The Armed Forces, an unwell serving member and duty of care.

[Osinjak]

BlueMeganeII said:

I am serving member of the RAF. She IS NOT entitled to register with a civilian GP unless she is on leave and it is on a temporary/emergency basis only and there are no military units near by which can see her. The NHS has specific contracts with the MOD to provide certain services at certain hospitals and in the case of smaller units, the local GP surgery may be contracted to provide services beyond the units own. In short even though we pay national insurance we have no entitlement to NHS services. Emergency Care such as A and E works as normal and I presume the MOD is billed.

Actually she can, she just doesn't have to tell anyone. It happens all the time. However, she cannot register with a civilian GP if she intends to use that GP as a sole provider of healthcare and also with the expectation that any courses of treatment or longterm management will support her career, it just can't work like that as you know. We have the same entitlement to NHS services as anyone else does it's just that in an official capacity the processes are different in order to align them with service life. And no, the MOD is not billed for A&E attendances.

[BlueMeganeII]

Osinjak said:

Actually she can, she just doesn't have to tell anyone. It happens all the time. However, she cannot register with a civilian GP if she intends to use that GP as a sole provider of healthcare and also with the expectation that any courses of treatment or longterm management will support her career, it just can't work like that as you know. We have the same entitlement to NHS services as anyone else does it's just that in an official capacity the processes are different in order to align them with service life. And no, the MOD is not billed for A&E attendances.

That's rather ambiguous, much the same as most of the information in the JSPs. The wording for GP use does not seem say that at all. The entitlement to NHS services does not seem to be automatic at all either. You can use hospital services as normal and these are often specific services based on contract arrangements. Interesting to know that A&E appointments arn't billed. Where are you getting this information from? I genuinely would like to know more - particularly on the NHS hospital contracts.

[Osinjak]

BlueMeganeII said:

That's rather ambiguous, much the same as most of the information in the JSPs. The wording for GP use does not seem say that at all. The entitlement to NHS services does not seem to be automatic at all either. You can use hospital services as normal and these are often specific services based on contract arrangements. Interesting to know that A&E appointments arn't billed. Where are you getting this information from? I genuinely would like to know more - particularly on the NHS hospital contracts.

It all rather depends on the integrity of the serviceman and any long term intervention is unlikely to be sustainable for fairly obvious reasons but it's not impossible. For example, I crocked my knee skiing once and when I returned to the UK I went straight to A&E. They x-rayed me, treated me gave me a physio referral and sent me on my merry way. I could, in theory, have been treated by the NHS and the forces would have been none the wiser. I didn't of course, I went straight back to the MRS and got treated properly. Some service personnel have been known to have psychiatric problems treated by a 'private' GP for fear of losing their career in the forces but as for numbers I really couldn't tell you but it does happen. You are absolutely right about NHS contracts though, Birmingham is a perfect case in point where civilian GP practices are contracted by the MOD to provide healthcare and any subsequent referrals are also billed to the MOD up to the point where those services are contracted in. Anything outside of the contract is at the behest of the NHS and their ability to provide it in the same way that the rest of society experiences it. I haven't perused the JSPs for some time, you're probably more up to speed than I am.

[paulmakin]

no idea of the protocols/procedures and what went on in his unit behind the scenes but, this week, i have dealt with a serviceman in my AE - presenting with mental health problems (the aftermath of which required medical treatment).

with consent, i contacted his CO who pitched up to the department within a couple of hours with a colleague of the patient in tow. we finished our medical stuff, i did the psych consult and and discharged the patient to care of the CO who had already arranged an immediate secondary psychiatrist review with, i assume, a psych attached to, or working into, the unit.

within an hour of leaving, the patient was in the offices of the forces psychiatrist, we had conducted a verbal handover, paperwork got dealt with and follow up was arranged. welfare officer also now involved.

really quite impressive; no stigmatising, clear empathy from the CO, "sensible" psychiatrist following up, no knee-jerk or catastrophising etc

paul

[ChocolateFrog]

I am currently serving (Army) and can't add much more to several excellent posts above.

If her line manager is genuinely being overzealous or a bully then there are clear protocols in place starting at the lowest level of a discussion in person upto a Service Complaint.

That said it does sound like her lifestyle and situation is not particularly compatible with service life. These reasons are one of the reasons why we get paid X factor.

[Osinjak]

paulmakin said:

within an hour of leaving, the patient was in the offices of the forces psychiatrist, we had conducted a verbal handover, paperwork got dealt with and follow up was arranged. welfare officer also now involved.

really quite impressive; no stigmatising, clear empathy from the CO, "sensible" psychiatrist following up, no knee-jerk or catastrophising etc

paul

When the system works, it really is second to none.

[JumboBeef]

My friends says thanks, she really appreciates the time everyone spent replying in this thread, and to those who emailed me/her.

She has made the decision to come out asap. Family life and her children are much more important than this on going stress. Even if she moves closer to family and everything sorts itself out, in 6/12 months time she might have to go through it all again.

Thanks again. PH is full of wonderful people

[Fozziebear]

JumboBeef said:

My friends says thanks, she really appreciates the time everyone spent replying in this thread, and to those who emailed me/her.

She has made the decision to come out asap. Family life and her children are much more important than this on going stress. Even if she moves closer to family and everything sorts itself out, in 6/12 months time she might have to go through it all again.

Thanks again. PH is full of wonderful people

Good decision, family and ones own health should always be priority. I would still look at a service complaint ref the bullying, I would look at putting it as a secondary reason for PVR.