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The Armed Forces Covenant in Action? Part 1: Military Casualties 13The DMS has 15 regional rehabilitation units (RRUs) across the UK and Germany, 5 Ministry of Defencehospital units (MDHUs) embedded into NHS acute trusts, the Royal Centre for Defence Medicine(RCDM) in Birmingham, and 15 military-run Departments of Community Mental Health (DCMH) inthe UK with 5 DCMHs at the major permanent overseas bases.The Surgeon General 10 is the 3* professional head of the DMS and the Process Owner for end to endDefence healthcare and medical operational capability. He is accountable to the Defence Board, reportingroutinely through the Defence Operating Board and Service Personnel Board, both of which he attends asrequired.The SG is responsible for:• Defining the boundaries and processes, organisational structures and composition of forces, andthe standards and quality needed, to deliver advice on health policy, healthcare and medicaloperational capability in consultation with top level budget holders• Setting the overall direction on all clinical matters relating to the practice of medicine within themilitary• Setting and auditing the professional performance of all medical personnelSetting clinical and medical policies and standards, and auditing compliance by militaryorganisations across Defence• Developing the science of military medicine to develop approaches and treatments that will bestcounter threats to the health and well being of Service personnel• Providing deployable medical operational capability• Building and maintaining the medical infrastructure and cadre of people• Delivering a comprehensive healthcare system that provides the appropriate timely healthcare toService (and other entitled) personnel• Ensuring coherence of health plans between Defence and the NHS• Chairing the Defence Medical Services Board, the forum for providing strategic direction andguidance to the DMSThe stages of medical treatment and rehabilitation11. The seven stages of the medical pathway for personnel injured 11 are as follows:1. Battlefield – A soldier is wounded in Afghanistan. He carries his own fielddressings and morphine, and will be attended initially by the team medic who istrained to deliver “enhanced” first aid. If too serious to be dealt with in the field,a call for assistance will be flashed to Bastion.2. Evacuation – A medical emergency response team, including an anaesthetist,A&E specialist, medics and force protection soldiers travel to the scene in aChinook helicopter. Two Apaches provide security. The median time frominjury to arrival at Bastion is 99 minutes for the worst injuries.10 Defence Medical Services, www.mod.uk/DefenceInternet/MicroSite/DMS/WhatWeDo11 Defence explained: The seven stages of medical pathway,www.mod.uk/DefenceInternet/PictureViewers/DefenceExplainedTheSevenStagesOfTheMedicalCarePathway