Slides from launch event on 16 July 2013 for CDE themed call for research proposals. For full details of this call see: http://www.science.mod.uk/events/event_detail.aspx?eventid=260
17. CDE themed call programme
Secure communications Call close 22 Aug 2013
Innovation in drug development
processes
Call close 29 Aug 2013
The medic of the future Call close 5 Sept 2013
Novel solutions for emulating ship
signatures
Call launch 23 Jul 2013
Strengthening biological security Call launch 17 Sept 2013
Register and further details at www.science.mod.uk under ‘Events and Calls’
All calls close at 17:00 hrs
33. Surgeon General
Defence Medical Services Mission
Our Mission. Provide health policy & advice, healthcare
and medical operational capability in order to maximise
the fighting power of the Armed Forces
34. Surgeon General
AIM
To PROMOTE, PROTECT & RESTORE
the health of the Defence population
in order to maximise fitness for role
Aim of the Defence Medical Services
HealthcareAdvice
Operational Capability
THE STRATEGY FOR THE DMS
35. Surgeon General
Role of Surgeon General
End to end process owner of healthcare pathway for
Service personnel
Head of Service
CEO of Defence Medical Services
37. Surgeon General
Scope
Main Effort
• Operations: Afghanistan & return to contingency
Primary Care
Rehabilitation & Mental Health
Secondary Care
Education & Training
Research
Current Issues/Discussion Points
39. Surgeon General
The Operational Patient Care Pathway
Point of Wounding }
Buddy-Buddy Care } Pre-hosp
Role 1 Effect – Medic + Doc }
Evacuation – Damage Control Resuscitation } Care
Role 2/3
• Damage Control Resuscitation
• Damage Control Surgery
• Hold
Evacuation
• Tactical
• Strategic
40. Surgeon General
The Operational Patient Care Pathway
Role 4
• Royal Centre for Defence Medicine – Birmingham
– Clinical Care
– Support to the Patient Group
• Defence Medical Rehabilitation Centre Headley Court
Return to Duty / Medical Discharge
41. Surgeon General
Operating Theatre History
Number of trips to theatre 27
Specialities involved 6 inc: Orthopaedics, Plastic Surgeons,
Vascular, Urology, General Surgeons,
Intensivists.
Total amount of time spent in surgery 75 hours & 15 mins
Theatre trip time length Shortest: 1hr 15 mins
Longest: 6hrs
Procedures included Femoral nail, closure of abdo,
consistent debridement & washout of all
wounds, reconstructive soft tissue flap,
split skin grafting, colostomy, insertion
of iliosacral screws, changing of
dressings, inc application of TNP &
other necessary procedures
43. Surgeon General
The formation of Defence Primary Healthcare means that SG will now
deliver end-to-end clinical care in the firm base and the permanent
bases overseas
•More efficient use of personnel & resources;
•Quicker implementation of healthcare policy & Defence
change;
•Better governance and performance management;
•Better links with the NHS to manage access to secondary
care;
•More attractive employer for clinicians and administrative
staff.
Defence Primary Healthcare - Implications
Key Benefits
44. Surgeon General
Primary Care
1 Apr 13 – Defence Primary Healthcare Care
SG now directly accountable for tri-Service primary
care delivery with budget
DMS legislated to provide primary care
Occupational Primary Care Service
• Return to duty philosophy
45. Surgeon General
Defence Medical Rehabilitation
Programme
Tiered approach – Multidisciplinary occupational approach
Tier 1 – Primary Care Rehabilitative Facility (PCRF)
Tier 2 – Regional Rehabilitation Unit (RRU)
• 16 in UK
• Function:
– Medical Injury Assessment Clinic (MIAC)
– Group Treatment capability
Tier 3 – Defence Medical Rehabilitation Centre (DMRC)
• Complex Trauma
• Musculoskeletal
• Neuro
46. Surgeon General
The Future – Defence National Rehabilitation Centre
A decision on a Defence National Rehabilitation Centre to
meet future UK rehabilitation needs is likely this year
•With a Defence element at its core, it
would replace Headley Court
•A campaign to raise £300M is being
led by the Duke of Westminster
•The Duke has already acquired a site –
Stanford Hall in the Midlands
•An announcement is likely once £200M
has been raised (possibly later in 2013)
•If confirmed, the intention would be to
open the Defence element in 2017
47. Surgeon General
Defence Mental Health
Occupational Community based service
Departments of Community Mental Health (DCMHs)
• Multidisciplinary – Psychiatrists, Clinical Psychologists,
Mental Health nurses & social workers
• 13 in UK
Minimal requirement for in-patient capability
• NHS contracted service with South Staffs consortium
• NB – Lower admission threshold
Academic Centre for Defence Mental Health - Kings
48. Surgeon General
Secondary Care
NHS Provision under our entitled access to
secondary care
• Vast majority for provided under NHS routine access
driven by clinical need
• Majority of elective care is outpatient or day case
• Contract for rapid access to Imaging & Operative
orthopaedic care
49. Surgeon General
Strategic Challenges – Secondary Care Commissioning
We need to resolve uncertainty about funding to meet the secondary
care needs of Service personnel under new NHS arrangements.
•Funding for military patients will be held
centrally by NHS England, not regionally.
•Will funding requirement be calculated
accurately?
•Discussions held up by delays to
establishing posts within NHS England.
•There is uncertainty about who will fund
occupational referrals.
•Our position: Any funding shortage
should be a NHS risk not a Defence
one.
50. Surgeon General
Education & Training
Doctors:
• Medical Cadets
• Specialist training
• GPVT
• Direct Entrants
Nurses
• Direct Entrants
• In-house Nurse Training – Birmingham City University
AHPs
• Some In-house some recruited post training
51. Surgeon General
Education & Training
Defence Medic
• Current Training Programme
– Common Core 20 weeks
– Individual Services
Army/RAF – 7 weeks
RN – 19 weeks
– Professional Status
– Keogh Barracks Aldershot
52. Surgeon General
The Future – Creating a Regional Centre of Excellence
DMS Whittington will be at the hub of a regionally-based
centre of professional excellence for the 21st Century
•£138m construction including HQ,
training and accommodation
•Future home for over 1,000 military
and 400 civilian staff
•Phase 2 Construction will be
completed by Feb 2014
•Currently on-time/on-budget/to user-
defined requirement
•Feedback is good across the board
53. Surgeon General
Research
Created Medical Director post in 2009
Mission:
To support deployed DMS personnel through academia,
research, clinical policy, personnel management, and
equipment capability developments, which ensure the
highest standards of governance, whilst continually
promoting innovative, world leading, quality and safe
patient care.
54. Surgeon General
JMC Medical Directorate
Title ‘Medical Director’ aligns to NHS titles
Job is outward looking to civilian NHS and academic
practice
Combines professional leadership with academic
research
Development of Clinical Policy and provision of
clinical advice to Theatre/PJHQ in real time
55. Surgeon General
Defence Medical Academia
8 Defence Profs with senior lecturers and lecturers
• Emergency Medicine
• Surgery
• Orthopaedics
• Medicine
• Anaesthetics & Critical Care
• General Practice (GP)
• Mental Health
• Nursing
Royal College recognition
All are deployable and most have deployed in last 18
months
56. Surgeon General
DMS Academia & Research
Research is focussed through SG’s Research Plan
Multiple Internal, National and International
Collaborative Partners (Dstl, Russell Group Universities, NIHR,
TRBL Blast Centre, US, NATO
Research and audit is part of medical revalidation
Clearance of all clinical papers
End users are often the researchers – unique to
Defence
58. Surgeon General
QUALITY AND ASSURANCE
Care Quality Commission
• Very positive review of both Primary and secondary care
including operational environment
Inspector General
• Accountable to SG
Defence Internal Audit
Joint Force Command / SoS /HCDC
60. Surgeon General
Clinical Skills post Afghanistan
Is a ‘dip’ in performance inevitable following draw-down in
Afghanistan and if so, how deep will it be?
•Unless maintained, skills will have to be
relearned on the next campaign.
•Will we retain our most able people if we
return to a ‘peace-time’ routine?
•Our Position. To maintain hard-won
skills, we need to provide:
•quality clinical placements,
•exposure to simulation,
•rewarding research opportunities
•‘real-life’ opportunities
61. Surgeon General
Changes in NHS
Efficiency pressures in NHS.
DH committed to development of new, mutually beneficial
arrangements.
Includes DAs on Partnership Board
Placements for Secondary Healthcare Personnel
Level 1/Major Trauma Centres
Current MDHU Arrangements (placements & commissioning) no
longer fit for purpose
Review has DH support.
DMG Scotland
Partnerships & Collaboration
Generate symbiotic relationships
Changes in NHS England
63. Surgeon General
VISION
To be recognised by those
we serve as a World
Leader in military
healthcare and health
advice
THE STRATEGY FOR THE DMS
64. Surgeon General
THE STRATEGY FOR THE DMS
VALUES
Excellence, by striving for continuous improvement and
the highest quality in all that we do
Commitment to patients, and evidence-based practice
Integrity, by adhering to the highest professional and
ethical standards, maintaining the trust and confidence
of all with whom we engage
Teamwork and leadership, which are key to success
Respect, by treating those with whom we serve and
work with dignity and respect
86. Read available
information
Start with –
Quick Start
Guide
plus other CDE manuals –
Account Manual, User
Manual, Technology
Application Manual
Know what is available
106. Based on a claim of future benefit
Contribution to realisation of future benefit
Logical programme of work
Evidential outcomes
Demonstration of progress towards goal
Health check
109. www.science.mod.uk
Events and Calls > Current calls for proposals
> The Medic of the Future
Webinar:23 July 2013 14:30-15:30
Register online
Further information
110. Centre for Defence Enterprise
cde@dstl.gov.uk
www.science.mod.uk/enterprise
Call process queries