Priority Treatment of Military Veterans Policy - Halton and St Helens ...

CORPORATE POLICY
POLICY ON THE PRIORITY TREATMENT OF MILITARY VETERANS
For use in:
PCT-wide
Target Audience:
Purpose:
Document Author:
Approved by:
Ratified by:
Policy Indexed No:
Version Number: 1.1
All clinical staff of NHS Halton and St Helens,
General Practitioners, local acute trusts and
mental health trusts.
To set out the arrangements for the priority
treatment of military veterans
Deborah Leigh, Head of Planned Care
NHS Halton and St Helens Management Board
NHS Halton and St Helens Trust Board
HStHCP225
Effective From: April 2010
Review Date: April 2013
Statutory and legal requirements
Implementation Lead
Implementation Process
HSG 97 31 Priority Treatment of War
Veterans. Standards for Better Health_Core
Standards C6, C7e.
Deborah Leigh
Refer to the attached dissemination plan
The Trust is committed to creating an environment that promotes equality and embraces
diversity, both within our workforce and in service delivery. This document should be
implemented with due regard to this commitment
This document seeks to uphold the duties and principles contained within the Human Rights
Act. All Staff within the PCT should be aware of its implications
This policy is due for review by April 2013. After this date, this policy and associated process
documents may become invalid. All users should ensure that they are consulting the current
version of this document.

Key individuals involved in developing the document (Internal Staff Only)
Name(s)
Designation
Deborah Leigh
Simon Banks
Head of Planned Care
Operational Director of Planned Care &
Market Development
Distributed to the following for approvals and comments
Committee(s)
Members of the Policy Sub Committee (PSC)
NHS Halton and St Helens Management Board
NHS Halton and St Helens Trust Board
Individual(s) (Include email address of external
individuals (NON NHS))
Designation
Dr Steve Cox
stephen.cox@hsthpct.nhs.uk
Dr Ian Schofield
ian.schofield@nhs.net
Dr Cliff Richards
clifford.richards@nhs.net
Dr Karen Beeby
karen.Beeby@hsthpct.nhs.uk
Dr Shikha Pitalia
shikha.pitalia@ssphealth.com
PCT Medical Director
Chair of Widnes PBC Consortia
Chair of Runcorn PBC Consortia
Chair of StHealth PBC Consortia
Chair of United League PBC Consortia
Revision History and Version Control
Revision
Date
Reason for Change Version No. By Who Version No.
29/01/2009 Document Creation 1.1 D.Leigh
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Table of Contents
Introduction ..................................................................................................................................4
Purpose........................................................................................................................................4
Scope...........................................................................................................................................5
Implementation and Compliance..................................................................................................5
Policy Review...............................................................................................................................5
Duties and Responsibilities ..........................................................................................................6
Document Storage and Filing.......................................................................................................7
References...................................................................................................................................8
Appendix 1 ...................................................................................................................................9
Appendix 2 .................................................................................................................................13
Appendix 3 .................................................................................................................................14
Appendix 4 .................................................................................................................................15
Appendix 5 .................................................................................................................................16
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INTRODUCTION
In December 2007 the NHS Chief Executive wrote to all PCTs issuing guidance that updates
and extends existing guidance on priority treatment for war pensioners from 1st January 2008.
(Refer to the letter in Appendix 1.)
The previous guidance (HSG (97) 31) issued in 1997 set out the principles for access for war
pensioners and these are still in use and should therefore be used in conjunction with the latest
guidance. (Refer to the HSG in Appendix 2).
The latest guidance requires health authorities and trusts to ensure that general practitioners
and relevant hospital staff are:
Advised of the new definition
Reminded of the arrangements for the priority treatment of military veterans
In 1953 hospitals run by the Ministry of Pensions for the treatment of war pensioners were
transferred to the NHS. The Government gave an undertaking that there would be priority
examination and treatment for war pensioners in NHS hospitals for the condition or conditions
for which the war pensioner received a pension or gratuity.
In the 1997 guidance, a war pensioner that is to be treated as a priority has previously been
classified as someone who has served at least one day in the UK armed forces and receives a
pension (or another form of compensation) for disablement caused during the 1914-18 and
1939-1945 wars and service since 1945. This included merchant seamen and civilians who
receive pensions for wartime injuries.
The latest guidance states that:
The term ‘war pensioner’ now extends to cover people who were injured or disabled
as a result of service in the armed forces either before the First World War or between
10 October 1921 and 25 September 1939 (the ‘inter-war years’), and that
Priority treatment now extends to all veterans requiring treatment whether or not they
receive a war pension (or similar compensation) for injuries sustained relating to
service and
Veterans should not need to have first applied and become eligible for a war pension
before receiving this treatment.
PURPOSE
The purpose of this policy is designed to set out the PCT’s arrangements for the priority
treatment of all military veterans to all PCT providers.
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Objectives
The objective of this policy is to inform providers that Ex Service Personnel who have served at
least one day in the UK armed forces and sustained injuries during service are eligible for
priority treatment in the NHS.
Outcome
All GPs will be aware that they are required to make it clear in referrals for treatment that
the patient is a military veteran and requires priority treatment for a condition that, in their
clinical opinion, may be related to their military service
Local Acute Trusts including Mental Health Trusts will be aware that they are required to
give priority to military veterans, both as out-patients and in-patients, for examination,
diagnosis or treatment of the condition or conditions related to their military service (unless
there is an emergency case or another case demands clinical priority) but note that priority
should not be given for unrelated conditions.
SCOPE
The scope of this policy relates to all independent practitioners, relevant community services
staff, and colleagues in acute and mental health trusts that may need to refer or treat military
veterans with conditions which may relate to their service.
IMPLEMENTATION AND COMPLIANCE
The PCT’s Planned Care team will ensure that the arrangements for prioritising treatment for
military veterans are notified to independent practitioners, relevant community services staff,
and colleagues in acute and mental health trusts. The implementation plan is shown in
Appendix D.
Compliance with the policy will be tested through the PCT’s complaints system. Details can be
found at:
http://www.haltonandsthelenspct.nhs.uk/pages/YourSay.aspx?iPageId=412
The PCT will monitor any problems generated by the guidance via its complaints system, and
will act to resolve any breakdowns in the arrangements for priority treatment.
POLICY REVIEW
Unless further guidance is issued by the Department of Health, this policy will run for three
years and will then be automatically extended.
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DUTIES AND RESPONSIBILITIES
Duties within the Organisation
The PCT’s responsibility is to ensure that GPs, in making referrals for diagnosis or treatment to
secondary care, are aware of the current priority treatment provisions and of their extension to
all veterans who have a condition that is likely to be related to their service.
A letter sent by Halton & St Helens Primary Care Trust to all General Practitioners in Halton &
St Helens and acute trusts in Halton & St Helens where patients may be referred is shown in
Appendix 4. (Refer to appendix 3).
General Practitioners should make it clear in referrals for treatment that the patient is a military
veteran and requires priority treatment for a condition that, in their clinical opinion, may be
related to their military service.
NHS Hospitals and mental health trusts should give priority to military veterans, both as out
patients and in-patients, for examination, diagnosis or treatment of the condition or conditions
related to their military service (unless there is an emergency case or another case demands
clinical priority). Priority should not be given for unrelated conditions.
Chief Executive
The Chief Executive is responsible for signing the letter to all General Practitioners.
Trust Board
The Trust board is responsible for ratifying the policy.
Title of any other relevant Committee or Group
The Policy Sub Committee is responsible for approving the policy.
Director of Strategic Development
The Director of Strategic Development is responsible for ensuring delivery within timescale.
All Halton & St Helens Staff
All Staff are responsible for adhering to and complying with the requirements of the policies,
guidelines, protocols and standard operating procedures (SOPs) contained within and
applicable to their area of operation.
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Temporary and Agency Staff, Contractors and Subcontractors
All Staff are responsible for adhering to and complying with the requirements of the policies,
guidelines, protocols and standard operating procedures (SOPs) contained within and
applicable to their area of operation.
DOCUMENT STORAGE AND FILING
The approved and ratified corporate document will be uploaded to the document portal. Follow
the link below to view the policy document and its related pages.
http://sharepointcompliance/default.aspx
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REFERENCES
Reference
Health Service Guideline (97) 31 Priority
Treatment for War Pensioners, NHS Executive,
June 1997
http://www.dh.gov.uk/en/Publicationsandstatisti
cs/Lettersandcirculars/Dearcolleagueletters/DH
_081171
Dept. of Health Gateway 9222: Access to
Health Services for Military Veterans,
December 2007
http://www.dh.gov.uk/en/Publicationsandstatisti
cs/Lettersandcirculars/Healthserviceguidelines/
DH_4018351
WPA – Leaflet – 2 Notes for people getting a
war pension living in the UK
Relevance
(whole
document or
section, please
state)
Whole Level 1
Whole Level 1
Section
Leaflet
Evidence Grade
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APPENDIX 1
Access to Health Services for Military Veterans (Gateway 9222)
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Page 10 of 17

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APPENDIX 2
Priority Treatment for War Pensioners HSG (97) 31
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APPENDIX 3
Letter Sent to all Halton & St Helens PCT General Practitioners
Dear Dr.
Subject: Priority Access to Health Services for Military Veterans
In December 2007 the Chief Executive of the NHS wrote (Gateway Ref. No. 9222) to all PCT
Chief Executives reminding them that as of 1 January 2008, all veterans should receive priority
access to NHS secondary care for any conditions which are likely to be related to their service,
subject to the clinical needs of all patients.
This is an extension to existing guidance HSG (97)31 for war pensioners who should already
receive priority access for conditions for which they receive a war pension. Military veterans
should not need first to have applied and become eligible for a war pension before receiving
priority treatment.
General Practitioners are therefore asked, when referring a patient who they know to be a
veteran of any past military campaign to secondary care for a condition that in their clinical
opinion may be related to their military service, to make this clear in the referral letter/form.
The PCT is also writing to acute and mental health trusts, and NHS Foundation Trusts to ensure
that clinical staff are aware of HSG (97)31 and its extension to all military veterans. Where
secondary care clinicians agree that a veteran’s condition is likely to be service-related, they
have been asked to prioritise military veterans over other patients with the same level of clinical
need, but not over patients with more urgent clinical needs.
The PCT’s policy on priority treatment for military veterans can be found at:
http://sharepointcompliance/default.aspx
Whilst the 1997 and 2007 guidance can be found on the Department of Health’s website.
The PCT will monitor any problems generated by this guidance via its complaints system, and
will act to resolve any breakdowns in the arrangements for priority treatment.
Yours sincerely
Andrew Burgess
Chief Executive
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APPENDIX 4
EQUALITY IMPACT ASSESSMENT TOOL
To be completed with the corporate document when submitted to the appropriate committee for
consideration, approval and ratification.
1. Does the corporate document affect one group
less or more favourably than another on the basis
of:
Yes/No
Race No
Ethnic origins (including gypsies and travellers) No
Nationality No
Gender No
Culture No
Religion or belief No
Sexual orientation including lesbian, gay and
bisexual people
Age No
Disability - learning disabilities, physical disability,
sensory impairment and mental health problems
2. Is there any evidence that some groups are
affected differently?
3. If you have identified potential discrimination, are
there any exceptions valid, legal and/or
justifiable?
4. Is the impact of the policy/guidance likely to be
negative?
5. If so can the impact be avoided? n/a
6. What alternative is there to achieving the
policy/guidance without the impact?
7. Can we reduce the impact by taking different
action?
No
No
No
No
No
n/a
n/a
Comments
If you have identified a potential discriminatory impact of this corporate document, please refer it
to [insert name of appropriate person], together with any suggestions as to the action required
to avoid/reduce this impact. For advice in respect of answering the above questions, please
contact [Deborah Leigh].
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APPENDIX 5
DISSEMINATION AND TRAINING PLAN
To be completed with the corporate document when submitted to the appropriate committee for
consideration, approval and ratification. The status column must be given a Red, Amber or
Green rating with evidence to demonstrate an action has been completed.
DISSEMINATION PLAN
Title of document: Priority Treatment of
Military Veterans Policy
Dissemination Lead: (Print name and
contact details) Deborah Leigh
Proposed action to retrieve out-of-date
copies of the document: N/A
Date finalised: April 2010
Previous document already being used?
Withdraw from the internet/intranet/portal
No
To be disseminated to:
Write to Central Mersey LMC. Write to all
GPs, community services and acute trusts.
Write to local War Pensioners Association.
Write to local MPs
Disseminated
by whom?
Timescale
(Date)
Status
R A G
Paper
or
Electronic
Comments
Trust Times
Team Brief
Training sessions (Give Details Below)
Other (Give Details Below)
o
o
The PCT will raise awareness of the
new policy within the Primary Care
bulletin.
Develop PCT webpage that describes
the PCT’s policy towards military
veterans and the NHS guidelines.
Include links to DoH guidance.
IMPLEMENTATION PLAN
Deborah
Leigh
Deborah
Leigh
Vicki Rowe
3 months Document
Portal.
Include in
appropriate
contracts
where
possible.
2 months
3 months
Training Timescale Owner Status
R A G
Training Event (Please provide details of available training venues/dates
to educate staff about this document)
Training Plan Lead (Please provide details of staff who will be
responsible for overseeing this training)
N/A
N/A
N/A
N/A
Compliance Monitoring Timescale Owner Status
R A G
Methodology to be used for monitoring/audit (please include PCT
Audit Proposal Form)
6 months D.Leigh
D. Szwandt
Responsibilities for conducting monitoring/audit 9 months D.Leigh
D. Szwandt
Frequency of monitoring/audit (e.g. annually, 6 monthly etc)
o Monitor complaints/feedback to PCT.
Ongoing
D.Leigh
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o
Visibility of policy.
• Access/waiting list policies of acute trusts are
changed to implement new guidance.
Process for reviewing/reporting results
Denotes: Action not yet taken or deadline for action not met. Action plan to address this must be provided.
Denotes: Action partially implemented.
Denotes: Action complete.
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