In Conversation with Nicky Murdoch
What is the Armed Forces Public Patient Voice Group?
It is a group of people who serve and have served in the armed forces and who have ”lived experience” of being a patient or family/carer and who help to advise NHS England’s Armed forces Healthcare Commissioning team about the specific issues that impact the community where healthcare is concerned. The NHS have a legal requirement to consult and engage with both the patient and public when designing and developing services and our group helps provide a voice in the engagement process. We are critical friends, advisors, advocates and communicators to the NHS and to our communities. The group is made up of the serving, the reserves and veterans from all 3 services, members of the commonwealth and Gurkha and Fijian communities, women who serve and have served and with a variety of injuries and illnesses. WE also include family members and children and young people from the armed forces. It is the “lived experience that makes them credible.
What is your role as Independent Chair?
The Chair works very closely with the NHS England Armed Forces Team and is integral to that team. I act as the first point of contact for advising on patient issues related to recruitment of members, training and development and ensuring we have people with the right lived experience for the work streams in the NHSE Armed work programme. This will include mental ill health such as complex PTSD, physical challenges including amputees, female veterans, LGBTQIA+ members, members of the ethnic minority communities including commonwealth personnel and families. I represent the group on wider meetings with the Departments of Health and Social Care, the Office of Veteran’s Affairs and the Ministry Of Defence. It is a coordinating role, a leadership role, a representative role and a real privilege to be part of an equal partnership with NHS England’s Armed Forces team and the Clinicians involved in treatment of our community.
What was your path to where you are now?
I served in the Army for over 30 years first in the Women’s Royal Army Corps and then the Adjutant General’s Corps (Staff and Personal Support) Branch. I served in a wide variety of roles at regimental duty and on the staff including MOD, specialist intelligence and finally in military music! A diverse experience. However I was diagnosed with cancer and spent 2 years in treatment in the NHS system with physical and mental health challenges. After this time I was seconded to a youth education charity where I was tasked with designing, developing and delivering a recovery programme for wounded, injured and sick service personnel who had been away from work for extended periods of time. It was a rewarding job and after 2 years in this post I decided to leave the army and was selected to be the CEO of the St John and Red Cross Defence Medical Welfare Service. I did this for 7 years and it gave me insight into the NHS in a more comprehensive way so I was appointed to the Chair role in 2017.
What have been the biggest steps forward in terms of veterans healthcare in recent years?
The creation of a single armed forces healthcare commissioning team in NHS England in 2017 has allowed a real focus on the healthcare needs of the armed forces community. The AF PPV Group has evolved and developed alongside the team and we have been to identify gaps in the services together. The partnership and the preparedness of the team to listen to its patient voice partners has meant that new services have been commissioned absolutely taking into account the lived experience and needs of the community. We have been able to identify gaps in provision and the NHS has been able to commission the specialised services, pilot new ones and research areas where there is no data available. The biggest step forward has been for me a systematic approach to looking at specialist need and involving patients, families and carers in the commissioning process from the outset.
What do you think are the biggest challenges in women veterans healthcare provision right now?
There has been huge progress made in the last 5 years for the armed forces community. Op Courage – The veterans mental health and well-being service and Op Restore - The veterans physical health and well-being service, Op Nova – the service for veterans in the Justice System and Op Community – for families of those in the armed forces community. There have also been accreditation schemes to increase awareness of the armed forces with the GPs practices and in hospitals, mental health trusts and ambulance trusts through the Veterans Covenant Healthcare Alliance. All this activity has improved awareness of the community as a whole. The challenge for women who have served is that many of them do not identify as veterans and therefore they do not consider that they might be eligible for the services that are specifically designed for veterans. Additionally the NHS is a complex environment and is a devolved issue in the 4 home nations so there can be inconsistencies in access, naming conventions and awareness of the issues that women face. The other area where improvement is needed is educating service providers in healthcare, the public sector and the charity space to understand what women who have served might need by way of support and understanding. The toolkit will help in this regard and the succinct statement of need already in circulation is really clear about key issues. In meeting the challenge there needs to be a strong marketing and engagement campaign to raise awareness, improve knowledge and understanding of the services available and how to access them.
If you could set the military health research agenda what would be at the top of your list?
Given so much has been achieved for the whole community in recent years my focus for the future where there is little or no academic research would be to look at the impact of being a child in the military community and the impact of having a military parent(s) across the spectrum of families; serving, reserves and veterans. It really needs looking at. We have young people on the PPV group who have been living with a parent with PTSD since she was 6. It can impact continuity of care for those with health issues, learning disability, education, relationships with parents, siblings, mental health and there is nothing planned in terms of research and it needs it.
