In June 1997 the NHS published guidelines relating to the priority treatment of war pensioners, and this was updated in December 2007. From 1 January 2008 all service veterans should receive priority access to NHS care for any condition which is likely to relate to their military service. This is also subject to fair treatment of all other patients based on clinical needs.

The purpose of this protocol is to raise awareness of the requirements in relation to veterans and to summarise the DoH guidance on the subject.

Many conditions do not become obvious until after a veteran has left military service, therefore all GPs should be aware of the government wish to prioritise care of this nature and consider the military aspects of a condition when diagnosing and referring to secondary care.

Most Frequent Conditions

• Audiology – noise induced hearing loss. There has been a lack of compensation in the past and little understanding in relation to this problem. It is possible therefore that cases may present now which have been symptomatic for some time.
• Mental Health – may present some years after military discharge.
• Orthopaedic – may arise some time after discharge but be related to in-service activity.

Required Action

• Where a known veteran is referred, check with the patient that they are willing for the referral to show that they are a service veteran.
• Where consent is given by the patient the referral can state they are a veteran, and the clinician should give a clinical opinion within the referral as to whether the condition (or request for further investigation) is likely to relate to the period of military service.
• Where consent is refused by the patient the information should not be included.
• The secondary care provider clinicians are responsible for prioritisation, taking into account the relative priorities of other patient groups based on clinical need.
• When using Choose and Book, GPs should select the correct priority of the referral based on clinical need or clinical guidelines only. Where veteran’s details are included within the referral then the secondary care service is responsible for military prioritisation, and they will assess other demands on their limited resources based on clinical priorities.

Clinical System

The following Read Codes will be used for all known veterans in the Practice:

• Military veteran (XaX3N)
• Royal Marines veteran (XadCQ)
• Royal Navy veteran (XadCP)
• Royal Air Force veteran (XadCN)
• Army veteran (XadCL)

These will be coded regardless of referral activity where it is known that the patient is an ex-serviceman/servicewoman.

Where a veteran considers that the arrangements for priority treatment have not been properly considered or fulfilled they are able to use the NHS Complaints Procedure to have the matter investigated.

Updated and reviewed January 2019