Armed Forces healthcare commissioning

Responsibility for Armed Forces healthcare is split between the Ministry of Defence (MOD) and the NHS. Defence Medical services (DMS) provide a range of services for regular serving personnel in the UK, those serving overseas and in some cases their families.

From an NHS perspective, commissioning responsibilities are discharged through NHS England as a direct commissioner of services for serving personnel and families registered with a DMS practice, and through integrated care boards ICBs) for veterans and families registered with an NHS GP. In addition, NHS England commissions some bespoke services for veterans.

In early 2021 NHS England published ‘Healthcare for the armed forces community: a forward view’. This document sets out NHS England’s nine commitments to improve healthcare services for this community and a series of key considerations for integrated care boards (ICBs) that support the commitments of and compliments the NHS Long Term Plan.

A partnership agreement is in place between NHS England, the MOD and DMS to support the joint working that delivers on the statutory guidance of the Armed Forces Covenant. A revised agreement was signed in November 2022.

Our work complements the MOD’s Defence people mental health and wellbeing strategy 2017-2022, which details the support for serving personnel across five broad themes in their careers: join well; train well; live well; work well; and leave well. It also supports the implementation of the Government’s Strategy for our veterans, with the aim that ‘all veterans enjoy a state of positive physical and mental health and wellbeing, enabling them to contribute to wider aspects of society’.

Service charities play a vital role in our work, supporting the delivery of care and support, driving research to better understand the needs of this population, and providing advocacy for the Armed Forces community. This contribution is particularly effective when working in partnership with health and social care, recognising the positive impact this has on the health and wellbeing outcomes of this patient group. Recognising the importance of this collaborative working, the dedicated services we commission for the Armed Forces community include Armed Forces charities in their delivery.  In addition, NHS England also provides funding to a number of Armed Forces charities to deliver dedicated support, such as social prescribing and peer support.

The Armed Forces Covenant

The Armed Forces Covenant reflects the moral obligation that exists between the Armed Forces and society.

The Covenant commits that: the Armed Forces community should not face disadvantage compared to other citizens in the provision of public and commercial services; and special consideration is appropriate in some cases, especially those who have given the most such as the injured or bereaved.

The Armed Forces Covenant is reflected in the NHS Constitution. For further information about the Armed Forces Covenant visit Armed Forces Covenant: guidance and support – GOV.UK

The Armed Forces Bill, which received Royal Assent in December 2021, sees the Armed Forces Covenant enshrined in law, creating a duty for certain public bodies, health, education and housing to have ‘due regard’ to the unique obligations of and sacrifices made by the Armed Forces principle that it is desirable to remove the disadvantages arising from being a member of the Armed Forces community; and principle that special provision may be justified.

The Armed Forces community includes:

  • Regular personnel – any current serving members of the Royal Navy, Army or Royal Air Force.
  • Volunteer and regular reservists – Royal Naval Reserve, Royal Marine Reserve, Territorial Army, Royal Auxiliary Air Force, Royal Fleet Reserve, Army Reserve Air Force Reserve, Royal Fleet Auxiliary and Merchant Navy (where individuals served on a civilian vessel whilst supporting the Armed Forces).
  • Veterans – anyone who has served for at least a day in the Armed Forces as either a regular or a reservist, or Merchant Mariners who have seen duty on legally defined military operations.
  • Families of regular personnel, reservist and veterans – spouses, civil partners and children, and where appropriate can include parents, unmarried partners and other family members.
  • Bereaved – the family members of Service personnel and veterans who have died, whether that death is connected to their Service or not.