The Contact Group

The UK collaboration for military mental health policy, treatment and research

Contact Armed Forces

The UK collaboration for military mental health policy, treatment and research

The Contact Group is the UK collaboration for military mental health policy, treatment and research, and the mental health cluster for Cobseo.

Supported by the Veterans’ Foundation and NHS England & NHS Improvement, Contact was delighted to host a one-day military mental health event in Cardiff on Wed 22 June 2022.

The event focused on the military mental health sector (for serving, veterans and families) in both Wales and the UK. It included an introductory address by the Veterans’ Commissioner for Wales, speaker panels featuring a range of speakers, and sessions on key Contact workstreams with opportunities for questions, small group discussions, and feedback. The programme follows below with links to speaker slides where used (additional slides will be added shortly). The event delegate pack can also be downloaded.

Thanks to the generous support of the Veterans’ Foundation and NHS England & NHS Improvement, the event was free and open to all and was attended by a range of sector professionals, both statutory and non-statutory (charity representatives and academics) from all parts of Wales as well as further afield, including England and Scotland.

Event summary (see links to speaker slides in event programme below)
In his welcome opening remarks, Charles Winstanley, Independent Chair of Contact, thanked everyone for attending and the event funders, Veterans’ Foundation and NHS England, for their generous support. 

The new Veterans’ Commissioner for Wales, Col (Retd) James Phillips, then delivered an introductory address, introducing himself, the role and his priorities and plans, before taking a number of questions from attendees.

The first speaker panel focused on the military mental health sector in Wales in 2022 and beyond. Speakers from organisations including Veterans NHS Wales and a range of Welsh charities active in veterans’ mental health and wellbeing described their services and support and the ways in which they collaborate with others from across the sector. A range of questions from attendees followed, about both the work of Veterans NHS Wales, Welsh veterans’ charities, and the relevant academic research being carried out in Wales at institutions including Cardiff and Swansea Universities.

The Contact workstreams session on case management, the Veterans Mental Health Information System (VMHIS) and common assessment, the Common Assessment Framework (CAF) featured video presentations on each of these from the Contact Executive Leads for this work, Roy Brown from Cobseo and Debra Elliott from NHS England respectively. Alison Treadgold from NHS England also explained the relationships between the different relevant NHS England systems – the shared care record is designed for the provider to share information about the patient with secondary care services; the summary care record in England is basic demographic+ information; and the patient-held record pulls the first two together and is seen by the patient, as well as including some GP and other local provider information. The NHS England Mental Health dataset, which is a huge repository, takes information from the shared care record. It is structured like a web with multiple tables, so can be very flexible in how it reports. The CAF is about health assessment and how the information in the shared care record feeds the MH dataset. The work involves pulling all the different strands of information together with appropriate governance so that people who need to access it can do so for the benefit of the veteran, thus avoiding repetition and clinicians having to input information into multiple systems (albeit there are four home nations with four different systems). The armed forces community also includes families of veterans and all of the above NHS systems exist for everyone, including veterans, if they want to be identified as such.

After the small group discussions which followed the presentations, the group feedback featured points, including: the importance of veteran consent and the ability to determine what information is included/excluded and who has access; the safeguarding of service users to encourage honesty, for example when recovery is going well; the importance of agreements between organisations for standardised assessment, as well as data sharing and storage (the NHS digital toolkit exists for this but some trusts do not subscribe to it); the question of how to capture veteran consent and information in the system from the outset, for instance while still serving/transitioning (this could be part of transition services), together with the important role played by GPs; and the cost and complexity of creating interoperability and integration of data, including from DWP. In summary, the key points raised were those of veterans’ caution/sensitivity and consent, information governance and the complexity and technical practicalities involved.

The next session, which examined Contact workstreams focusing on the data dashboard and military mental health research, featured video presentations on each of these areas from the Contact Executive Leads for this work, Tammy Cheng from the OVA and Liz Brown from NIVSO, respectively. 

After the small group discussions which followed, the group feedback on the data dashboard, in response to the questions of whether organisations would find the data included in the dashboard useful for their work, as well as whether they would consider submitting data of this kind to the dashboard in future, featured points including: overall agreement on the importance and value of this kind of data for all organisations’ work and the willingness of the majority of organisations to contribute relevant data to this workstream in future; the importance of identifying data bias (and/or that of support services/initiatives) and the ‘what’ and ‘why’ of data; the importance of sharing data in a responsible way and with consent; the importance of using measures for success to help identify what is working; the need for more operational data; the importance of data in generating ‘intelligence’ rather than just information; the need for ‘wraparound data’ to help push for action; and the importance of having common, shareable data to help establish a ‘baseline’.

The group feedback on research, in response to questions about whether organisations use this kind of research, how and what type of research is most helpful, and how the work of the Contact Research sub-group could assist their work in future, featured points including: overall agreement that all organisations use research of this kind, but that small and medium sized charities may need more assistance in understanding and interpreting research and data to aid their work; the importance of using research and data to help identify gaps and to inform policy; and the importance of, rather than focusing on crises as and when they happen, instead trying to focus on emerging themes, in order to tackle some of these issues before they escalate into crises.

The Contact workstream session on quality and accreditation, the Quality Network for Veteran Mental Health Services (QNVMHS), featured video presentations about the network from the Contact Executive Lead for this work, Hannah Lucas-Motley and Jemini Jethwa from the Royal College of Psychiatrists, and on their organisations’ experiences of participating in the network from Neil Kitchiner from Veterans’ NHS Wales and Felix Davies from Combat Stress. 

After the small group discussions which followed, the group feedback featured points including: overall agreement that this is a very useful and important initiative and it should be a question of why wouldn’t organisations do it, rather than why they should; on the membership cost, there was broad agreement that there is a cost attached to processes of this kind but the quality ‘kitemark’ that will be awarded to accredited teams will drive commercial benefits for organisations, including the prospect of increased profile and fundraising, as well as from contracts; for smaller charities, the cost may be an initial barrier so any help with funding/subsidies in the early years of membership would be helpful and will aid the long-term future of the network; the question of capacity for small charities may also be an issue for consideration; whether an organisation that did not achieve accreditation would be negatively affected was considered – it would, but support would be provided through the process to meet the quality standards before and after applying for accreditation, and this would be in the context of improving services, quality and safety for service users; the importance of providing a forum to share best practice and not necessarily provide a ‘standard approach’, but rather a guide to quality and a process for ensuring that different approaches are consistent in terms of quality; and finally that this process will help to provide understanding and positive reassurance between organisations, including for those considering partnership working (e.g. to know that their staff/therapists are trained to a similar standard in a similar way), and also for when organisations refer veterans elsewhere for treatment (i.e. they can look for those who have been awarded the kitemark as an indicator of quality).

The final substantive part of the event was a speaker panel focused on the UK military mental health sector in 2022 and beyond, featuring speakers from Cobseo, the Confederation of Service Charities, and academic researchers from King’s College London and Queen’s University Belfast.

Following this, and in bringing the event to a close, Charles Winstanley presented final thoughts including a summary of the presentations and feedback that had been received throughout the day, as well as thanking the event funders, speakers and delegates for their invaluable contributions.

Next steps
Contact will continue to progress work on its various workstreams through the Contact Executive Leads for each of these areas, taking into account the feedback received during the event (as summarised above), building this into the work where possible. Stakeholders will continue to to be consulted and engaged in this work where appropriate. Regular updates on Contact workstreams as they move forward will continue to be posted to our What we do webpage. Future online and in-person events will also be planned to further update and invite feedback on Contact work. The delegate feedback received through the event feedback form will also be used to evaluate this event, report back to the event funders, and help plan future events on these themes. Feedback on all aspects of Contact’s work is welcome and can be shared at any time via Contact us.

Contact Group UK Military Mental Health sector event
Wed 22 June 2022, 10.00am-4.00pm
Cardiff Marriott Hotel, Mill Lane, Cardiff CF10 1EZ

Open to all – Free to attend

Event programme with speaker slides

9.30-10.00 Registration & coffee

10.00-10.05 Welcome & introduction – Charles Winstanley, Contact Group
10.05-10.30 Introductory address – Colonel (Retd) James Phillips (slides), Veterans’ Commissioner for Wales. Followed by Q&As chaired by Charles Winstanley

10.30-11.35 Speaker panel: Overview of the Military Mental Health sector in Wales in 2022 and beyond – Speakers: Neil Kitchiner (VNHSW slides, Research slides), Veterans NHS Wales and Cardiff University; Roger Lees (video 1, video 2), Adferiad; Finola Pickwell (slide), Adferiad; David Trotman (slides), Woody’s Lodge; Simon Frith (slides), Alabare. Followed by Q&As and discussion chaired by Neil Kitchiner

11.35-11.45 Coffee break

11.45-12.00 Contact workstreams: Case management (VMHIS) & Common assessment (CAF) – Speakers: Debra Elliott (slides), NHS England; Roy Brown (notes), Cobseo; Charles Winstanley, Contact Group
12.00-12.15 Small group discussions
12.15-12.30 Group feedback moderated by Charles Winstanley

12.30-1.30 Lunch

1.30-1.45 Contact workstreams: Data dashboard and Research – Speakers: Tammy Cheng, OVA; Liz Brown (slides), NI Veterans’ Support Office
1.45-2.00 Small group discussions
2.00-2.15 Group feedback moderated by Charles Winstanley

2.15-2.30 Contact workstream: Quality & accreditation (QNVMHS) – Speakers: Jemini Jethwa & Hannah Lucas-Motley, Royal College of Psychiatrists; Felix Davies (slides), Combat Stress; Neil Kitchiner (slides), VNHSW
2.30-2.45 Small group discussions
2.45-3.00 Group feedback moderated by Neil Kitchiner

3.00-3.10 Break

3.10-3.55 Speaker panel: Overview of the UK Military Mental Health sector in 2022 and beyond – Speakers: Rachel Price, Cobseo; Nick Grace, Cobseo (Cobseo combined slides); Marie-Louise Sharp (slides), King’s College London; Cherie Armour, Queen’s University Belfast. Followed by Q&As and discussion moderated by Charles Winstanley

3.55-4.00 Final thoughts and close – Charles Winstanley, Contact Group