Medical discharge from the UK Armed Forces and the role of combat injury: A short report from the ADVANCE-INVEST study

The recent conflict in Afghanistan resulted in hundreds of serious injuries to UK Armed Forces personnel, necessitating their aeromedical evacuation. Due to the nature of their injuries, many individuals have been medically discharged from the Armed Forces. Using both quantitative and qualitative data from the ADVANCE and ADVANCE-INVEST studies, this report investigates the outcomes and experiences of those who were medically discharged, with a focus on those with combat injuries. The ADVANCE-INVEST study, a sub-study of ADVANCE, is a mixed-methods investigation of transition experiences and outcomes for those with combat injuries arising from the conflict in Afghanistan, funded by Forces in Mind Trust. The study used questionnaire data from over 500 ex-Service personnel who had sustained combat injuries, as well as 28 in-depth interviews regarding their perceptions and experiences of transition in the context of their injuries. Most participants who sustained a combat injury left the military via a medical discharge. Some of those who were medically discharged experienced an abrupt ending to their career and life in the military, contrary to their ambitions and expectations of a long career in Service. This was also true of those who believed the military would retain them in spite of the seriousness of their injuries and did not anticipate a medical discharge. The difficulties that some participants felt in relation to the rapid ending of their military career was exacerbated by a perceived lack of collaboration with the military regarding their leaving, something they felt they had little, or no, control over. The abrupt ending to their service was felt to be compounded by a lack of communication from their former military chain of command after they had left.UK Armed Forces personnel who were medically discharged were eligible for the highest level of support provided by resettlement services for their transition. Nonetheless they had lower rates of post-Service employment compared to those who left via other methods of discharge. This could have been due to the nature of their injuries; however, participants also reported a lack of tailored careers advice specific to the challenges they faced related to their injury. The pace at which participants engaged with future career planning was varied, and existing structures did not always have the flexibility to match the needs of the injured person. Transfer of medical records was still reported as being inconsistent, with some complaints of civilian medical practitioners being unable to access their full medical details, forcing injured personnel to retell their medical histories many times. Compensation for injuries was welcomed and could be seen to have benefits beyond merely the immediate material benefit to the injured person; for example, it provided acknowledgement of their injury, a buffer while seeking re-employment in the civilian job market and supported a healthy worklife balance in the context of ongoing pain and medical issues. Conversely, problems could occur when payment amounts and transfer dates were unknown, when a lack of tailored financial advice was provided, and/or when poor financial decisions were made. Some participants were engaged in lengthy tribunal processes to claim compensation, particularly those who were injured but did not sustain limb loss; these processes were emotionally demanding for them. Based upon our findings, a summary of our recommendations and the audiences they are aimed at is given.

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