Service in the military is a job like no other. Armed Forces families (historically know as dependants) often shoulder many of the burdens of their serving relation. Armed Forces families include spouses and children of serving personnel. As the NHS provides most health care services for these individuals, it is important to be aware of the specific health needs, which may arise as a result of being a member of an Armed Forces family.
Service families often have additional pressures on their personal life and may be more vulnerable as a result. These pressures may include:
- stress around deployment and the social and emotional disturbance this can cause
- extended and repeated periods of separation from spouses, partners and parents
- social isolation from family and friends
- the social and emotional pressures created around ‘single’ families
- readjustments when the serving person returns, particularly from combat
- additional and sudden caring responsibilities (for both the spouse/partner and children), including accepting and coping with physical and/or mental disability of the serving person
Service families, particularly from the RAF and Army, tend to move every two years. This should not mean they are disadvantaged by losing their place on hospital waiting lists when this happens. This is an area often raised by families as an issue, particularly in relation to accessing hospital, community, dental and orthodontic services.
In all local NHS services, including GPs, staff should be asking if patients have ever served in the UK Armed Forces or are from an Armed Forces family and recording this in patient records.
Birth and children
Whilst every effort is normally made to ensure the serving partner can return for the birth of any children, inevitably, due to the needs of the Armed Forces, there will be times when this is not possible. This needs to be considered by midwifery teams when personalising the care of these families. Issues such as having a birth partner or help with childcare for older children, either at the time of birth or in the immediate postnatal period, may be present and support needs to be sensitively coordinated.
Ordinarily, children must be registered at a GP practice where at least one parent is registered, however, in the case where both parents are serving and registered with DMS, GP practices must still register the child.
Points of transition in and out of the NHS
Registration with primary care may occur at several points such as on:
- posting to a new area where care transitions from the NHS to the NHS
- posting to a new area where care transitions from DMS to the NHS or vice versa
- posting back into the UK from an overseas accompanied posting.
- leaving Service and transitioning to civilian life
- mobilisation/demobilisation for reservists.
Due consideration needs to be given locally to the transfer of medical records to ensure continuity of care in a timely fashion.
Information for families can be found on the NHS.uk website.