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Healthcare case studies: Understanding local need in order to plan the provision of healthcare services

***This Covenant case study database is still being built. If you have any case studies about understanding local need, suitable for adding to the database, please submit a case study.***

Re-assessment of local needs

  • Following the closure of RAF Cottesmore and the establishment of Kendrew Barracks (an Army base), Rutland County Council identified the need to reassess its health offer to the new Armed Forces Community. The Council’s Armed Forces Officer and Public Health team worked with local units to conduct a health needs assessment to understand the different needs of an RAF station vs an Army base, how those needs differ to the local civilian population, and whether military and civilian health services could meet the new demand. It established the local population and their health needs – particularly those impacted by Service life. It used literature reviews for health conditions, policy reviews, primary qualitative data collection (in the form of interviews and focus groups) and quantitative analysis. National data, as well as local data, was used. A report was published, and a Health & Wellbeing Board was dedicated to the health needs of the Armed Forces Community. The report informed the Council’s Joint Strategic Needs Assessment.
  • The local Armed Forces Community in West Norfolk raised concerns that there was insufficient dental service provision near the local base, RAF Marham. The views of families, supported by research from Healthwatch Norfolk into local health provision and user needs, were fed into the Norfolk Health Overview and Scrutiny Committee, ensuring the commissioning process reflected local, as well as regional, needs. Led and negotiated by the Norfolk Armed Forces Covenant Board, partner organisations then collaborated to find a solution to meet those needs. NHS England worked closely with RAF Marham and the Defence Infrastructure Organisation to address the gap by opening the first NHS dental practice based on an MOD site.

Conducting research to understand local Armed Forces healthcare needs

  • Harborough Locality Integrated Leadership Team has representatives from public and third sector organisations working to enhance individuals’ health and wellbeing experiences through collaborative working. A Local Authority and HealthWatch survey of Armed Forces Community members found that many respondents had mental (22%) and physical (29%) health issues directly related to Service, but felt they had a lack of support, access, and understanding from their public service providers. The Locality Integrated Leadership Team responded to the survey findings and reached out to the NHS to improve this experience. They worked with Armed Forces officers and case workers providing healthcare support to members of the Armed Forces Community. The result was an online training workshop to improve health practitioners’ awareness of Service life and related health concerns. Anecdotal evidence showed increased engagement with Armed Forces Community clients and referrals to specialist providers.
  • Hertfordshire Armed Forces Covenant Board worked with Healthwatch Hertfordshire to undertake to conduct a survey, interviews, and focus groups with 100 local veterans, as well as NHS professionals, funded by Hertfordshire Public Health. This led to an action plan, including action to increase understanding of Service life and the Armed Forces Covenant among secondary care practitioners, promotion of Veteran Aware to local hospitals, and the Royal College of General Practitioners’ Veteran Friendly GP Practice scheme to local surgeries.
  • Rutland County Council led tri-Council work (with Harborough and South Kesteven District Councils) to commission HealthWatch to create a user-friendly survey of the military community online and on paper over a four-month period. The Rutland Armed Forces Officer worked closely with HealthWatch to construct the survey and promote completion across the community. Supported by a communications strategy (social media, radio, posters, and visiting bases), this led to 700 verified responses and a report that assisted in policy changes.
  • In 2020, research by the Veterans’ Gateway found that, out of all issues facing the veteran community, at least 23.27% of searches on its online portal were for mental health services, and at least 6.75% of searches were for physical health issues. In order of highest number of searches, veterans were most concerned about: accessing support; support groups; treatment; drug, alcohol, and rehab services; bereavement; home and physical mobility aids; GPs; blindness; limb loss; and end of life care.
  • Reports are also available from wider experts and Armed Forces advocates that identify issues for veterans and families, and make recommendations over how public bodies can respond. For example, the Scottish Veterans Commissioner’s reports Veteran’s Health & Wellbeing A Distinctive Scottish Approach and Are We Getting It Right?
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