Medical Discharge from the Armed Forces requires a diagnosis and an assessment of the individual service person’s deployability.

Service personnel have a Structured Mental Health Assessment at their discharge medical examination, which identifies any previously undiagnosed mental health needs and enables signposting and referral where necessary.

Where personnel leaving the Armed Forces have an enduring need for mental healthcare, the Defence Medical Services works in partnership with the NHS to ensure continuation of care. MOD’s Departments of Community Mental Health (DCMH) are accessible for up to six months after discharge to complete therapeutic work in progress and to provide continuity of care during the transition period until appropriate handover to other services can be completed as required.

In England, the NHS Op COURAGE provides a complete mental healthcare pathway for service leavers, with similar services in other parts of the UK.

Medical Discharge from the Armed Forces requires a diagnosis and an assessment of the individual service person’s deployability.

Service personnel have a Structured Mental Health Assessment at their discharge medical examination, which identifies any previously undiagnosed mental health needs and enables signposting and referral where necessary.

Where personnel leaving the Armed Forces have an enduring need for mental healthcare, the Defence Medical Services works in partnership with the NHS to ensure continuation of care. MOD’s Departments of Community Mental Health (DCMH) are accessible for up to six months after discharge to complete therapeutic work in progress and to provide continuity of care during the transition period until appropriate handover to other services can be completed as required.

In England, the NHS Op COURAGE provides a complete mental healthcare pathway for service leavers, with similar services in other parts of the UK.

The medical discharge process is delegated to the single Services to afford each branch of the Armed Forces the necessary flexibility to respond effectively to the unique and varying environments in which their people are employed. While each of the single Services' medical discharge process is subject to regular review, Defence has no plans to commission an independent review.

Programme CORTISONE will collectively link MOD systems with NHS systems in all four home countries, providing the ability for the transfer of a service person's healthcare record in electronic form to a GP practice at the end of their service. This will be available to anyone leaving the services and not just those being medically discharged.

The programme has now delivered a live connection to the NHS, which has been used successfully to transfer COVID-19 vaccination status for service personnel. The next stage of the programme will be the roll-out of connectivity with pilot GP practices which will commence from June 2023.

The Defence Medical Services facilitates the transfer of healthcare information for all service personnel when they leave the Armed Forces. Personnel leaving the Armed Forces are provided with a summary of their medical care, known as an FMed133, and advised to provide this to their NHS General Practitioner (GP) on registration. Personnel are advised to register with an NHS GP one to three months before discharge, and the GP may decide they require a copy of the full Defence Healthcare Record.

Between 1 January 2001 and 30 September 2022, a total of 2,170 UK Regular Armed Forces personnel were medically discharged with a principal or contributory cause of hearing loss/damage, of which 1,455 had been previously deployed to either Afghanistan and/or Iraq. The breakdown of the figure is provided below:

1,119 had been deployed to Afghanistan.

839 had been deployed to Iraq.

Personnel may have deployed to both Afghanistan and Iraq therefore the breakdown cannot be summed. The medical discharges included in this response cannot be attributed to deployment to Afghanistan or Iraq. This means that the hearing loss/damage may not have been sustained when on deployment and the subsequent medical discharge may have occurred a number of years after deployment.

When a medical condition or fitness issue affects a member of the UK armed forces, their ability to perform their duties is assessed. If they are unable to perform their duties and alternative employment within the armed forces is not available, personnel may then be medically discharged. The medical reason for the discharge is recorded and categorised following detailed individual assessment in each case. As part of that assessment all relevant medical conditions, both physical and psychological, are taken into consideration when awarding the final medical grading.

Information on critical care bed numbers and occupancy has been published by NHS England from Thursday 24 November as part of a weekly summary of the Urgent and Emergency Care Daily Situation Reports.

The Critical Care Bed Capacity and Urgent Operations Cancelled data collection was paused, along with other official statistics, due to the coronavirus pandemic and the need to release capacity across the National Health Service to support the response. NHS England will keep the paused collections under review to establish at which point further collections should be reinstated and update published information when the status of any of the collections change.

The quarterly Cancelled Elective Operations official statistics publication has resumed, and data for Q2 2022-23 last published on 10^th November.

Data on hospital discharges is now collected through the acute daily discharge sitrep and is published monthly. These reports can be found at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/

Medical discharges in the UK Armed Forces involve a series of practices and protocols, which differ in each Service to meet their specific employment requirements. Due to these differences, data is presented separately for each Service.

The following table provides the numbers and rates per 1,000 of UK Regular Armed Forces personnel who were medically discharged between 1 April 2012 and 31 March 2022, by Service and financial year.

Army Regular personnel include Gurkha and Military Provost Guard Service. The Royal Navy includes both Royal Navy and Royal Marines.

Medical discharges in the UK Armed Forces involve a series of practices and protocols, which differ in each Service to meet their specific employment requirements. Due to these differences, data is presented separately for each Service.

The table below provides the numbers and percentage of UK Regular Armed Forces personnel who were medically discharged with a principal cause of mental and behavioural disorders between 1 April 2012 and 31 March 2022, by Service and financial year.

Figures include trained and untrained UK Regular personnel. Army Regular personnel include Gurkha and Military Provost Guard Service. The Royal Navy includes both Royal Navy and Royal Marines.

Percentages presented are the percentage of all cause coded medical discharges.

Medical discharges due to mental and behavioural disorders were identified as personnel discharged with a principal or contributory cause of discharge coded as F00 - F99 according to the International Statistical Classification of Diseases and Related Health Problems Tenth Revision (ICD-10).

Figures for cause information between 2019-20 and 2021-22 are provisional and subject to change.

As defined within primary legislation, Armed Forces pension awards reflect the actual time served. In 2000, a member would have served 16 years as an Officer or 22 years as an Other Rank to qualify for the immediate payment of a pension on discharge, and those who served at least two years would be entitled to receive a deferred pension, payable at age 60 for service between 1975 and April 2006. Circumstances of dismissal relate to terms and conditions of employment and not the provisions of the Armed Forces Pension Schemes, meaning that Service personnel dismissed or discharged in respect of their sexuality retained their accrued pension rights.

In the early 2000's, the Ministry of Defence settled a number of claims from former members of the Armed Forces who had been dismissed for being LGBTQ. The compensation awarded to claimants consisted of damages for loss of earnings, loss of pension and injury to feelings. These claims were reported in the national press at the time of settlement. However, upon completion of the Lord Etherton PC Kt QC independent review into the impact of Defence's historic policy on homosexuality, the Government will carefully consider the recommendations and decide what action to take.

The Ministry of Defence is committed to a smooth and successful transition from military to civilian life for all personnel, and there is a wide range of support available. Support may include help with registering with a doctor or a dentist, housing, budgeting and children's education. Employment support and job finding services are provided to all Regular Armed Forces Service leavers through the Career Transition Partnership (CTP). For those medically discharged, it includes CV development, interview preparation and vocational training courses to build on military qualifications or to retrain for a new career. Grants and travel costs are available to undertake resettlement activities. 83% of Service leavers who used the CTP in 2020-21 were employed within six months of leaving their service, higher than the UK employment rate of 75%.

The Armed Forces Compensation Scheme (AFCS) was introduced for personnel whose injury, ill health or death was caused by Service on or after on 6 April 2005. Awards under the AFCS could provide a tax free lump sum payment for pain and suffering, or a Guaranteed Income Payment which is a tax free, index linked monthly payment.

The Veterans Welfare Service provides free and confidential advice on a wide range of issues, working closely with local authorities, voluntary organisations and all areas of the Department for Work and Pensions. In addition, veterans can receive support from their Regimental and Corps Associations, ABF The Soldiers' Charity and charities that serve both the serving and the ex-Service community.

The Ministry of Defence is committed to a smooth and successful transition from military to civilian life for all personnel, and there is a wide range of support available. Support may include help with registering with a doctor or a dentist, housing, budgeting and children's education. Employment support and job finding services are provided to all Regular Armed Forces Service leavers through the Career Transition Partnership (CTP). For those medically discharged, it includes CV development, interview preparation and vocational training courses to build on military qualifications or to retrain for a new career. Grants and travel costs are available to undertake resettlement activities. 83% of Service leavers who used the CTP in 2020-21 were employed within six months of leaving their service, higher than the UK employment rate of 75%.

The Armed Forces Compensation Scheme (AFCS) was introduced for personnel whose injury, ill health or death was caused by Service on or after on 6 April 2005. Awards under the AFCS could provide a tax free lump sum payment for pain and suffering, or a Guaranteed Income Payment which is a tax free, index linked monthly payment.

The Veterans Welfare Service provides free and confidential advice on a wide range of issues, working closely with local authorities, voluntary organisations and all areas of the Department for Work and Pensions. In addition, veterans can receive support from their Regimental and Corps Associations, ABF The Soldiers' Charity and charities that serve both the serving and the ex-Service community.

It is vital for carers to be involved in critical decisions regarding their loved ones’ care. The Government will publish shortly new statutory discuss charge guidance, which will include the new statutory requirement to involve carers. NHS bodies and local authorities will be able to use that guidance as a resource to support carers from the point of hospital admission through to post-discharge care and support.