At AFF we think that it is very important that healthcare provision for our Army families is adequately met, whether this is through NHS funding or private provision. We are particularly aware that regular moves around the UK or overseas can sometimes impact on the care or treatment you receive. If you are having any issues or concerns about your healthcare provision please contact Karen Ross, the Health and Additional Needs Specialist at firstname.lastname@example.org
Health and social care provision in Northern Ireland (NI)
Changes due for organ donation in Wales
New NHS Constitution
NHS Choices for Military families
Registering with a GP
Registering with a NHS Dentist & Orthodontist
NHS Waiting List Times
NHS Complaints Procedure – a simple guide on how to complain
Have your say and get involved
AFF has received a number of enquiries regarding healthcare provision and NHS waiting list times in Northern Ireland. As a result of these enquiries, we have complied some specific information about health and social care provision in Northern Ireland. Read more
Prepare for your assignment to NI
1. It is important to register your family memberís specific health or additional needs requirements (including acute and chronic illness, mental health and any specific medication being taken) to ensure the chain of command is aware of the support or provision your family member may need. This can be done by:
- Reading JSP 820 and AGAI 108 and completing the Career Management Notification Proforma at Annex A. For more information, visit click here
- It is also important for the serving person to include this information on their Assignment Preference Proforma, so that any specific information is available to the chain of command before an assignment is offered or agreed.
2. It is important to research the health and social care available in NI (see the information below) ahead of requesting or accepting an assignment. Although NI has a NHS, some healthcare provision isnít available, including some drugs for cancer treatment. For other healthcare provision, there may be longer waiting lists than you are currently experiencing.
3. When transferring ongoing care or treatment it is advisable to:
- Speak to your current healthcare professionals for referral across to equivalent care or provision
- Ensure you have copies of your current patient records
- Ensure you have enough medication to tide you over until you have registered with your new GP
Who provides health and social care in Northern Ireland?
Belfast Trust is one of five Health and Social Care (HSC) Trusts that provide health and social services across NI. While the board commissions services, itís the Trusts that actually provide them Ďon the groundí. Each Trust manages their own staff and services and controls its own budget. The other four Trusts in Northern Ireland are:
- Northern Trust
- South Eastern Trust
- Southern Trust
- Western Trust
Ambulance services in NI are provided by the NI Ambulance Trust. For more information, visit www.niamb.co.uk
Access to information
- For further information on the Belfast Health and Social Care Trust, please visit www.belfasttrust.hscni.net
- To find an NHS GP in NI, visit www.nidirect.gov.uk/articles/your-local-doctor-gp. The HIVEs in NI can also give advice on GP practices and how to register, for their contact details visit nihives.blogspot.co.uk
- You may also be eligible to register with a doctor at the Defence Primary Healthcare medical centre in Aldergrove
- If you have an issue with finding a GP practice, or wish to make a complaint about NHS healthcare provision, please visit www.nidirect.gov.uk/articles/make-complaint-against-health-service
Belfast Health and Social Care Trust is committed to strengthening and improving the quality and effectiveness of personal and public involvement in order to tackle inequalities in health, promote health and wellbeing, and to improve service delivery and patient experience. Effective involvement means working together to make things better. High quality engagement with, and involvement of, patients, clients, service users, carers and the public can have a positive impact on the delivery of services. Effective involvement is central to the delivery of quality care and can lead to improvements in the experience of using services. For more information, visit www.patientclientcouncil.hscni.net
Some procedures may be offered to be performed in the Republic of Ireland as this is an EU country and therefore funding has, in the past, been available to reduce waiting lists in NI. If this were offered, advice would be given through 38 (Irish) Brigade Central Risk Assessment Cell (CRAC) team reference personal security.
Healthcare provision that is not available in Northern Ireland
Termination of pregnancy
The law in NI is different from that of Great Britain. In NI, it is lawful to perform a termination of pregnancy only if:
- it is necessary to preserve the life of the woman, or
- there is a risk of real and serious adverse effect on her physical or mental health, which is either long term or permanent.
It is for a medical practitioner to assess, on a case-by-case basis, using their professional judgement as to whether the individual womanís clinical circumstances meet the grounds for a termination of pregnancy in NI. Termination can be made available for serving personnel through the medical centre who will refer to the MPAC system; however, it does require travel to England and on advice only given by MPAC for non- serving personnel.
Enhanced Screening for Pregnancy is not available due to the Abortion law. If this is required, it may result in the individual returning to England to access this procedure. For more information on the antenatal care provided, click here.
Bariatric surgery (gastric band surgery)
Bariatric surgery is not available in NI. Again, it would be advisable to discuss your options with your GP or consultant in England before planning a move to NI.
Certain cancer drugs are not available in NI. Advice would be to discuss with your oncologist, before leaving your current location, availability of your treatment plan in NI.
For more information on what you can do if cancer drugs are not available, click here.
NHS waiting list times
NHS waiting list times vary in NI to those in your current location. At the moment, there are long waiting list times for certain specialisms, especially for orthopaedics, plastic surgery, ENT, general Surgery, cardiology and certain other specific specialisms. NI is working hard to reduce these times. The advice would be to discuss options and seek advice with your current GP before leaving your current location.
For information on NHS waiting times, click here.
Different healthcare provision
Assisted conception and In Vitro Fertilisation (IVF)
This is available in NI for both heterosexual and same sex couples. One cycle of IVF is available on the NHS in NI, even if you have a child. For more information, click here.
There is no charge for prescriptions for anyone in NI.
There is no local variation within NI for dental services. Orthodontic treatment is provided at certain dental surgeries. It is important to research the provision available and whether ongoing treatment can be continued in NI, before leaving your current location. To find a dentist in Northern Ireland, visit servicefinder.hscni.net
Mental health treatment and counselling is available on the NHS in NI but there is also other support available to Armed Forces families. Families requiring mental or emotional support can be referred to Staffcare. Staffcare are external to the military and are all qualified counsellors. Staffcare is unique to NI and is provided in support of the Army Welfare Service (AWS) due to it not always being appropriate for people to make use of all the civilian agencies that would be an option in England.
An individual can refer themselves or can be referred by welfare agencies, doctors or other healthcare professionals with the individualís permission. The AWS Intake and Assessment Team (IAT) will usually refer to the AWS Personal Support team (this is a team of four, two military, and two civilian trained Army Welfare Workers). They are there to help single and married personnel and their families. They are based in Lisburn, but cover all of NI and can do home or office visits as appropriate. They are trained in counselling skills and can deal with most matters, but can also refer to Staffcare.
All requests for help and advice should go via the Intake and Assessment Team (IAT) on telephone number 01904 882053 or 882054 (Mil: 99477 3053 or 3054) or email AWS-HQ-IAT@mod.uk
Some families may have concerns about their current treatment and future assignments and may need to consider one of the following:
- Geographical stability if undergoing assisted conception treatment
- Retention of Service Families Accommodation in your current location if your healthcare or additional needs cannot be met in NI
- Discuss transferring care with your healthcare professionals before accepting an assignment to NI
Have you lived in Wales for a year or more?
From the 1 December 2015, the Welsh Government is changing the way people choose to become organ donors in Wales. These changes will affect Army family members aged 18 years or more, who have lived in Wales for at least 12 months.
Regular soldiers posted to Wales as part of their Service will not be affected.
The new NHS Constitution has now been released – take a look at what this means to you. There is a useful handbook which explains the constitution but also provides guidance on the complaints process. Read more
AFF was consulted in this process and is delighted that the Armed Forces Covenant has now been recognised and included in this document. Keep talking to us and let us know if you experience disadvantage as a result of Service life.
For more information and to view the NHS Constitution click here.
To download copies of the NHS Constitution, Handbook and Complaints guidance click here.
AFF recently helped the Department of Health to develop a new NHS Choices Military Healthcare page for Service families. We hope you find it helpful but as always we welcome your feedback. Take a look here.
All serving personnel are registered at Defence Primary Healthcare (DPHC) Medical Centres. You and your family may be able to register at a DPHC medical centre, depending on where you live. Clinical Commissioning Groups (CCG) do not run DPHC medical centres and access to services may differ slightly from your local GP practice. At a DPHC medical centre you will receive treatment from a mixture of Service and civilian healthcare specialists. Alternatively your family can register at a local GP practice of your choice. Read more
Top Tips for finding a GP practice right for you
- Your local HIVE should have information on the local GP practices available in your area. They can also inform you whether you can register with a DPHC medical centre. Or speak to friends and other people who live locally to see which practice they recommend.
- To find a GP practice near you in England visit NHS Choices. This search engine gives a five star rating for GP practices and whether patients would recommend it. To find information on registering with a GP in NI visit NI Direct, Scotland visit NHS Scotland or NHS 24 and Wales visit – NHS Direct Wales.
- The NHS Friends and family Test (FFT) became available in GP services on the 1st December 2014 and it asks patients if they would recommend this service to friends and family. Your feedback will help to improve and shape all NHS services in your area and will also help other Army families to access a good service. For more information visit: NHS Choices
Temporary GP Registration
For children at boarding school:
Most children who attend boarding school should be registered with a GP practice local to their school but this will only usually cover term time. This is because there is often a significant distance between the child’s school location and home, therefore the GP practice would not be able to cover emergency visits. Also if you child were ill you wouldn't necessarily want to travel long distances to visit their GP. If your child requires medical treatment while they are at home in the holidays they can be registered as a temporary resident at your local GP practice. You are able to see a temporary GP for up to 3 months (if you require longer than this you will have to re-register with the practice). The temporary GP will pass on any treatment details to your child’s permanent GP to add to their medical records.
For more information on temporary GP registration visit NHS Choices
Visiting from Overseas:
If you are living overseas you should be able to register as a temporary resident if you need medical treatment whilst in the UK. For more information visit the CAB Advice Guide
For more advice or if you have had problems finding or registering with a GP please contact Karen Ross at email@example.com
AFF understands that some families have experienced or will experience problems with registering with a NHS dentist. We are also aware that orthodontic treatment can involve long waiting lists and is subject to local area variations. This can result in disrupted care provision due to frequent moves, please remember we are here to help. Read more
Some of the issues we are aware of are:
- Boarding school children’s access to NHS dentists & orthodontists – if your child attends boarding school in UK it is expected that they will be registered with a dentist close to school or near their legal guardian’s home. Children are not entitled to access dental treatment in the overseas area where their parents are living. This is also the same for those requiring orthodontic treatment
- Waiting list times for orthodontic treatment – we are aware of some families experiencing long waiting list times for orthodontic treatment. There have also been issues with transferring waiting list times on moving
- Continuity of orthodontic treatment –some families have experienced problems with continuing the orthodontic treatment their child is having when they move to another area
What are you entitled to?
- In NI visiting dependant children are entitled to emergency care under the NHS, provided the Dental Practioner is willing to take them on under temporary registration. Their UK medical card should suffice as evidence of entitlement or if their parents are registered at the same practice
- You do not have to be registered with a dentist in the area you currently live in, so you can remain registered with a dentist you have previously used
- If your child requires emergency dental care and is too far away to visit their own dentist, you can contact your dentist or contact your Local Area Team or call NHS 111
- If your child is visiting you at an overseas location contact your own dental practice and see what treatment they can offer (there may be a charge for treatment)
- The issues with accessing orthodontic treatment, such as waiting lists and continuity of care, are not straightforward so are best dealt with on an individual basis, so please contact Karen Ross at firstname.lastname@example.org
For information on accessing Orthodontists and treatment visit NHS Choices
If you are struggling to find an NHS dentist that will take new NHS patients or if you are having issues with orthodontic provision please let us know. We use this information to help you resolve your problem but also effect change for others.
AFF is aware that some specialist NHS waiting lists for treatment in Wales can be as long as 40 weeks, which is significantly longer than those in England. We are monitoring the situation at present and we are trying to clarify how the waiting time accrued on a waiting list elsewhere in the UK is interpreted by NHS Wales, so that the commitment of the Armed Forces Covenant can be honoured. We would really welcome your feedback on any issues you are having with NHS waiting lists, particularly when you are moving from one area or country to another. Read more
NHS England states that you have the right to access certain services commissioned by NHS bodies within maximum waiting times. However if this is not possible the NHS will take all reasonable steps to offer you a range of suitable alternative providers (further information is given in the NHS Constitution). Your rights are:
- For non - urgent conditions your consultant-led treatment should start within a maximum of 18 weeks from referral. The clock starts when you book your first appointment or when your referral letter is received by the hospital
- For urgent referrals such as the possiblity of cancer you should be seen by a cancer specialist within a maximum of two weeks from referral by your GP.
Consultant-led treatment includes treatments where a consultant has overall clinical responsibility for your treatment. Only services commissioned by the NHS are included, so public health services commissioned by local authorities are not covered by this right. If you cannot be seen within the maximum waiting time, the organisation that commissions and funds your treatment, the Clinical Commissioning Groups (CCGs) or NHS England have a responsibility to investigate and to offer you suitable alternative hospitals or community clinics that can see or treat you more quickly. However you should contact the original hospital, clinic or commissioner first before any alternatives are investigated for you. In Scotland this is your local NHS Scotland Boards. For Wales visit Wales.Gov.UK and for Northern Ireland visit the CAB Advice Guide.
- Try local resolution by talking to your GP or practice manager
- If you are not happy with the outcome or prefer not to raise the issue locally then you can raise it with your local CCG or contact NHS England at email@example.com making sure you put ‘For the attention of the complaints manager’ in the subject line
- For hospital and other NHS services write to NHS England
- NHS Choices has more information on the complaints procedure
- The Parliamentary and Health Service Ombudsman can be contacted if you have contacted either your CCG or NHS England but you are still not happy with the outcome of your complaint
- Patient Advice and Liaison Service (PALS) offers confidential advice, support and information on health-related matters. They can also help you if you want to make a complaint.
- You can also contact the health and additional needs specialist at firstname.lastname@example.org, particularly if you are unsure about making a complaint or if your issues are complex
- To raise a complaint in the devolved administrations visit NI Direct, Scotland and Wales
DPHC Complaints – a simple guide
- Every DPHC medical centre should have a local medical complaints policy and a medical complaints manager (MCM)
- You can make a verbal (or informal complaint) to the MCM to see if there can be a local resolution
- Or you can make a formal written complaint if local resolution isn’t possible. Include the names of the people involved and any witnesses to the event. Also state you desired outcome
- You should receive acknowledgement within 2 working days and a full response within 10 working days
- If you are still not happy with the outcome your complaint can then be sent to the Regional Clinical Director who has a further 30 days to investigate
- If it still can not be resolved it will then be forwarded to HQ Defence primary healthcare for further consideration
It’s really important to get involved in feedback. This is because it shapes the services available in your area but you can also help other Army families access good services. Healthwatch is an initiative where the NHS must consult with the public on how their local health services are run. As a Service family they would really like to hear from you because your experiences of frequent moves and transferring healthcare can provide a unique perspective. It will help them provide a service structure that supports you.