Our Research & Projects

Take a look at some of the latest research projects within the Centre.

The Evaluation of the Tackling Serious Stress in Veterans, Families, and their Carers Programme has been funded by the Armed Forces Covenant. £4,263,084 was awarded to 8 projects through the Tackling Serious Stress in Veterans, Carers and Families Programme. The programme supports projects that are expected to deliver good outcomes for veterans, families and their carers that are better than what is currently on offer. It will be our job, at the University of Chester to evaluate these. Projects have been funded across the United Kingdom, with two projects in Northern Ireland, one project in Scotland, one in Wales and three in England.

The latest Tackling Serious Stress in Veterans, their Families and Carers report is now available.

Grant holders include:

  • Inspire: Recovery Together (Northern Ireland)
  • Ely Centre: Veterans Support (Northern Ireland)
  • V1P Scotland: Live Life - veterans and families (Scotland)
  • CAIS: Change Steps - Next Steps (Wales)
  • Solent NHS Trust: Portsmouth Military Wellbeing Alliance (England)
  • Walking with the Wounded: Northern Care Coordination Partnership (England)
  • Wigan Council: Unite, Inspire, Achieve Programme (England)

Update:

Serious Stress e-Bulletin May 2019  Serious Stress e-Bulletin November 2019 

Serious Stress e-Bulletin May 2020  Serious Stress e-Bulletin November 2020

Media Links

To see further information regarding this evaluation, please view the media coverage below.

Finding the Forgotten (FtF) was designed to motivate veterans to register with a GP practice and to use education to motivate Primary Healthcare (PHC) staff to engage. This enterprise was in recognition that only 9% of veterans are correctly registered within PHC. Despite significant NHS investment in enhanced veteran services; there remains significant numbers who are unaware of either their entitlement to priority medical services or the wider services available.

Often, veterans believe healthcare professionals "cannot understand" their experiences and clinical staff feel unprepared to address these beliefs. FtF’s presentation of veteran’s demographic profiles, combined with the clinician’s identification of effectiveness, benefits, and problems, provide indictors for further advancement. This may improve the targeting of services and improve help-seeking whilst reducing stigma. There are existential benefits of nurses sharing their improved knowledge with family, friends and other clinicians.

The Aged Veterans Fund is a £30 million grant available over 5 years (2 rounds of funding with a total of 19 awarded grants - 9 in 2016 and 10 in 2017) to fund projects that support the wellbeing and social care needs for older veterans (born before 1 January 1950).

Through this portfolio, the Armed Forces Covenant Fund Trust (AFCFT) are supporting a number of projects to increase understanding of the impact of ageing on veterans, and capture the effect that military service may have had on their ageing experience. They are also funding projects that are contributing to better outcomes for ageing veterans, such as supporting those with dementia or reducing isolation, and help projects with proven effectiveness to be extended and operate at greater scale.

The UoC role in the project is to look at the overall impact of the Age Veterans Fund and produce a research digest which will inform wider provision, practice and policy makers. Currently we are at an initial stage of the project. Specifically, we are contacting the organisations to understand the programmes, collect data (reports and case studies) and we are preparing the review matrix. Data will be analysed on NVIVO by using a content analysis, to enable the identification of common themes (findings, issues and methodologies).

This study is funded by the Forces in Mind Trust (FiMT) and it aims to compare the prevalence of mental and physical health disorders in veterans and non-veterans.

Diagnoses to be compared are Common Mental Health disorders (depression, anxiety, alcohol misuse, substance misuse) plus suicide, self-harm, PTSD, and dementia.  Physical health diagnoses include diabetes, hypertension and smoking,

This study also aims to identify and analyse the demographic trends between the two groups.

To do this comparison, the researchers are partnering with 13 PHC (Primary Heath Care) practices, many of whom were involved in the previous PHC projects, as they have significantly more registered veterans than the estimated national average and are ideal sites to undertake a comparison study with a non-veteran sample. 

Practices will complete a search of their medical records and identify those with a code for “Military Veteran.” Then they will match the demographics of their veterans with a civilian population.

This study builds on previous work done in the Centre such as the NHS England (NHSE) funded Finding the Forgotten (FTF) pilot study which worked with 4 practices across Lancashire in 2018 (Finnegan et al, 2018), and the Forces in Mind Trust (FiMT) funded Where Are All the Veterans (WAATV) study which increased veteran registration in 12 PHC practices in Cheshire, whilst also interrogating PHC records to identify the levels of common mental health (MH) disorders in military veterans (Finnegan & Randles, 2022b).

Media Links

To see further information regarding this study, please view the media coverage below:

 

Tom Harrison House 

The aim of the project is to independently evaluate Tom Harrison House’s service provision for female veterans.

Data will be collected via:

  • A demographic questionnaire
  • A post-program questionnaire
  • Qualitative Interviews co-developed with THH staff and service users
  • A focus group with THH staff and service users

 

You can read more about the study here.

  • This project is informed by co-production with military spouses/partners. 
  • Funded by the Armed Forces Covenant Fund Trust. 
  • Aims – Identify the challenges spouses/partners may experience when accessing employment, identify the impact of mobility and if this influences employment experiences, and determine how, if any, improvements can be made for spouses/partners gaining employment. 
  • Mixed methods – Online survey with an invite to a one-to-one interview.  Participants will additionally be invited to a focus group. 
  • At the end of the research we will produce an information guide for spouses/partners about how to access employment. 

     

High-Intensity Services (HIS)

An Appraisal of the impact of the NHS Solent High-Intensity Service for veterans’ (HIS) evaluation aims to explore the effectiveness of the NHS mental health High-Intensity Service (HIS) for veterans across the South East Region. Additionally, this evaluation aims to advance knowledge and understanding of the predisposing factors and the associated symptoms, in those veterans accessing the service. This evaluation will seek to drive long-term sustainability for the service; aiming to offer innovative support, further development, and inform current clinical practice and policy makers.

The report is available to read online.

The ‘One is Too Many’ (OITM) evaluation aims to explore social isolation, help-seeking behaviour and provide indicators of the situational factors causing distress and potentially self-harming / suicide in military veterans. The evaluation intends to provide recommendations to help improve health outcomes and reduce determinates of poor health for military veterans. 

In April 2021, as part of the Armed Forces Covenant Fund Trust’s Veterans’ Mental Health (MH) and Wellbeing Fund, the One is Too Many (OITM) programme awarded grants of up to £300,000 to two-year projects that aim to reduce suicide risks within vulnerable veterans in a co-ordinated and targeted way. Projects were required to provide direct assistance to those who were at significant risk and were not accessing support; or to deliver a project that would have a clear and demonstrable impact on suicide prevention. Grants were provided to eight organisations consisting of Inspire in Northern Ireland  Adferiad in Wales, SSAFA and the Samaritans; The Royal Marines Association (RMA), Help for Heroes, The Baton, the Forces Employment Charity (RFEA) in England, and Walking With the Wounded in Scotland.

The University of Chester was commissioned to conduct an evaluation of these programmes. Of the organisations listed above, four engaged in the evaluation; Adferiad, Inspire, RFEA, RMA. A mixed-methods approach utilising a survey, allowed participants to add written comments to support their answers. The survey was administered at Entry (Timepoint 1: entry into the OITM programme) and Exit (Timepoint 2: from the OITM programme). Data collection ended in March 2023 and the final report was published in October 2023.

In September 2021, the team attended a two-day Engagement Event at Chester Racecourse, along with members of the Armed Forces Covenant and representatives from the grant holders, as pictured above.

The final report launched today on October 11th 2023, to view the full final report, please click the following link:

 

OITM report

 

Media Links: 

To see further information regarding this evaluation, please view the media links below:

NHS England provide healthcare services for the families of veterans and serving personnel, regular and reservist, who have registered with an NHS GP practice. However, not everyone in the NHS understands the specific health needs of Armed Forces families and what they are entitled to under the Armed Forces Covenant. Additionally, some Armed Forces families have problems getting the right care and support, which can present further challenges and difficulties for them.

NHS England and NHS Improvement engaged with Armed Forces families and the organisations which support them, seeking to identify how the NHS can improve care, treatment, and support for Armed Forces Families. Key findings suggested the establishment of an Armed Forces families and Armed Forces community care coordination support framework system and single point of contact across England to act as a point of contact for Armed Forces families and community, could offer support and guidance to Armed Forces families to help navigate the NHS in addition to providing social care support and guidance.

Op Community is an 18 month pilot with initial pilots having commenced in April 2022 in the North East, East of England and South East England. Phase 2 of the pilot commenced in October 2022 in the North West, Midlands, London and the South East.

Funded by NHS England, the University of Chester’s qualitative evaluation of the Op Community initiative commenced in December 2022. The evaluation explores the perspectives of staff working within Op Community, both clinically and operationally. The study aims to identify the benefits, challenges and effectiveness of the initiative, highlighting how Op Community helps families navigate the NHS and determine the impact that the initiative has on Armed Forces Families’ social needs and healthcare mobility.

The Royal College of General Practitioners (RCGP) Veteran Friendly GP Practice Accreditation Programme aims to better identify, treat and refer veterans, where appropriate, to dedicated NHS services. Funded by National Health Service England (NHSE), the UoC Westminster Centre for Research in Veterans conducted a mixed-methods evaluation to assess the impact of the programme on both the veteran and the practice and explored the implementation/ delivery of the programme itself. Practices who had gained accreditation by April 2021 (N=949) were invited to complete an online survey and asked to take part in a short interview. Quantitative data was obtained from 225 online surveys and qualitative data from 15 face to face interviews with primary healthcare (PHC) staff. Findings of the evaluation will provide evidence to improve the healthcare needs of the Armed Forces Community in PHC and inform future delivery of the programme.

The results of this evaluation are very encouraging and highlight the positive impact accreditation has upon veterans and PHC practices. The programme has greatly improved understanding of the needs of veterans and increased signposting to veteran specific services. Recording of veteran status has improved and there is evidence of a better medical record coding system in PHC practices. The evaluation demonstrates how accreditation results in better treatment and identification of veterans.

The evaluation ran from May- June 2021, with the final report written up in July 2021. The report has been shared with the RCGP and NHSE and will be publicly available from April 2022. The peer-reviewed paper has been accepted for publication in The British Journal of General Practice.2

The report can be found here:

RCGP report

Media Links:

To see further information regarding this evaluation, please view the media links below:

In the UK, the Armed Forces Covenant (2011) is a promise to the Armed Forces Community of Regular and Reservist military personnel, veterans and their families that they will be treated fairly and will not be disadvantaged in accessing public and commercial goods and services as a result of their military employment. This pledge extends to providing bespoke services for 2 million veterans and permits priority access to National Health Service (NHS) care (including hospital, primary or community care) for conditions associated with their time within the Armed Forces.  The UK has witnessed considerable statutory and non-statutory investment in veteran health services, with the latest initiative being a pilot scheme across 17 UK Trusts and the introduction of an Armed Forces Veterans Advocate  appointment.

This strategic programme evaluation is required to measure improvements in health outcomes for members of the Armed Forces Community. The funding to evaluate this programme has been awarded by the Armed Forces Covenant Fund Trust, who are also funding the roles in the Secondary Healthcare institutions in Scotland, Wales and Northern Ireland; with NHSE funding the initiative across England. The funding will allow the team to complete a mixed methods research study and provide the evidence to inform future policy and investment.  This award will fund the Centre to support all 17 Trusts, including in the North West of England the four successful healthcare organisations at: Warrington and Halton Hospitals NHS Trust; East Lancashire Hospitals NHS Trust; Wrightington, Wigan and Leigh NHS Foundation Trust, and Manchester University NHS Foundation Trust.

View our most recent newsletter here: 

 

The newsletters previously published in 2023 can be found below:

Supporting Armed Forces in Acute Hospital Settings (Aug 2023)

Supporting Armed Forces in Acute Hospital Settings (May 2023)

Supporting Armed Forces in Acute Hospital Settings (Feb 2023)

 

Media Links

To see further information regarding this evaluation, please view the media links below:

Understanding the impact of hearing impairment on working age British Armed Forces veterans as a direct result of service or acquired whilst in service.

The Royal British Legion want to understand the experiences of veterans with hearing impairment and have commissioned the University of Chester’s Westminster Centre for Research in veterans to carry out this research project.

Members of the armed forces are likely to be exposed to noise ranging from small arms fire to blasts from explosive devices, regardless of the amount of time spent in the services. As a result, hearing damage is one of the less visible but most common injuries sustained as a outcome of military service, yet there has been limited research carried out in the UK.

Previous research by the Royal British Legion found working age veterans were over three times more likely than the wider population to report hearing difficulty, with other international studies further demonstrating the need for research to examine the extent and impact of this issue, potentially affecting hundreds of thousands of veterans in the UK.

The Centre is asking veterans with hearing impairments acquired whilst in service to participate in a survey being distributed throughout the UK. The findings from the research will help to further support the veteran population with hearing impairments.

Dr Alan Finnegan, Professor of Nursing and Military Mental Health and Director of the Westminster Centre for Veterans’ Research at the University of Chester, said: “We are very pleased to be working with the Royal British Legion to deliver this vital research project which aims to support veterans suffering from hearing damage. We encourage as many veterans as possible to participate.”

This questionnaire will take around 12-20 minutes to complete. All your responses will remain completely anonymous and confidential.

The survey can be found here: RBL Hearing Survey

Media Links:

To see further information regarding this project, please view the media links below:

 

Forces in Mind Trust (FiMT) have awarded a grant to the University of Chester’s Westminster Centre for Research in Veterans to conduct research into the experiences of BAME veterans and their families. The aim of this research is to identify the impact that serving in the United Kingdom Armed Forces has on the Indian Sub-Continent and West Indian veteran communities. This study will use mixed-methods (survey, interviews, focus groups) to understand the motivators behind why BAME communities choose to join the British Armed Forces, remain and ultimately their reasons for leaving. We also want to understand their experiences of health, housing, employment, education and service life including integration, benefits, challenges and what can be improved.

Whilst the study is regarding the impact of serving within the British Armed Forces for the Indian sub-continent and West Indian veteran and their families, some elements of the study will involve recruiting BAME veterans of any ethnicity (except Irish and Gurkhas as we feel this is another research project). The results should provide valuable insight into the experiences of the BAME community in the Armed Forces and indicate how these experiences influence their help seeking behaviour, physical and MH needs. In addition, the study will help those working with these communities gain understanding and awareness of the health and social issues experienced by BAME communities in the Armed Forces and help shape policy.

Who is carrying out this study?

The University of Chester’s Westminster Centre for Research in Veterans have appointed several members of staff to bring this project to fruition.

The principal researcher is Prof. Alan Finnegan (Professor of Nursing and Military Mental Health and Director of the Westminster Centre for Research in Ageing, Mental Health and Veterans at the University of Chester). Alan joined the British Army as a Nursing Officer and reached the rank of Colonel with appointments including Manager of Military Departments of Community Mental Health, the MOD Nurse Consultant in MMH and the MOD Nursing Advisor in MMH. He has a wealth of experience leading military and veterans specific research and is also an active member of many committees looking to improve the well-being of veterans and their families.

Alan is supported by Mrs Phebean Gahlé who has been appointed a researcher and joins the team from a military background. Phebean has experience of the BAME community with personal knowledge of the West Indies.

Alan and Phebean are joined by Mrs Kate Sawyers who is providing administrative assistance to the project and whose husband is currently a serving officer in the Royal Marines.

The team at the Westminster Centre for Research in Veterans are joined by an Expert Reference Group, a group of visiting staff from the NHS, RCGP, Law, Military Psychiatry, Third Sector Charity, Academia and the MOD. This group of professionals have all been approached to help ensure that the research continues to flow in such a direction that the aims and objectives of this study are all realised, and all bring a wealth of knowledge and understanding to the area being studied.

The Expert Reference Group for this study comprises the below list of professionals, all dedicated to making this project a success and in turn, helping to improve the lives of veterans and their families.

Estephanie Dunn – Regional Director, Royal College of Nursing, North-West region.

Lt Colonel Bhairavi Sapre – Consultant Psychiatrist, visiting Professor at the University of Chester, Cheshire and Mersey Perinatal Services Joint Clinical Lead, CWP LNC Chair, Military Veterans’ Clinical Champion.

Horace Barnes – Chairperson of the Why Are West Indians In This Country Project.

Mr Bruno Daniel – Inclusion Programme Lead, Royal College of Nursing.

Professor Basma Ellahi – Research Professor (Public Health and Nutrition Research with a focus on ethnic minorities), University of Chester.

Professor Andy Bacon – Armed Forces and Global Health, University of Chester.

Lt Colonel Tariq Ahmad – Senior Medical Officer, Catterick Medical Centre, British Army.

Squadron Leader Calum Ferguson – Royal Air Force, Chair Defence (MOD) Buddhist Network.

Sue Liburd MBE DL – Managing Director Sage Blue, Army veteran.

Dr Maxton Scotland - Founder and Director ImpaktX limited, Advisor United Nations Department of Global Communications (UNDGC) Youth Steering Committee, Partner NHSE Armed Forces PPV Group.

Lt Colonel Taitusi Saukuru MBE QGM - Chairman, MOD’s Fiji Support Network.

You can read the latest newsletter here:

Research Newsletter

Media Links

To see further information regarding this project, please view the media links below:

The Faculty of Health and Social Care has a unique Alliance with HCD Economics. 

Studies into the societal burden of illness are being undertaken within the Faculty of Health and Social Care in alliance with HCD Economics. The work is founded on six successful research bids with an aggregate funding of over £3,000,000 and offers a unique insight and perspective into what matters to patients as well as decision-makers, informed by academic rigour, independence and credibility. The studies share a common theme in engaging with leading charities such as the Haemophilia Society, British Liver Trust, National Hemophilia Foundation and Crohn’s and Colitis UK, who are integral to all decision making. Further governance develops study protocols which are overseen by internationally renowned Expert Reference Groups.

These international comprehensive ‘bottom up’ epidemiologic, economic and humanistic studies are being completed in a number of countries including the UK, France, Germany, Italy, US, and Spain. The results provide a global profile of the societal burden of the illness studied, representing an accurate assessment of disease incidence or prevalence and morbidity or mortality for medical conditions such as Haemophilia, Non-Alcoholic Steatohepatitis and Ulcerative Colitis. Once correctly identified and quantified, these results can then be landscaped at a regional and national level.

The research is characterised from a societal perspective using a range of relevant measures of burden, including patient-reported outcomes, healthcare resource use, and personal medical and non-medical costs. A growing profile of widespread dissemination is being projected through international conference presentations including Washington and Vienna and an impressive arsenal of peer review publications.   

The alliance between University of Chester and HCD Economics provides a mechanism to meet the health demand for economic analysis within healthcare and specifically the need for health economics and business intelligence within the public and third sectors.  With more studies being developed, and international interest growing, the University’s status in alliance with HCD is set to flourish.

Website: www.hcdeconomics.com

 

Burden of Illness Studies

CVESS (WVB) - The Cost of Von Willebrand Disease in Europe: a Socioeconomic Study

What is Von Willebrand Disease?

Von Willebrand disease (VWD) is a genetic disorder caused by missing or defective von Willebrand factor (VWF), a clotting protein. VWF binds factor VIII, a key clotting protein, and platelets in blood vessel walls, which help form a platelet plug during the clotting process. The condition is named after Finnish physician Erik von Willebrand, who first described it in the 1920s.

What is the objective of this study?

The objective of this study was to explore the impact of Von Willebrands Disease on patients’ quality of life using patient reported outcomes measures (PROMs) for each country and by disease subtype. It was a descriptive, retrospective and cross-sectional and multi-site bottom-up burden of illness study of adults and children with CWB in Europe, endorsed by the UK Haemophilia Society and with ethical oversight from the University of Chester.

CHESS PAED EU5 - The Cost of Haemophilia

What is Haemophilia?

Haemophilia is a medical condition in which the ability of the blood to clot is severely reduced, causing the sufferer to bleed severely from even a slight injury. The condition is typically caused by a hereditary lack of a coagulation factor, most often factor VIII.

What is the objective of this study?

The primary objective of this study was to provide a comprehensive ‘bottom-up’ burden-of-illness study in the EU5- France, Germany, Italy, Spain and the UK- in order to capture the economic and humanistic burden associated with childhood haemophilia.

CHESS US - Cost of Haemophilia: A Socioeconomic Study

Haemophilia is defined as a genetic disorder (factor deficiency) characterised by a deficiency in thrombin, leading to prolonged bleed events. The disease is carried on the X chromosome and as a result, primarily affects males, though female carriers of the gene may exhibit symptoms of mild haemophilia. The two forms of the condition are Haemophilia A (Factor XIII deficiency) and Haemophilia B (Factor IX deficiency); Haemophilia A is approximately four times more common than Haemophilia B. In 2015, 18,456 individuals with haemophilia were registered in the United States representing a prevalence of 5.8 per 100,000 population.

What is the objective of this study?

The primary objective of this study was to provide a comprehensive ‘bottom-up’ burden-of-illness study in the US in order to capture the economic and humanistic burden associated with severe haemophilia.

LUCID - Living with Ulcerative Colitis, IDentifying the socioeconomic burden in Europe

What is Ulcerative Colitis?

Inflammatory bowel disease (IBD) is a terminology used to describe chronic, idiopathic inflammatory conditions of the colon and small intestine.  Ulcerative Colitis (UC) and Chron’s Disease (CD) are the most common forms of IBD. UC is a chronic, ongoing and life-long disease characterised by inflammation localised in the mucosae (i.e. inner lining) of the rectum and colon (i.e. large bowel).

What is the objective of this study?

The aim of this study was to characterise the socioeconomic burden and the HRQoL (health-related quality of life) of UC across the ten European countries of France, Germany, Italy, Spain, United Kingdom, Denmark, Norway, Poland, Romania and Turkey. The primary objective of the study was to quantify the existing UC-related costs for each country and by disease severity (moderate and severe UC / active and in remission): Direct medical costs by country and disease severity; direct non-medical costs by country and disease severity; indirect and societal costs by country and disease severity.

NASH – Burden of Non-alcohol related Steatohepatitis: a socioeconomic study

Non-alcoholic steatohepatitis (NASH) is an advanced form of non-alcoholic fatty liver disease (NAFLD). NAFLD is caused by build-up of fat in the liver. When this build-up causes inflammation and damage, it is known as NASH, which can lead to scarring of the liver. Scarring of the liver is a potentially life-threatening condition called cirrhosis.

What is the objective of this study?

The objective of this study was to determine the socioeconomic burden of NASH across the five European countries and the USA. It was to explore the impact of NASH on patients’ quality of life using patient recorded outcomes measurements (PROMs) for each country and by disease severity (fibrosis stage).

 

The Westminster Centre for Research in Veterans held a successful 'Where are all the veterans?' report launch on Wednesday 20th July 2022. A recording of the launch is available here. Our '10-step video to improve the registration of military veterans' that was played during the launch can be accessed by clicking here, and will be embedded into this webpage soon.

The report is available through the FiMT website, and can be viewed here.

You can find out more about the project below:

Forces in Mind Trust (FiMT) has awarded £133,150 to the University of Chester to conduct research to examine how an advertising campaign can motivate ex-Service personnel to register with Primary Health Care practices.

This project will build upon earlier reports which show that ex-Service personnel can hold negative attitudes towards registering with GPs. This can lead to low awareness of the support available to them, as well as a limited understanding of their needs by primary health care professionals.

The study aims to identify what motivates veterans to register with a GP and to inform them of their Armed Forces status.  It will look at which parts of an advertising campaign are effective at influencing veterans to register, examine trends relating to the demographic of the ex-Service personnel who do register, and provide detail relating to their physical and mental health profile.  The project will also develop a theoretical model highlighting the primary initiatives that are successful in encouraging ex-Service personnel to register.

The project was awarded under FiMT’s Health Programme and is expected to be conducted over two years.

FiMT are committed to supporting the Armed Forces community throughout and beyond COVID-19 and this includes the continuation of funding to much needed projects such as this grant. The latest FiMT COVID-19 response can be found here. 

Ray Lock, Chief Executive of Forces in Mind Trust says, “This study will build upon the existing research and help to develop a solution by providing a solid evidence base on the health needs of veterans whilst seeking to positively change behaviour.  This will lead to improved recognition of the needs of ex-Service personnel from point of presentation and a better understanding of clinical priorities.”

Professor Alan Finnegan from the Westminster Centre for Research in Veterans at the University of Chester is Principal Investigator for this study and says, “Veterans are entitled to a broad range of healthcare benefits, and to maximise the uptake of these services, then it is vital that ex-Service personnel and their families register with a Primary Healthcare practice. Equally important is that the Primary Healthcare staff of General Practitioners, nurses and ancillary staff are mindful of the veteran’s status and that this is correctly recorded. This study will explore the factors that can be employed to maximise the Primary Healthcare offered to veterans and present a cost-effective template that can be implemented on a national basis.”

Media Links

To see further information regarding this project, please view the media links below:

 

Newsletters

Where are all the Veterans Newsletter.pdf

 

Frequently Asked Questions

If you have any queries or comments regarding the project, please contact Dr Rebecca Randles (R.Randles@chester.ac.uk). 

Stages of the Project

What are the stages of the project?

There are essentially four different stages of this project to encourage Veteran registration. The first 6 weeks will involve the practice putting up posters and a Zap stand. This will then be followed by 6 weeks of posting on social media and sending out text messages to patients. We will then move into external avenues. For the third stage, we will be disseminating the information into pubs, gyms, community halls and local sports venues. The final stage involves getting access to the older Veteran by getting the information into care homes and assisted living. 

After finishing the searches we will then be returning to the practices to ask for feedback on what worked well, what didn’t work well and how we could improve. We will also be conducting interviews with the expert reference group.

Are practices able to implement any of their own strategies during this project?

Yes. All that we ask is that practices hold off putting anything in place until the first initial search has been conducted, and that practices inform the research team of what they are doing and when. This will help to identify reasons for spikes in registration.

When and how will the practices receive payment?

Payment will be arranged with the practices once the first initiative has begun. Details of which will be arranged at the time.

Is the project looking at which initiatives work?

Yes. We are aiming to synchronize the searches with the ends of each of the stages. This will allow us to see any spikes in registration and potentially see which is the most effective.

Background and Information

Who is classified as a Veteran?

A Veteran is defined as a person who has served a minimum of one day in Military Services. This includes National Service, the Territorial Army, Merchant Navy, Royal Navy, Army, Royal Air Force and Marines. This also includes those who are Military Reserves.

Does the one day of service include training?

Yes. If someone has completed one day and this day was solely training, they would still be classified as a Veteran.

How many Veterans are there in the UK?

There is an estimated number of 2.9 million Veterans in the UK, it is estimated that 5.1% of this population resides in the North-West. The Armed Forces Community, which includes Veteran families, is estimated to be around 10 million.

What services are available to Veterans?

The NHS is responsible for providing all hospital and most community services for serving personnel (except for mental health, general practice and rehabilitation services). The NHS also provides nearly all community, general practice and hospital services for the families of serving personnel, reservists and veterans. Included as part of this are the following dedicated services and initiatives to support the Armed Forces community.

What percentage of a practice should be Veterans?

It is estimated that 5% of your practice population should be a Military Veteran.

What about Military Veterans families?

Whilst we recognise that the armed forces community is huge, this is not one of the focuses of the current project. Though this could potentially be a focus of future research.

Conducting the Searches

How many searches should be conducted and when?

We are asking for a total of five searches. The first search will be prior to any initiatives to see the starting point of the practice. We are asking for this search w/c 24th of August. We will then ask for searches following completion of each stage and one final search at the end of the project.

What do we need to search for?

A SNOMED code has been provided to practices which will identify any Military Veterans that you have registered to your practice. We are asking practices to search individual records, removing any identifiable factors such as NHS number and name, and to send onto Dr Rebecca Randles. We would like these searches to include the following demographics as well as identifying whether any of the Veterans have been diagnosed with any of the following criteria, see table below.

We are asking for individual records so we are able to see co-morbidity as well as to view demographics in relation to such.

Demographics

Criteria

Age

Drugs

Gender

Dementia

Marital Status

PTSD

 

Depression

 

Anxiety

 

Alcohol

 

I’m struggling to conduct the search you are asking, what should I do?

Please contact Dr Rebecca Randles (R.Randles@chester.ac.uk) who will be able to help.

Recent list of publications.

2023

Finnegan, AP., Di Lemma L., Mcghee S., Watson R. (2023). Evaluating serious stress in military veterans, their carers and families: a protocol. BMJ Mil Health. Jun;169(3):263-268. DOI:10.1136/bmjmilitary-2020-001715. Epub 2021 Feb 5. PMID: 33547195.

Finnegan, AP., Salem, K., Green, N., Ainsworth-Moore, L., Ghomi, M. (2023). Evaluation of the NHS England ‘Op COURAGE’ High Intensity Service for military veterans with significant mental health problems; BMJ Military Health, Published Online First: 14 July 2023. DOI:10.1136/military-2023-002385

Finnegan, AP. (2023). How Nurses Can Improve Mental Health Outcomes for Nurses. Mental Health Practice.  RCNi 16 May, At: https://rcni.com/mental-health-practice/opinion/expert-advice/how-nurses...

Finnegan, AP., & Randles, R. (2023). Where are all the veterans? A mixed methods assessment of a systematic strategy to increase veteran registration in UK primary healthcare practices BMJ Open 2023;13:e068904. DOI:10.1136/bmjopen-2022-068904

Randles R., Burroughs H., Green N., Finnegan, AP. (2023). Prevalence and risk factors of suicide and suicidal ideation in veterans who served in the British Armed Forces: a systematic review BMJ Mil Health Online First: 16 June 2023. DOI:10.1136/military-2023-002413

Randles, R., & Finnegan, AP. (2023).  Guidelines for Writing a Systematic Review. Nurse Education Today. Jun; 125:105803. DOI:10.1016/j.nedt.2023.105803 Open Access

Morgan, G., Back, E., Rosa, D., O'Hara, J., & Finnegan, AP. (2023). Assessing the value of bypassing agent therapy used prophylactic versus on-demand, during immune tolerance induction for treatment of Inhibitors: a retrospective chart review. Orphanet Journal of Rare Diseases. 18:47. DOI:10.1186/s13023-023-02654-0 Open Access.

Rodriguez-Santana, I., Mestre, T., Squitieri, F., Willock, R., Arnesen, A., Clarke, A., D'Alessio, B., Fisher, A., Fuller, R., Hamilton, J.L., Hubberstey, H., Stanley, C., Vetter, L., Winkelmann. M., Doherty. M., Wu, Y., Finnegan, AP., Frank, S. (2023). Economic burden of Huntington’s Disease in Europe and the USA: Results from the Huntington’s Disease Burden of Illness Study. European Journal of Neurology. 30; 1109-1117. DOI:10.1111/ene.15645 Open Access

Salem, K., Randles, R., Sapre, B., & Finnegan, AP. (2023). The experiences of ethnic minority personnel in the armed forces: a systematic review. J of Mil, Veteran and Family Health 9 (1), 5–14. DOI:10.3138/jmvfh-2022-0019 open access

Finnegan, AP. (2023). Educating Nurses to Deliver Optimum Care to Military Veterans and their Families. Science  Talks. DOI:10.1016/j.sctalk.2023.100144 Open Access

Currie, J., Thompson, C., Grootemaat, P., Andersen, P., Finnegan, AP., Carter, M., & Halcomb, E. (2023). A scoping review of clinical skill development of preregistration registered nurses in Australia and five other English-speaking countries. Journal of Clinical Nursing, 32, 283–297. DOI:10.1111/jocn.16239

2022

Morgan, G., Brighton, S., Laffan, M., Goudemand, J., Franks, B., Finnegan, AP. (2022). The Cost of von Willebrand disease in Europe: The CVESS study. Clinical and Applied Thrombosis/Hemostasis.  DOI:10.1177/10760296221120583

Finnegan, AP., & Randles, R. (2022). Nursing care for the military veteran and their family. Journal of Clinical Nursing, 00, 1–   3. DOI:10.1111/jocn.16345

Finnegan, AP., Salem, K., Ainsworth-Moore, L., Randles, R., West, L., Simpson, R., & Benedicta Grant, V. (2022). The veteran friendly practice accreditation programme: a mixed methods evaluation. BJGP Open, 12 July. DOI:10.3399/BJGPO.2022.0012 Open Access

Mighiu, C., O’Hara, S., Grazzi, EF, Murray, KF, Schattenberg, JM., Ventura, E., Karakaidos, M., Taylor, M., Brrang, H., Dhawan, A., Willemse. J & Finnegan, AP. (2022). Impact of progressive familial intrahepatic cholestasis on caregivers: caregiver-reported outcomes from the multinational PICTURE study. Orphanet Journal of Rare Diseases, 17:32 At: DOI:10.1186/s13023-022-02177-0 (Open Access)

Di Lemma, Howe, S., & Finnegan AP. (2022). An evaluation of the Armed Forces Covenant Fund Trust’s Aged Veterans Fund. British Medical Journal (Military Health). 186(1) pp 49-56. DOI:10.1136/bmjmilitary-2020-001716 At: https://militaryhealth.bmj.com/content/early/2021/03/30/bmjmilitary-2020...

Finnegan, AP., & Breeze, J. (2022).  Improving research and initiatives to support veterans and their families.  British Medical Journal (Military Health).  168 (1) pp i – ii http://dx.doi.org/10.1136/bmjmilitary-2021-001939

Randles, R., & Finnegan, AP. (2022). Veteran Health-Seeking Behaviour for Mental Health Issues: A Systematic Review.  British Medical Journal (Military Health). 168 (1), pp 99-104  http://dx.doi.org/10.1136/bmjmilitary-2021-001903  Open Access

Finnegan, AP., & Randles, B. (2022). Prevalence of common mental health disorders in military veterans: using primary healthcare data – BMJ Military Health. Published online 18 Jan 2022. DOI:10.1136/bmjmilitary-2021-002045 Open Access

2021

Ruiz Casas, L., Evans, J., Rose, A., Ghizzi Pedra, G., Lobo, A., Finnegan, AP., Hayee, B., Peyrin-Biroulet, L., Sturm, A., Burisch, J., Terry, H., Avedano, L., Tucknott, S., Fiorino, g., Limdi, JM. (2021). The LUCID study: Living with Ulcerative Colitis; Identifying the socioeconomic burden in Europe. BMC Gastroenterology, 21, 456. DOI:10.1186/s12876‐021‐02028‐5

Steen, M.P., Di Lemma, L., Finnegan, A., Wepa, D., &McGhee, S. (2021). Self-Compassion and Veterans Health: A Scoping Review. Journal of Veterans Studies, 7(1), 86–130. DOI: 10.21061/jvs.v7i1.219

Ruiz-Casas,L., O’Hara, S., Mighiu, C., Finnegan, AP., Taylor, A., Ventura, E., Dhawan, A., Murray, KF., Schattenberg, J., Willemse, J., Karakaidos, M., & Brrang, H. (2021). Burden of illness of progressive familial intrahepatic cholestasis in the US, UK, France, and Germany: study rationale and protocol of the PICTURE study, Expert Review of Pharmacoeconomics & Outcomes Research, DOI: 10.1080/14737167.2021.1859371 https://www.tandfonline.com/doi/full/10.1080/14737167.2021.1859371

2020

Finnegan, AP., McKenna, H., McCourt, K. (2020).  Reflecting on the Characteristics and Values of Military Nurses. War Zone Qualitative Research. Nursing Standard, 35 (10), 82-85. DOI:10.7748/ns.35.10.82.s391

O’Hara, J., Finnegan, AP., Dhillon, H., Ruiz-Casas, L., Pedra, G., Franks, B., Morgan, G., Hebditch, V., Jonsson, B., Mabhala, A., Reic, T., Van Thiel, I., Romero-Gomez, M., Bugianesi, E., Schattenberg, J & Anstee, Q. (2020). Cost of Non-Alcoholic Steatohepatitis in Europe and USA: the GAIN Study JHEP Reports. DOI:10.1016/j.jhepr.2020.100142

McGhee, S., Finnegan, AP, Angus, J., Lewis-Pierre, L., & Ortega, J. (2020). Cutaneous Leishmaniasis. A Guide for Emergency Department Nurses. Emergency Nurse. Mar 10;28(2):23-29. DOI:10.7748/en.2020.e1993. Epub 2020 Feb 4.

Finnegan, AP., Di Lemma, L., Moorhouse, I., Lambe, R., Soutter, EM., Templeman, J., Ridgway, V., Hynes, C., Simpson, R., & McGhee, S. (2020). Educating Nurses to Deliver Optimum Care to Military Veterans and their Families. Nurse Education in Practice. DOI:10.1016/j.nepr.2019.102654

Finnegan, AP., & Aitkenhead, S. (2020). A Research Portfolio: Transformational change by nursing, midwifery and care staff across health and care.  Journal of Advanced Nursing. 76, 7,8. DOI:10.1111/jan.14228

2019

Willock, R., Laffan, M., Goudemand, J., Tiede, A., Skouw-Rasmussen, N., Giraud, N., Peake, R., de Meris, J., Caroll, L., & Finnegan AP. (2019). An Introduction to CVESS: The cost of von Willebrand disease in Europe- a socioeconomic study. Meeting Abstract. Haemophilia, 1 (SI) PP 163 ISSN: 1351-8216

McGhee, S., Finnegan, AP., Angus, N., & Clochesy, J. (2019). Responding to Nerve Agent Poisoning: A Guide for Emergency Nurse Part 2. Emergency Nurse, Published online 16 April. DOI:10.7748/en.2019.e1925

Ruiz, L., Willock, R, Russell, T., Morgan, G., O’Hara, J., Anstee, Q., Thiel, IV., Finnegan, AP., Rhys, J., Hebditch, V., Madhala, M., Scattenberg, J., Romero-Gomex, M., Bugianesi, E., Ratziu, V., Reic, T., Guzauskas, G., Jonsson, B., & Hatswell, A. (2019). The socio-economic burden of NASH in Europe and the United States: The gain study. Meeting Abstract. Journal of Hepatology 70, 1, E35-36 DOI:10.1016/S0618-8278(19)30064-7

Finnegan, AP., McGhee, S., Roxburgh, M., & Kent, B. (2019). Knowledge Translation and the Power of the Nursing Academic Conference. Nurse Education Today. 73 pp – 38-40. DOI:10.1016/j.nedt.2018.10.014

Kiernan, M,. & Finnegan, AP. (2019). Committee examine Armed Forces Covenant Annual Report 2018. Written evidence to the Commons Select Committee. 12 Feb. At: http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidence...

McGhee, S., Finnegan, AP., Angus, N., & Clochesy, J. (2019). Nerve agents: a guide for emergency nurses. Part One.  Emergency Nurse, Published online – 19 Feb. DOI:10.7748/en.2019.e1896

Kip, KE., Berumen, J., Zeidan, A., Hernandez, DF., Finnegan, AP. (2019). The emergence of Accelerated Resolution Therapy (ART) for treatment of post-traumatic stress disorder (PTSD): A review and new subgroup analyses. Counselling and Psychotherapy Research, 2019;1–13. DOI:10.1002/capr.12210

2018

Carter C., & Finnegan AP. (2018). Nurse Education in the British Armed Forces. Journal of Perioperative Practice. Nov;28(11):304-308. DOI:10.1177/1750458918804788

Finnegan, AP., Bashford, J., & Green, M. (2018). Defence Committee: Oral Evidence: Mental health and the Armed Forces, Part 2: The Provision of Care http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidence... 11 September Crown London HC1481

Finnegan AP & Kiernan M (2018).  Mental Health and the Armed Forces, Part Two. The Provision of Care Inquiry http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidence... 11 September Crown London POC 0096

McGhee, S, Visovksy, C, Zambroski, C, & Finnegan, AP (2018). Lyme disease: recognition and management for emergency nurses. Emergency Nurse. 26(2). DOI:10.7748/en.2018.e1850

Kiernan, M., Finnegan, AP, & Hill, D. (2018). Defence Committee: Armed Forces and Veterans Mental Health Inquiry. Part One At:  http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidence... published 12 June 2018.  Crown London VMH0046

Finnegan, AP., Currie, J., Ryan, T., Steen, M. (2018). Nurse education and the military veteran. Australian Nursing and Midwifery Journal, Vol. 25 (10): 38.  ISSN: 2202-7114. [cited 18 Aug 19].

Finnegan, AP., Jackson, R., Simpson, R. (2018). Finding the Forgotten. Motivating Military Veterans’ to Register with a Primary Healthcare Practice. Military Medicine. 183 (11-12) 01 Nov: e509-e517. DOI:10.1093/milmed/usy086

McGhee, S., Visovsky, C.F., Clochesy, J & Finnegan, AP. (2018).  Translating the Power of Coverdall Fellows to Address Global Nursing Challenges. Nurse Education Today 65 pp 94–95. DOI:10.1016/j.nedt.2018.02.033

2017

Finnegan, AP., Brownsell, M., Steen, S., & Templeman, J. (2017). Evaluating the Needs of the Armed Forces Community. Internal Video Report – University of Chester. At: https://www.chester.ac.uk/health/crivw  Internal E Publication.

Finnegan, AP., McGhee, S., & Leach, J. (2017). Educating Nurses to Provide Better Care for the Military Veteran & their Families. Nurse Education Today. 54, pp 62-63. DOI:10.1016/j.nedt.2017.04.014

2016

Finnegan, AP. (2016).  Editorial.  Military Veterans Healthcare & Wellbeing Special Issue.  Nurse Education Today.  47, pp 1.

Finnegan, A.P., McKenna, H., & Lauder, W. (2016). The Challenges and Psychological Impact of Delivering Nursing Care within a War Zone. Nursing Outlook, (64), pp 450-458. DOI:10.1016/j.outlook.2016.05.005

Finnegan, AP. (2016).  The biopsychosocial benefits and shortfalls for armed forces veterans engaged in archaeological activities.   Nurse Education Today (Military Veterans Special Edition). 47, pp 15-22.  DOI: 10.1016/j.nedt.2016.03.009

Finnegan, AP., Kip, K., Hernandez, D., McGhee, S, Rosenzweig, L., Hynes, C & Thomas, M. (2016). Accelerated Resolution Therapy. An Innovative Approach to Treating Post Traumatic Stress Disorder. British Medical Journal (Military Health).  162(2), pp 90-97 DOI:10.1136/jramc-2015-000417

Finnegan, AP, Finnegan, SE, McKenna, H., McGhee, S., Ricketts, L., McCourt, K., Warren, J, & Thomas M (2016).  Characteristics and Values of a British Military Nurse. International Implications of War Zone Qualitative Research. Nurse Education Today. Volume 36, Pages 86–95. DOI: 10.1016/j.nedt.2015.07.030

Finnegan, AP., Finnegan, S., Bates, D., Ritsperis, D., McCourt, K., & Thomas, M. (2015). Preparing British Military Nurses to Deliver Nursing Care on Deployment. An Afghanistan Study. Nurse Education Today. 35, pp 104-112. DOI: 10.1016/j.nedt.2014.07.008

2015

McGhee, S., Weiner, A., Finnegan, AP., Visovsky, C., Clochesy, J., & Graves, J. (2015). Assessing and Managing Spider & Scorpion Envenomation. Emergency Nurse, 23(7) pp 32-37. DOI:10.7748/en.23.7.32.s28

McGhee, S., Finnegan, AP., Clochesy, J., & Visovsky, C. (2015). Effects of Snakebite Envenomation. A Guide for Emergency Nurses.  Emergency Nurse, 22(9) pp 24 - 29. DOI:10.7748/en.22.9.24.e1406

2014

Finnegan, AP., Finnegan, SE., & Thomas, M. (2014). Factors Affecting the Mental Health Support to British Armed Forces Personnel on Deployment in Afghanistan. Part Two Journal of Community Nursing. 28(6), pp 53-58

Carter, C., & Finnegan AP. (2014). Nurse Education in the British Armed Forces. Nursing Standard. 29(7) pp 43-48.   DOI:10.1177/1750458918804788

Finnegan, AP., Finnegan, SE., & Thomas, M. (2014). Factors Affecting the Mental Health Support to British Armed Forces Personnel on Deployment in Afghanistan. Part One. Journal of Community Nursing.  pp 30-32.

Finnegan, AP. (2014). Conducting Qualitative Research in the British Armed Forces. Theoretical, Analytical and Ethical Implications. British Medical Journal (Military Health), 160(2), pp 135-140. DOI:10.1136/jramc-2013-000223

Finnegan, AP. (2014). Fieldwork & Practical Implications for Conducting Qualitative Research in the Defence Medical Services. British Medical Journal (Military Health), 160(2) pp 141-145. DOI:10.1016/j.jhepr.2020.100142

Finnegan, AP., & Thomas, M. (2014).  Effective Support for Serving Personnel.  Adjacent Government. Published online 18 May 14.

Finnegan, AP., Finnegan, S., Thomas, M., Deahl, M., Simpson, R., & Ashford, R. (2014). The Presentation of Depression in the British Army. Nurse Education Today, Vol 34(1), pp 83-91 DOI: 10.1016/j.nedt.2013.02.020

2013

Kiernan, M., Finnegan, AP., & Farrell, D. (2013). Role of the Military Community Mental Health Nurse.  Nursing Standard, 27(51), pp 35 - 41.  DOI: 10.7748/ns2013.08.27.51.35.e7725

2012

Finnegan, AP,. & Nolan, P. (2012). Influences of British Army Nurses on Mental Health Care.  British Journal of Mental Health Nursing, 1(4), pp 214-219. DOI:10.12968/bjmh.2012.1.4.214

Batham, D., Finnegan, AP., Kiernan, M., Wall, C. & Simpson, R. (2012). Factors Affecting Role 1 Trauma Casualty Care in Afghanistan.   British Medical Journal (Military Health), 158(3), pp 173-180.  DOI: 10.1136/jramc-158-03-05

2011

Finnegan, AP., & Simpson, R. (2011).  Stress in Battle. Psychology Review. 17(2), Nov, pp 10-13.

Finnegan, AP., Finnegan, SE., McGee, P., Ashford, R., & Simpson, R. (2011). Serving in the British Army: Research into Mental Health Benefit. British Journal of Nursing, 20(19), 26 Oct; pp 1256 – 1261.  DOI: 10.12968/bjon.2011.20.19.1256

2010

Finnegan, AP., Finnegan, SE., McKee, P., Srinivasan, M., & Simpson, R. (2010).  Predisposing Factors Leading to Depression in the British Army.  British Journal of Nursing, 19(21), pp. 1355 – 1362.  DOI: 10.12968/bjon.2010.19.21.80000

Finnegan, AP., Finnegan, SE., Jackson, C., Simpson, R., & Ashford, R. (2010).  Predisposing Factors and Associated Symptomatology of British Soldiers Requiring a Mental Health Assessment.   British Medical Journal (Military Health), 2010, 156(2), pp.90-96.   DOI:10.1136/jramc-156-02-05

1996 – 2009

Finnegan, AP., & Finnegan, SE. (2007). Assessing the Effectiveness of the British Army’s Mental Health Service.  British Journal of Nursing, 16(12), pp. 725 – 730.   DOI: 10.12968/bjon.2007.16.12.23724

Finnegan, AP., Finnegan, SE., & Gamble, D. (2007). A Review of One Year of British Armed Forces Mental Health Hospital Admissions.  British Medical Journal (Military Health), 153(1), pp. 26 – 31.   https://doi.org/10.12968/bjon.2011.20.19.1256

Finnegan, AP. (1999). Major Trauma Response Service in Northern Ireland. Professional Nurse, 1999, Vol 15, No 3, pp. 179-182.

Finnegan, A.P., Cumming, P., & Piper, M. (1998). Critical Incident Stress Debriefing Following the Terrorist Bombing of Army Headquarter Northern Ireland. British Medical Journal (Military Health).  (144), pp. 5-10. DOI: 10.1136/jramc-144-01-02

Finnegan, AP. (1998). Clinical Assessment of Post-Traumatic Stress Disorder, British Journal of Nursing, Vol 7 (4), pp. 212-218.   doi: 10.12968/bjon.1998.7.4.212.

Vassallo DJ., Taylor JC., Aldington DJ., & Finnegan AP. (1997). Shattered Illusion – the Thiepval bombing, 7 October 1996.  British Medical Journal (Military Health), 143(01), pp 5-11.  DOI:10.1136/jramc-143-01-02

Finnegan, AP. (1997). Societal Factors that Negatively Effect the Mental Health Support for the British Army’s Service Personal Involved in Major Trauma. British Medical Journal (Military Health). (143), pp. 107-111   DOI: 10.1136/jramc-143-02-08 

Finnegan, AP. (1995). Critical Incident Stress Debriefing in Clinical Practice. British Journal of Therapy & Rehabilitation. 1995, 2(12), pp. 679- 685. doi.org/10.12968/bjtr.1995.2.12.679   DOI: 10.1136/jramc-144-01-02

Finnegan, AP. (1995).  Treating Post Traumatic Stress Disorder Using Riehl’s Interaction Model. British Journal of Nursing, 4(20), pp. 1214 1217.  DOI: 10.12968/bjon.1995.4.20.1214