below shows the locations of key Defence Medical facilities.
There are about 6,500 (as at 1 April 2009) trained regular uniformed medical personnel from the Royal Navy, Army and Royal Air Force - collectively known as the Defence Medical Services. Despite some shortfalls, we are able to meet our commitments through careful prioritisation, the contribution of our Reservists, and working in partnership with coalition allies and the NHS.
There is no question of British Forces deploying on operations without the appropriate medical support. Medical support to personnel injured on operations is of an excellent standard.
For hospital treatment of Armed Forces personnel in the UK, we use NHS facilities under a partnership arrangement, rather than maintain dedicated military hospitals. This is the right solution for Defence and the nation. Partnering with the NHS enables us to provide modern and advanced clinical care and give our medical staff the broadest and most up-to-date training and experience.
To achieve this, Defence Medical Staff are grouped into five MOD Hospital Units across the UK and the Royal Centre for Defence Medicine in Birmingham where the skills they learn in NHS hospitals save lives on military operations. On average the number of military in-patients in NHS hospitals across the UK for all illnesses and injuries totals about 60-75 personnel. Personnel returning from operations for treatment in the UK usually go to the University Hospital Birmingham Foundation Trust (UHBFT) - and typically to the Trust's hospital at Selly Oak, one of the country's top performers, and a centre of excellence for treating the complex injuries being suffered by our troops on operations overseas.
The number of military personnel returned to the UK from Iraq and Afghanistan as a result of an injury or illness that have been treated at the Royal Centre for Defence Medicine (RCDM) and the Defence Medical Rehabilitation Centre (DMRC) Headley Court fluctuates depending on the tempo of operations; statistical information on Armed Forces can be found on www.dasa.mod.uk under 'All Other Publications', 'Health/Medical Statistics', Monthly Iraq and Afghanistan UK Patient Treatment Statistics.
Selly Oak
The former Chief of the General Staff, General Sir Richard Dannatt said in March 2007: "There is nowhere better in the country, nowhere more expert at polytrauma medicine than that hospital in Selly Oak, that's why our people are there."
Our partnering arrangements with the NHS have been particularly tested as a result of the high levels of Operational Commitments over recent years. A lesson we have learned is that, while NHS hospitals offer the best treatment available for our people, they would benefit from a greater military focus during their care.
"We readily acknowledge the extraordinary work which is carried out at Headley Court and have nothing but praise for the staff, who have had to cope with an increased tempo of operations and treat patients with injuries which, only a few years ago, would have been fatal."
House of Commons Defence Committee
Developing the military-managed ward concept at Selly Oak
For this reason we started in 2006 to develop with the NHS Trust the concept of a Military Managed Ward at Selly Oak hospital in Birmingham, centred on the main trauma and orthopaedic ward. Whenever clinically appropriate military patients are grouped together in this ward, which has military nurses, a military ward manager and deputy ward managers. There is also a dedicated patient coordinator and visiting nurse teams - every military patient being treated at a Birmingham hospital is visited at least three times a day by military medical staff.
We have improved the food provided for military patients at Selly Oak - essential for Armed Forces morale - and tightened up on the ward's security arrangements, including installing a swipe card access system.
And we have introduced improved travel and accommodation arrangements for families visiting patients at Selly Oak, refurbishing three flats for this purpose with financial support from SSAFA and setting about making similar longer-term provision with the UHBFT.
In 2010, Birmingham’s new QE Hospital will open. At a cost of £545 million, it will have 1,213 in-patient beds and 30 theatres. New major medical technology will be incorporated into the project, specifically in the areas of imaging and intensive care.
In the new QE Hospital we will have a military ward with around 30 beds and other facilities for military use in treatment and rehabilitation. A gymnasium, counselling and 'chill out lounge' will all be made available for injured service personnel to boost their recovery.
Again the majority of military patients will go to this ward as it is located within the trauma and orthopaedics service. The whole of this floor, containing six wards and around 200 beds for clinical aggregation will hold most of the clinical specialties which focus care on military casualties such as:
- Trauma and orthopaedics
- Plastic surgery
- Burns
- ENT/Maxillo-facial surgery
- Neurosurgery
- Neurology
This means the concepts we have developed in Selly Oak will be transferred to the most modern and largest acute trauma hospital in Europe.
Headley Court
The Defence Medical Rehabilitation Centre at Headley Court in Surrey
[Photo: Allan House, Crown Copyright/MOD 2007]
Our world-class Defence Medical Rehabilitation Centre (DMRC) at Headley Court aims to return injured or seriously ill personnel to full physical and psychological fitness. DMRC is specialised in the treatment of orthopaedic and sports injuries, spinal injuries, neurological rehabilitation (head and brain injuries) and rheumatic disease. It also hosts the unique Limb Fitting and Amputee Centre which enables military personnel to quickly receive prosthetic limbs and to have them expertly fitted.
The rehabilitation staff of over 300 include specialist medical officers, nurses, remedial instructors, physiotherapists, occupational therapists, speech and language therapists, a cognitive therapist, social workers, engineers, and administration support staff.
The Defence Rheumatology Centre (DRC) at St Thomas's Hospital (London), a sub-unit of Headley Court, provides treatment for out-patients.
The House of Commons Defence Committee said of the DMRC, "We readily acknowledge the extraordinary work which is carried out at Headley Court and have nothing but praise for the staff, who have had to cope with an increased tempo of operations and treat patients with injuries which, only a few years ago, would have been fatal. We regard this as a good example of the Government and charities cooperating to provide those services which they can most appropriately deliver." Quote from - Seventh Report of Session 2007-08 - House of Commons Defence Committee - Medical care for the Armed Forces - 18 February 2008.
To improve the excellent facilities and rehabilitation care that the DMRC already provides, we are working in partnership with Help for Heroes to deliver a new rehabilitation complex, including a state-of-the-art swimming pool and a new gym. Services charities (including Help for Heroes, the Royal British Legion, SSAFA and the Army Benevolent Fund) have played a key part in the welfare support of the armed forces for almost a century; the Headley Court estate is itself owned by a charitable trust.
Treatment for Mental Illness
Our mental health services are configured to provide community-based mental health care in line with national best practice, and the guidelines and standards set by the National Institute for Health and Clinical Excellence and the National Service Frameworks.
We do this primarily through our 15 military Departments of Community Mental Health (DCMH) across the UK (plus other centres overseas), which provide out-patient mental healthcare.
In-patient care, when necessary, is provided in dedicated psychiatric units through a central contract MOD has with a group of NHS Trusts. Close liaison is maintained between local DCMHs and the Trusts to ensure that all Service elements relating to an inpatient care and management are addressed. The arrangements mean that the majority of our patients can be treated much closer to their parent units, than if we had retained a dedicated military psychiatric hospital.
All service personnel requiring emergency in-patient care are admitted immediately to an appropriate facility. Those with a serious problem are offered an appointment the next working day and those with other mental health problems are offered appointments within 20 working days. This compares extremely favourably to the NHS.
A medic checks an x-ray image of a patient at the field hospital at Camp Bastion, Afghanistan
[Picture: Sgt Ian Houlding, Crown Copyright/MOD 2008]
Ministry of Defence Hospital Units (MDHUs) and the Royal Centre for Defence Medicine are where Defence Medical Services personnel work alongside civilian colleagues in NHS hospitals. As well as contributing to the care provided by these hospitals, they gain the depth and range of experience necessary to be able to administer first class treatment when deployed on Operations. When clinically sensible, military patients are kept together and treated by military staff at these units. They are located at:
- Derriford
- Frimley Park
- Peterborough
- Portsmouth
- Northallerton
- Royal Centre for Defence Medicine (RCDM) at Selly Oak hospital in Birmingham
The Departments of Community Mental Health (DCMHs) are located in the areas with a strong Military population. These military treatment centres for psychiatric illness are staffed by military mental health specialists and located in the UK at:
- Aldershot
- Brize Norton
- Catterick
- Colchester
- Cranwell
- Donnington
- Kinloss
- Leuchars
- Marham
- Faslane
- Plymouth
- Portsmouth
- Tidworth
- Belfast
- Woolwich
Regional Rehabilitation Units (RRUs) are responsible for rehabilitation of injured soldiers - including those wounded on operations - back to full fitness. The flagship location is at Headley Court, which includes the amputee fitting centre. Locations in the UK:
- Aldergrove
- Aldershot
- Bulford
- Catterick
- Colchester
- Cranwell
- Edinburgh
- Halton
- Honnington
- Lichfield
- London area (Headley Court)
- Plymouth
- Portsmouth