ADVANCE-INVEST: New evidence about the experiences of medical discharge for those injured in combat in Afghanistan
The conflicts in Afghanistan (2001-2021) 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. New research published in August 2025, by the King’s Centre for Military Health Research, aimed to provide a holistic view of medical discharge and transition for combat casualties who leave the UK Armed Forces.
The report showed that those medically discharged following injuries sustained in Afghanistan experience several difficulties with transition to civilian life; these included adjusting to a sudden and unexpected end to their career, post-Service career advice that was inappropriate due to their injuries, and difficulties in transitioning their health care to the civilian sphere. Compensation was welcome and had many positive effects but could also give rise to issues related to financial literacy and decision-making. Key changes which could be made to improve medical-discharge related issues include acknowledgement and support from the military, and better-tailored financial and career advice.
The ADVANCE-INVEST study (a sub-study within the ADVANCE study, which looks at transition to civilian life for those with injuries), used data collected from ADVANCE participants on their clinical assessment days and from one to one interviews conducted specifically for the ADVANCE-INVEST study to learn more about transition experiences.
The sample for ADVANCE-INVEST comprised 435 former regular Service personnel, of which 292 had left with a medical discharge. All Service branches were represented, but there were no women in the sample as women were not eligible for front-line combat roles until after main hostilities had ended in Afghanistan, and hence there were too few with serious combat injuries for inclusion.
Key Findings
An abrupt end to service
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. The difficulties that some participants felt in relation to the rapid ending of their military career were 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.
Re-employment support was not always appropriate
Those with medical discharges had lower rates of post-service employment compared to those who left via other methods of discharge. Participants 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.
Compensation could be invaluable but carried risks
Compensation for injuries was welcomed and could be seen to have many benefits; immediate material benefit, acknowledgement of their injury, acting as a buffer while seeking re-employment in the civilian job market, and supported a healthy work-life balance in the context of ongoing pain and medical issues. However, 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.
Transfer of medical records was still a barrier
Transfer of medical records to civilian services 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 re-tell their medical histories many times.
Reccomendations
Based on these findings, ten recommendations were proposed, designed to help provide solutions to the challenges faced, stating who the recommendation should be actioned by.
Conclusion
The report identified a number of ways in which medical discharge could be improved to better serve the needs of those leaving the Armed Forces with combat injuries. While some of these topics are already being addressed, e.g. by new policies, charitable provision, and so forth, it is important that continued surveillance be undertaken to determine whether these recommendations are actioned and the issues identified mitigated in the future.
The full report is available here [1]. If you have any questions about the report, you can get in touch using the study email address: [email protected].
Many thanks Anna Verey and Dr Howard Burdett for writing this Research Spotlight.
(1) A self-report scale to identify psychosocial factors predictive of post-separation psychological adjustment and mental health
(2) The Career Transition Partnership, the public/private entity delivering resettlement provision for Service leavers
Funding
The ADVANCE study is funded through the ADVANCE Charity. Key contributors to this charity are the Headley Court Charity (principal funder); HM Treasury (LIBOR grant); Help for Heroes; Nuffield Trust for the Forces of the Crown; Forces in Mind Trust (thanks to an endowment awarded to the Trust by The National Lottery Community Fund in 2011); Blesma, The Limbless Veterans; and the UK Ministry of Defence.
The ADVANCE-INVEST study is funded by Forces in Mind Trust and supported in part by the ADVANCE Charity.
References
[1] Verey, A., Burdett, H., Palmer, L., Bennett, A., Cullinan, P., Boos, C., Bull, A., & Fear, N. T. (2025). Medical Discharge from the UK Armed Forces and the role of combat injury: a short report from the ADVANCE-INVEST study. Link
