‘You may have more veteran patients than you think – here’s how GPs can help’

On Remembrance Day, Brigadier (Retd) Dr Robin Simpson shares how GP practices can become ‘veteran friendly’ to better support former military personnel patients

There are 1.74 million veterans in England – defined as anyone who has served a day or more in the British Armed Forces. Most veterans will have served for more than 10 years.

Half will be over the age of 75 and, while they are more likely to be male, around 13-14% are female. The average patient list per doctor is said to be 2,247, so, based on this, the average GP will have at least 30 veterans and most practices will see a veteran each day. 

However, there is evidence that almost half (47%) of practices may be unaware of how many of their patients are veterans. Given that many veterans experience health challenges as a result of their service, that could mean that many practice staff are missing key information on these patients.

As a veteran of 35 years and then an NHS GP, I have an acute understanding of both the veteran patient and the GP’s experience and perspective and so am pleased to share my learnings for how GP practices can best support this potentially vulnerable patient group. 

Why are veterans a special group?

When someone enlists as military personnel, they relinquish their civil liberties. They may face combat and, therefore, could be at risk of serious injury or trauma.

Research shows that many veterans have unique health needs because of their service. A 2024 Royal College of GPs (RCGP) survey of nearly 5,000 veterans in England found that over half (55%) have experienced a mental or physical health issue related to their service since leaving the Armed Forces.

Common health issues can include musculoskeletal disorders, pain, mental health problems, drug and alcohol misuse, adjustment disordersand hearing issues. A proportion of veterans may have PTSD, particularly if they served in a ‘fighting role’ in Iraq or Afghanistan.

Leaving the military

When they leave the military, veterans and their families will be under the care of their NHS GP – the same as any other civilian.

However, the RCGP survey found that, despite their health challenges, one in seven (14%) veterans who have experienced service-related issues after leaving the Armed Forces have not sought help from a healthcare professional. Common reasons include preferring to manage their issues on their own (30%) and believing that a civilian health professional ‘won’t understand their experiences’ (15%).

Armed Forces Covenant – a legal commitment

The Armed Forces Covenant, enshrined in UK law in 2011, is a promise by the nation that the armed forces and their families should be treated fairly and face no disadvantages when accessing health services, with special provision made in appropriate cases for those who have sacrificed the most.

The covenant is a part of the NHS Constitution and applies to all healthcare professionals.

RCGP Veteran Friendly Practice Accreditation Scheme

The RCGP Veteran Friendly Practice Accreditation Programme was launched in June 2019 as part of an NHS 10-year plan to improve the healthcare support provided to veterans. The idea originated from Dr Mike Brookes, a North Yorkshire GP who served in Iraq, when a patient told him that he had specifically joined his practice to see someone who could understand his needs as a veteran.

The aim of accreditation is to equip GP practice teams to better identify, understand, support and, where appropriate, refer veterans to dedicated specialist NHS services – such as Op RESTORE for physical health and wellbeing and Op COURAGE for specialist mental health services. It is an opportunity to meet the commitments made in the Armed Forces Covenant.

Once accredited, the practice will receive educational resources to help them establish processes for identifying and coding patients as veterans, best-practice advice for GPs on supporting veteran patients, and guidance on making referrals to NHS veteran health services.

The practice will also receive promotional materials to show its status as Veteran Friendly accredited. This is particularly important, as the RCGP’s survey found that 63% of veterans would be more likely to seek help if they knew their practice was part of the scheme. 

Success of the scheme

An evaluation of the scheme by the University of Chester showed that veterans receive better primary healthcare when the staff understand their needs. Getting accredited also builds the confidence of practice teams due to their increased knowledge.

The evaluation found that 99% of accredited practices would recommend the scheme to other practices and felt there was significant benefit to veterans.

How to get accredited

It takes just 20 minutes to sign up for Veteran Friendly accreditation and the information pack you receive can be consumed in less than two hours, with supplementary learning shared in a short newsletter on a quarterly basis.

The application form can be completed by anyone in the practice team, whether their role is clinical or non-clinical, with practice managers often taking the lead. A clinical lead must be named in the form.

In the week that we commemorate the contribution of servicemen and women in the two World Wars and later conflicts, getting Veteran Friendly accredited provides an opportunity for practice teams to demonstrate commitment to supporting veterans for best outcomes, ensuring that they’re not disadvantaged because of their service.

The practice team can really make a difference in the care of veterans – they need your help!

For more information and to sign-up, visit rcgp.org.uk/veterans

Brigadier (Retd) Dr Robin Simpson served in the Armed Forces for 35 years as a Military General Practitioner, holding a number of senior roles, including Postgraduate Dean of the Defence Medical Services. He then went on to become an NHS GP. Robin is widely published on veteran healthcare and is an RCGP Clinical Champion for veterans.