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

What we do

Contact members, associates and partners are currently working collaboratively on a number of identified priority military mental health projects. Each project is led by a nominated Contact member as Executive Lead to advise and assist with work in that area. If you would like further information about any of Contact’s work areas listed below, please contact us.

Photo credit: Combat Stress

Case Management >

Common Assessment >

Quality and accreditation >

Data Dashboard >

Research >

Associates programme >

Communications >

Case Management

Executive Lead: Cobseo

There has been growing recognition of the need to improve the beneficiary journey for veterans seeking mental health services and, in particular, the linking of relevant data held by the principal statutory and third sector service providers. Following the first Contact Case Management workshop in Edinburgh in June 2019, Cobseo and Contact convened a Case Management Working Group of key stakeholders in autumn 2019 to consider the feasibility of a more holistic approach. The group’s report and recommendations were supported by the Office for Veterans’ Affairs (OVA), who agreed to fund a Scoping Study for the development of a Veterans’ Mental Health Information System (VMHIS), and to appoint an IT consultant to take this work forward.

The key principles identified by the Working Group are that:
– Veterans seeking access to mental health services should only be required to relate their history once.
– The existing silo approach, which often applies when veterans need to access multiple service providers, should be replaced by a process for effective data sharing, covering both statutory and third sector providers.
– The envisaged System should provide an immediate overview of the veteran’s dealings (if any) with mental health providers and welfare systems.
– Approved System users will have pre-determined editing rights, and access to confidential data should be limited to overviews (with links to seek further information where necessary).
– The System should be GDPR compliant, and underpinned by veterans’ consent for personal data to be utilised to support the coherent provision of mental health services.
– The new System should link existing systems, and avoid the wholesale replacement of local networks. It should also be embedded in existing local information networks.
– While the initial focus is on mental health, it is envisaged that the System can evolve at a later stage to incorporate other clinical conditions and physical health issues.
– Finally, and most importantly, the interests of the veteran must be kept at the heart of this project as it proceeds.

The Scoping Study will address the IT development work needed to achieve these aspirations and will include the development of a project specification that potential suppliers will draw upon for their costed proposals.

Work on the Scoping Study is currently ongoing. The consultant has completed a comprehensive fact-finding phase, involving engagement with key stakeholders and their front-line service providers, to ensure all perspectives are reflected in the proposed way forward, and is now engaging with prospective suppliers. The information-gathering process has been challenging, usually because of the need to extend the engagement process to get to the heart of issues that need to be addressed, and the many constraints that will need to be overcome, including: promoting understanding and buy-in of the aims beyond the immediate stakeholder community; addressing the challenges of operating across devolved boundaries (involving both data sharing and differing IT and/or non-IT business processes); getting a sense of beneficiary numbers, both now and looking ahead; and establishing a representative baseline (including at least three of the devolved administrations) for the initial implementation phase. 

The Customer Group that has been established for and consulted during this process has also recognised the importance of seeking input from clinicians before engaging with prospective suppliers, and a focus group has been set up and consulted. 

The success of the project will be dependent on achieving widespread buy-in and support across the public and charity sectors, and a commitment to address the challenges that will need to be overcome, including ensuring understanding and buy-in for both the concept, the scope of the system and its target audience, and the governance of the system.

The Scoping Study is on track to deliver its specified outputs, anticipated to be in early 2022, which include a project specification, indicative costs from prospective suppliers, and a narrative on their proposals. The focus will then move to implementation and its associated costs, which are as yet unknown, and the VMHIS project may be brought within Cobseo’s ongoing OVA-funded Digital and Data Strategy (DADS). Although the report, recommendations and VMHIS itself will be designed specifically for the purposes of veterans’ mental health data, it is hoped that the principles could be applied to other specialties in the future.

Related to this work, in March 2021, Contact hosted an online military mental health and case management conference (the programme and outputs including a video recording are available at the link), as part of which the above aims and work were outlined and feedback was invited from attendees, many of whom were service providers. Feedback received to date has suggested that a VMHIS as described above would be welcomed by the sector. Feedback on the project is welcome at any time by contacting us

Common assessment

Executive Lead: NHS England and NHS Improvement

Contact work on a common assessment framework (CAF) for use by both NHS and charity/independent military mental health treatment providers is being led by NHS England which chairs a sub-group of Contact members and other relevant organisations working on this, including DMS, the devolved administrations and an NHS England provider. It is envisaged that, as a result of providers using the CAF, especially for veterans moving between or accessing multiple services (both statutory and non-statutory), the common information collected and the information-sharing capabilities of the system will mean that veterans will not be required to repeat their medical and military histories multiple times, which can obviously be traumatic, frustrating and time consuming.

The sub-group has developed and refined their framework document in response to feedback, including about essential and desirable criteria, and divided it into separate sections for different categories to aid providers who may carry out different types of assessments at different stages. The main challenge now is identifying the best way to implement the CAF to suit different providers. The group has done some investigating into the complexities involved, and also consulted with NHS England Op Courage providers about the draft CAF itself. As a result of this, many of the challenges involved and some potential solutions to them have been identified and an NHS England I.T. Director has offered his assistance on a pro bono basis to work through some of these. The plan is to look with the professions involved into how differing cultural attitudes to some of the issues might be addressed, and also to look at developing some generic guidance for some of the challenges around information governance and data sharing. There is currently much work ongoing in this space more widely, and a lot of potential future change, so the choice of system and timing will be crucial.

The draft CAF can be used by charity/independent and NHS providers on a voluntary basis currently – please contact us if your organisation is interested in doing this. NHS England will be considering including the CAF in the specification for new Op COURAGE contracts sometime between April 2022-April 2023. 

Quality and accreditation

Executive Lead: Royal College of Psychiatrists

Improved quality and accreditation of military veterans’ and families’ mental healthcare will assist members of the armed forces community to more easily identify and access services that are operating according to recognised best practice and agreed quality standards. With Prof Neil Greenberg of King’s College London and the Royal College of Psychiatrists (RCPsych), the Contact Group has produced the Contact Guiding Principles for the delivery of veterans’ and service families’ mental healthcare.

Contact has also collaborated with RCPsych to develop the first sector-specific quality network and accreditation programme for military mental healthcare providers, the Quality Network for Veterans Mental Health Services (QNVMHS). This is now established and the accreditation it will award to participating teams that meet the agreed quality standards in future will include an easily identifiable and widely recognised ‘quality mark’ so those looking for military mental healthcare can more quickly and easily identify providers that have been quality checked.

A clinical advisory group for the network, comprising expert clinicians from the UK military mental health sector, helped to draft the first set of quality standards for the network which were tested in a 12-month pilot funded by the Department for Health and Social Care and NHS England & NHS Improvement. Ten pilot teams participated, drawn from the NHS in England, Scotland and Wales and charity providers from across the UK.

The pilot ran from autumn 2020 to summer 2021 and consisted (as future cycles will) of a three month period of self-review, followed by peer reviews, reports on each service for their internal use, and finally the publication of an anonymised, collated report of the overall findings. At the end of the pilot, the quality standards were reviewed and some adjustments made in response to feedback from the pilot teams. The network’s first online annual forum was also held at which the findings of the pilot were presented, pilot teams shared their experiences of participating, relevant workshop sessions were held and the importance of this programme was highlighted in the context of other work being carried out across the UK military mental health sector.

The second annual cycle (2021-22) is now underway with all pilot teams continuing and a significant number of additional teams from both the NHS (in England, Wales, Scotland and Northern Ireland) and the charity/independent sector – in total, it is expected that around 30 teams will participate for this cycle. The participation of selected teams in the second cycle is being supported through further funding from DHSC/NHE England & NHS Improvement and the Veterans’ Foundation, for small charities (all partially subsidised places for the current annual cycle have been allocated). The QNVMHS recently published its first newsletter, with contributions about military mental healthcare provision provided by many of the teams that are currently participating in the network.

The first teams to achieve accreditation through the quality network are expected to achieve this in summer 2022 and will be drawn from the pilot cohort (it is not possible to be accredited as a result of a team’s first ‘developmental’ review cycle). Accredited teams/organisations will benefit from increased reputational profile among both potential beneficiaries, funders and partner organisations. Contact is delighted that both the Scottish Veterans Care Network (in their Mental Health and Wellbeing Action Plan) and the Armed Forces Covenant Fund Trust (as part of their Afghanistan Veterans Fund) have recognised the value of the network and participation in it by military mental healthcare providers. Further updates on the progress of the network and the associated ‘quality mark’ to be awarded to accredited teams will be provided here when available. 

The network is open to all UK military mental healthcare providers/teams that would like to participate in the current annual cycle for 2021-22. The annual membership fee of £2,500 +VAT per team is payable to RCPsych which covers the costs of coordinating and running the network. Further details and registration instructions for teams/organisations interested in joining can be found on the QNVMHS pages on the RCPsych website. Please contact us or email veterans@rcpsych.ac.uk with any queries or for further information.

Data dashboard

Executive Lead: Office for Veterans’ Affairs

Contact previously received support from the Ministry of Defence (MoD) health statistics team for the development of a UK military mental health data dashboard and are very grateful for their support for this work over the last 1-2 years. The MoD continues to provide data and analysis on the mental health of serving personnel for new editions of the dashboard. The Executive Lead and primary support for the dashboard is now the data analysis team at the Office for Veterans’ Affairs (OVA), which produces regular updated editions of the dashboard for member review.

The aim of the dashboard is to present a complete picture of the strength and nature of demand, capacity and outcomes across all parts of the UK military mental health sector using all available data on veterans and serving personnel accessing clinical mental healthcare in the UK, including from MoD, NHS and charity/independent providers, together with outcomes data and indicators of capacity. 

The dashboard is updated on a quarterly basis, where data allows. Editions of the dashboard to date have focused on available MoD, NHS and charity data. Work is currently underway with Contact member charities Combat Stress, Help for Heroes and Walking With The Wounded to explore their available data with the aim of more fully incorporating a comparable range of charity demand, capacity and outcomes data in future dashboards.

The latest edition of the dashboard produced for member review in December 2021 featured new MoD data on serving personnel, new NHS England and Veterans NHS Wales data on veterans seen within each of their specialised mental health services, and new charity demand and outcomes data. There remain some differences in the collection and types of some areas of charity data, including outcomes, work on which will be prioritised to enable easier comparability in future dashboards.

Research

Executive Lead: Northern Ireland Veterans’ Support Office

Contact work in the area of research includes the monitoring of relevant recent and ongoing military mental health (MMH)-related research and interpreting it for the benefit of the work of Contact, its member organisations and the wider sector, as well as identifying and monitoring potential gaps in relevant MMH research.

This is the specific role of the Contact Research sub-group which consists of a selection of Contact Research Associates. The group has twelve members of which nine rotate annually and is currently chaired (for 2020-22) by Dr Alan Finnegan from the University of Chester’s Westminster Centre for Research in Veterans. The group meets quarterly and provides input at Contact meetings.

The group’s work so far has included identifying the following potential gaps in military mental health research, all of which will be monitored and explored in further detail:

– Minorities’ access to healthcare
– Ageing veterans (especially women) and dementia 
– The needs of service (distinct from war) widow/ers
– The scope and nature of ongoing research into families and children
– Complex grief, including that as a result of violent or traumatic death
– The impact of Covid on military mental health clinical practice
– The impact of recent events in Afghanistan on veterans’ and families’ mental health

The group has held a deep-dive discussion on the identified research gap theme of ageing veterans and dementia. The key findings/questions that were identified for further exploration included:

– Planned research to look at experiences in the forces and early onset dementia will be monitored
Potential links between PTSD and Parkinson’s disease and between MTBI, PTSD and dementia
– The issue of h
ow we care for veterans with dementia and/or PTSD in care home settings
– The issue of caring for elderly relatives with dementia whilst also serving

The group also recently held a discussion on the theme of complex grief with specialist guest speaker for this area, Dr Michael Duffy from Queen’s University Belfast. Further deep-dive discussions on other identified research gap areas are also planned. 

In addition to this work, the group will also aim to capture the quantity and variety of ongoing relevant UK postgraduate research, as well as develop activities with and for UK postgrads engaged in MMH-related research, including collaborating with others such as the Defence Research Network. Some initial ideas for postgrad research-related activities to be explored further by the group include the organisation of a funded international conference for postgrads and a ‘library’ of questions for PhD studies with potential cross-university supervision to help build future multidisciplinary research programmes and foster a collegiate approach to research in this area.

Associate membership programme

Executive Lead: Togetherall

Contact associate membership has been introduced for Cobseo member organisations that can demonstrate direct and established involvement in the provision of mental healthcare (clinical treatment) or mental wellbeing (non-clinical) services to serving personnel, veterans or families (though this does not have to constitute core activity). The aim is to bring these organisations into Contact as associates to complement Contact’s core membership. Associate membership is free of charge and associates benefit from involvement in Contact’s ongoing military mental health-related workstreams (where opportunities arise), relevant consultations, information-sharing and other communications about Contact, its work and the wider sector. Associate members are also featured on our associates page where a summary of activities and links can be included.

If your organisation is interested in becoming a Contact associate, please read the associate membership criteria to check eligibility and if eligible, submit a completed application form via email. Applications for Contact associate membership will be considered by the Contact membership panel on a quarterly basis. If you have any queries, please feel free to contact us. The programme is currently open to organisations that are members of Cobseo, and in future will be extended to others. Further information about this will be shared here when details are confirmed.

Communications

Executive Lead: Walking With The Wounded

Contact work in the area of communications is aimed at improving awareness, sector-wide and beyond, of both Contact and its work, and that of its members and associates, through the use of various communications channels including the Contact website (the redesign and development of which was made possible through a grant from the Veterans Foundation), social media, newsletters and other information-sharing, and the hosting of both online and in-person events.

During the first Covid-19 lockdown, Contact worked with partners to help coordinate a series of regionally-focused online meetings for military mental healthcare providers. The aim was service information-sharing and networking, as well as signposting for beneficiaries. The first meeting, focused on SW England, was hosted by Contact member Togetherall. The second and third meetings, both focused on NE England, were hosted by Contact member Walking With The Wounded. If your organisation is interested in co-hosting or participating in a future online regional networking meeting for military mental healthcare providers, please contact us

Contact us

If you have queries about the work of the Contact Group or its membership, please email the Contact Project Officer, Anna Owen on: anna.owen@contactarmedforces.org.uk