Page last updated at 10:38 GMT, Monday, 2 March 2009

Praise for military trauma care

By Caroline Wyatt
Defence correspondent, BBC News

British troops under attack in Afghanistan (July 2008)
Outside front-line treatment, there was criticism from the commission

The treatment of British troops wounded on the front line is so good that NHS emergency departments should learn from it, a watchdog has said.

The Healthcare Commission's review of services for the Surgeon General rated trauma care as "exceptional" and rehabilitation services as "excellent".

It said there were valuable lessons for the NHS, especially in team work.

However, it was critical of standards at many military healthcare services away from the front line.

Dirty facilities

The commission said too many failed to comply with standards for hygiene, child protection and patient safety.

It described conditions at some armed forces medical centres in the UK and abroad as "unacceptable".

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Chairman Sir Ian Kennedy said: "We identified, for example, that premises weren't clean, or that they weren't maintained well, or that they were old and not properly looked after.

"All of those, first of all, pose risks to patients in terms of infection control, also they're not a nice environment [in which] to be looked after."

The commission also noted poor maintenance and a lack of privacy in its first independent review of the defence medical service for military personnel.

More than half of the Royal Navy's healthcare units admitted they did not comply with infection-control benchmarks, including reducing levels of MRSA, while nine ambulances used by the British military in Cyprus were found to be a danger to patients.

The commission also urged the armed forces to overhaul their child safeguarding strategy after it found that some military medical staff did not realise that 16 and 17-year-old recruits were legally still children.

Some 4,000 under-18s serve in the armed forces.

Maureen Burton, from the commission, told the BBC that there were serious concerns about ambulance safety in Cyprus - although that had been known about for some time.

Overall, the report is very positive but it highlights some things that are wrong, and also some facilities that are not up to standard
Defence minister Kevan Jones

"They've started to make plans to modify those particular vehicles and they've got a plan to replace them in June or July," she said.

"Our concern was that they've known about this for a long time and they needed to have taken action much quicker."

The health watchdog visited three military community mental health centres run by the Royal Navy, the Army and the RAF.

It said feedback from users of the services was very positive about both rehabilitation and community mental health services.

The service treats 258,000 personnel and their families in the UK and abroad and the commission found injured servicemen and women received "exemplary" treatment.

The commission said a soldier wounded in battle could be airlifted from a conflict zone and undergo an operation in Britain within 24 hours, offering a better chance of survival than ever before.

Sir Kennedy said: "The NHS could learn a lot from how the defence service plans care, trains staff and constantly seeks to learn and improve trauma services."

Soldier's criticism

Defence minister Kevan Jones said: "Overall, the report is very positive but it highlights some things that are wrong and also some facilities that are not up to standard.

"It's not about money, but how systems are being run. I'm determined things are put right."

The report comes two days after Lance Corporal Johnson Beharry VC accused the government of failing to offer enough help for veterans with mental trauma caused by their combat experiences.

He said that while the Army provided "first-class" treatment to those still serving, it was still not enough.

He said it was disgraceful that former soldiers who had served their country in Iraq and Afghanistan were forced to wait on the NHS or rely on charities once they had left the armed forces.

L/Cpl Beharry called on the government to give more help to his comrades suffering from post-traumatic stress disorder, depression and mental breakdowns and for better awareness within the NHS that veterans should have priority treatment.

The Department of Health said it was working with the Ministry of Defence on "improving information on how veterans' health needs differ from those in the population more generally".

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