Care Quality Commission
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Commission finds exceptional medical care for front line military personnel

The Care Quality Commission (CQC) yesterday published a review which praises the exceptional services run by the Defence Medical Services (DMS), the British military's trauma and rehabilitation unit for personnel injured in battle as well as military primary care services for service personnel and their families.

The report is based on inspections at land bases in the UK, Germany, Cyprus, a front line field hospital in Afghanistan as well as a royal navy ship and submarine.

The Surgeon General, Surgeon Vice-Admiral Philip Raffaelli requested this review by the CQC. The regulator undertook a series of inspections and an overall review of the directly managed health services, which are provided to members of the Armed Forces and their families and some civilians. This review follows a review by the Healthcare Commission in 2009.

The CQC review found marked improvements in place across the DMS since the last series of inspections, including significant changes to governance and assurance systems.

The report praises the care provided to casualties of war, highlighting the truly world class systems in place in the treatment of major injuries, the training of staff, design of field hospitals, clinical audits to feedback important lessons, and rehabilitation for injured personnel.

However, it found that there were still ongoing issues in the primary health care for services personnel and their families that required action. The buildings where care is delivered remain a major problem, causing deficiencies in the quality of patient care. Concerns over safeguarding arrangements were still apparent and documentation and information systems remain in need of improvement, which may have contributed to shortfalls in patient care.

Cynthia Bower Chief Executive Care Quality Commission, said: “Our inspectors found that front line treatment of trauma at the field hospital in Afghanistan was the very best that they had witnessed and gave a world class service to our Armed Forces. This is something of which as country, we can be rightly proud.

“This review also demonstrates that service personnel and their families are getting effective and appropriate primary healthcare medical treatment. Patients interviewed by inspectors were overwhelmingly positive about their local GP medical centres.

“We also found excellent care in the regional rehabilitation units and in the defence medical rehabilitation centre in the UK. We found compliance with the essential standards relating to respecting and involving people in understanding the care, treatment and support choices available to them. Primary healthcare medical, dental and mental health services ensured that people experienced effective treatment and support.

“We have seen how quickly and efficiently the medical services acted since the last review, making significant improvements.  I have no doubt that the findings in this report will be addressed with equal speed and professionalism. I am sure that the outcomes from this review will help with the continued development and improvement of the Defence Medical Services provided to the Armed Forces and their families.”

The Surgeon General, Surgeon Vice-Admiral Philip Raffaelli, said: “I requested that the Care Quality Commission (CQC) undertake a review of the Defence Medical Services (DMS) in support of my commitment to provide high quality healthcare benchmarked against the NHS, to Service personnel and in some instances their dependants. I am proud to report that the CQC has recognised as exemplary the management of trauma at the Camp Bastion hospital in Afghanistan and the rehabilitation of patients, both at regional level and at Headley Court.

“Overall the CQC found areas of good practice across all of the services inspected. Although the report demonstrated significant improvements in the DMS since the Healthcare Commission inspection in 2009, there are still areas that could be improved and we will address all the report’s recommendations. I am most grateful to the CQC for undertaking these inspections.”

The DMS provides healthcare to around 258,000 people, including service personnel, their families and other civilians entitled to care. It encompasses care provided in the Royal Navy, British Army, Royal Air Force and supporting units.

Health care provided by the DMS is mostly primary care, such as general practice, dentistry, occupational medicine and community mental health services within the UK and defence outposts overseas.

It also provides medical care in zones of conflict and is responsible for rehabilitation services in Headley Court Defence Medical Rehabilitation Centre in Surrey and at a number of other centres in the UK and Germany.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England. We make sure that care in hospitals, dental practices, ambulances, care homes, people’s own homes and elsewhere meets government standards of quality and safety – the standards anyone should expect whenever or wherever they receive care. We also protect the interests of vulnerable people, including those whose rights are restricted under the Mental Health Act.

We register services if they meet government standards, we make unannounced inspections of services – both on a regular basis and in response to concerns – and we carry out investigations into why care fails to improve. We continually monitor information from our inspections, from information we collect nationally and locally, and from the public, local groups, care workers and whistleblowers. We put the views, experiences, health and wellbeing of people who use services at the centre of our work and we have a range of powers we can use to take action if people are getting poor care.

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