Guidance

VAPC east Midlands: meeting minutes 19 October 2020

Updated 12 March 2024

Location

Zoom meeting hosted by Chairman.

Present

• Barry Smith (Chairman)
• Dick Hurwood (Vice Chair)
• Michael Whitehead
• Stavros Melides
• Larry Henson
• Tom Smith
• Andy Holt
• Helen Drew-Bradley
• David Wilson
• Jim Wright.

Apologies

• John Berry
• Gillian Ekins
• George Ellison
• David Taylor
• Sam Wileman.

Co-opted member

• Bill Dixon-Dodds

Welcome

The Chairman welcomed members to the meeting which again was taking place on Zoom. With the current impact of the pandemic on face to face meetings, the Chairman highlighted that this platform was likely to be utilised at least until Spring 2021.

The Chairman highlighted that the recruitment round for new committee members had now closed and that it was expected that the sift and interview process for the applicants would begin in the next 2 months.

The Chairman highlighted that there was considerable debate within the Chair of Chairs Forum on the future direction of travel for the VAPC construct. A seminal meeting with the Minister in November should provide us with his intent w/r to the governance of VAPC’s and our relationship with the different MoD/Cabinet Office organisations in the Veteran space.

Declarations of interest

There were no declarations of interest that would affect the work of the Committee.

Apologies for absence

The Chairman accepted apologies from those who were unable to attend the meeting. He emphasised that individuals’ attendance at committee meetings was a performance indicator that he was charged with monitoring by Veterans UK.

VWS update

General update

• VWS still take referrals and assist clients fully - i.e. by phone, email and letter
• The Death in Service and Mesothelioma protocols remain in place and we assist clients via phone call and email and where required, on an exceptional basis, Face to Face
• we continue to support the most vulnerable i.e. terminally ill/end of life cases and do offer home visits but by exception and under COVID safe and senior management approval
• Norcross and Glasgow operational staff have returned to the office, as claims could not be considered away from the site due to the fact all case documents are within a paper file
• Norcross, operational areas are working at full capacity within the safety guidance for the buildings. The staffs are now clearing more claims than they are receiving in both schemes, War Pension and AFCS, so the backlog is reducing
• Helpline is open with limited hours 10:00 - 16:00. Clients are still encouraged to email rather than telephone.
• the tribunals in England and Wales (and the Northern Irish jurisdiction) are up and running. Initially, they focused on clearing those appeals that were listed and then had to be cancelled due to the Mar 20 shutdown. England & Wales Courts have been held using BT Meet Me while Northern Ireland have used a video conferencing application from the start (England and Wales hope to move to this format in November). The Courts in Scotland have also come back online
• all participants are joining the hearings from home. From our Departmental Representatives (DRs) perspective, because of the need to incorporate social distancing measures within Norcross, we only have two rooms on site dedicated to conducting hearings by remote means. The other two DRs are working from home. This is not ideal as we would prefer all the DRs to have the awards files with them during a hearing. However, this issue is close to resolution as we hope to agree a process where the DRs can take award files away from the office and store them at home for short periods
• the tribunals are not yet back up to pre-March 20 levels of capacity. Northern Ireland is hearing roughly the same number and Scotland is listing more than pre-COVID. England & Wales (the largest jurisdiction) is running three courts, five days a week. Each day lists 3 cases on average per court (around 45 a week). We still have a small additional amount of DR capacity that will allow a further expansion of cases listed.
• in Scotland, they have been hearing an additional number of cases with just one tribunal member only (i.e. with no involvement from DR or appellant). England & Wales have also suggested hearing some cases in this fashion. This is only done with the agreement of all parties but will reduce the backlog further without placing an additional burden on our resources
• NHS priorities have changed because of the impact of the pandemic. Therefore, we have had to think about how best we can still obtain all the relevant medical information with the least added pressure on the NHS as they provide most of the medical evidence we use to make decisions under the Scheme. We have also had to factor in the suspension of face to face compensation scheme medical board examinations. On 24 Jul 20 Vets UK launched a new Medical Gathering Evidence Pilot.

What are the changes we are making?

No longer issuing requests for medical board examinations or Hospital Case notes. Instead, we issue a Primary Care Factual report and supplementary self-assessment questionnaire directly to the claimant.
A covering letter, the WPS1683 (claims) or WPS1683R (reviews), explains our expectations, while providing claimants with instructions to follow in accessing their primary health care provider and completing the relevant forms before returning them to us.

Self-Assessment Questionnaire - new form WPS1684

The Self-Assessment Questionnaire should be completed by the claimant. The questionnaire is pre-populated and once completed will provide the Medical Assessor with information that will inform their view on entitlement and level of compensation under the scheme.

The Primary Care Factual report AFCSWPS0306

The Primary Care Factual Report has been slightly redesigned for completion by either the GP or Surgery Practice Manager. They should be able to complete the relevant sections using treatment notes held on their records. The GP may ask the claimant to attend the surgery prior to completion of the form. This appointment should be arranged by the claimant at a suitable time for themselves and their GP. The claimant is to return this form to us along with the self-assessment form and any other documents related to their condition(s).

Other Items of Interest:

Recruitment

We are in the process of recruiting a new Welfare Manager to be based at Kidderminster ARC, covering the Birmingham area and a Welfare Advisor to be based in the Kidderminster ARC. The Transition Service is also recruiting a Caseworker for the Midlands and Wales.

Veterans Guaranteed Interview Scheme

The GIS is an opt-in programme for selected Civil Service (CS) jobs: Veterans will have the opportunity to opt-in to be considered as part of the scheme (as with the current Disability Confident scheme). Applicants will be guaranteed being moved to the next stage of recruitment if they meet the minimum criteria. If there are several layers in the recruitment process, e.g. application, online aptitude test, presentation and then interview, the guarantee is to move to the next stage, which might not be the interview. Entitled veterans must have served at least a year in the Regulars or Reserves. The pilot will evaluate if the scheme is compatible with the core CS recruitment principles and that veterans are not being given unfair advantage over other groups, particularly those with protected status.

Early adopter Government departments are MoJ, Cabinet Office, MOD and the Home Office. NI-based roles for UK Government posts will be included in the Great Place to Work initiative. The Welsh Government is considering adopting this scheme too. The Scottish government is looking at (a version of) this pilot but it’s likely to be organised differently and with different branding. Numerical targets will not be set against this scheme: take up will be reviewed every few months in respect of the pilot departments.

Mesothelioma Cases

Numbers of Mesothelioma cases in our area appear to be increasing with an apparent doubling post-lockdown compared to previous years (7 vice 3 in a normal period). It is thought that this is the result of greater scrutiny of lung conditions caused by the impact of the COVID-19 virus on patients. The referral process within the NHS for veterans with this condition appears to be working well and all of the recent claimants accepted the MoD offer and were compensated in line with the relevant protocols.

The procedural change where the VWS is now an Information Organisation Partner rather than a referral partner on the Veterans Gateway appears to be working well. This change allows VWS staff access to VG databases to take direct referrals.
More feedback was requested on the numbers of clients serviced via this procedural change.

EMVAPC retains the role of providing an overview of VWS activities in the EM region and a request to attend and present at the next meeting on 18 Jan 2021 would be made.

Confirmation of minutes of meeting held on 15 June 2020 and actions arising

The draft minutes were confirmed with a minor amendment to the attendance list and the inclusion of advice for veterans on their engagement with 3rd sector organisations.

NHS Best Practice Initiatives: Engagement with the new AF Health Transformation Division within NHS England is underway on the large number of initiatives being rolled out by the new organisation. These include a pilot in Lincolnshire to address veteran interaction with the criminal justice system and efforts within Leicestershire to address suicide amongst the veteran cohort. It was recognised that our ability to drive these initiatives forward with the NHS in our area had been impacted by the pandemic and updates will now form part of the Medical SC report.

Sub-group workstreams: an update on the findings from the various workstreams was provided later in the meeting.

Outbrief from Chair of Chairs discussions

Chairs Teams meeting - 9 September 2020

Early work on the proposed overarching Strategic Plan for the National VAPC construct has highlighted that the current ways of working as a “team” of national chairs is not working effectively. The loosely coupled arrangements (primarily focused on the bi-annual meeting with Vets UK and the Minister) on a non-hierarchical basis no longer meets the requirements of either the OVA or Vets UK. They prefer working through a Chair of Chairs as if the network of 13 x VAPCs were a hierarchical system; this in itself causes tensions and communication issues and runs the danger of ceding power and independence away from the existing regional chairs. Hence, there is a renewed focus on enhancing collaboration and cooperation between individual committees.

The intent is to develop a framework within which to deliver our agreed national objectives which will allow us to contribute to the national level debate with our major partners - OVA, Vets UK and the NHS. The aim is to have a lead chair for key areas of policy reporting via agreed objectives on a quarterly basis to the Chairs. Leads have already been established in terms of engagement with the Local Government Association & Defence Statistics (Yorkshire & Humberside) and others such as Justice, Housing, Education, Welfare etc are to be considered. The aim is to present central, common opinions at a strategic level while continuing to deliver output at a regional level with the talent and expertise available to each chair from within their committee.

A major discussion point was the output from the Veteran Community of Practice call hosted by the OVA on 8 September 20.

• £6-million of outcome based funding grants has been awarded to 103 military charities to be spent by end October
• an audit of the strengths/gaps in delivery of veteran support by the various government departments is to be undertaken by the OVA
• desire in government for a new charity sector partnership with the sector supporting the government’s long term aims w/r to veterans
• a Veterans Strategy Delivery Group meeting chaired by the Cabinet Office Minister will take place in October 20
• a new non-executive forum of 12 people has been established - the Veterans Advisory Board. The intent is that they will provide a diverse view of the veteran landscape and as critical friends, challenge government policy in this area. They will report direct to Minister.

This last announcement caused considerable angst as these individuals had not been appointed using the transparent public appointments process used by VAPCs and were seen as potentially challenging the VAPC construct. Clarification would be sought from the Minister on this point in our meeting with him in November.

The LGA policy unit engagement lead highlighted that the statutory consultation was underway, although the MoD guidance document had not yet been received. The focus appears to be on the resource impact for Local Authorities of implementing the duty of “due regard” on welfare, housing and education by having the AFC written into statute.

A brief on the AF Patient Public Voice (PPV) Group highlighted the continuing tension in the NHS between the commitment to the AF Covenant and the driver of clinical need in terms of resource allocation. The aim is to achieve an improvement in the services provided to all in the community, including veterans. A “lived experience” group now has 20 members to help the NHS with understanding the needs and the context of those needs from the AF community. VAPC help was required to identify suitable candidates for these PPVs and provide the necessary insight on how to develop the greater understanding of veteran needs. The regional nature of the VAPCs was also seen as vital to inform the balance of resources required in each of the regions.

A major consultation is about to start on continuity of care/family support within the community where input on the special needs of the AF community will be essential.

Individual member reports: updates future plans

Communications

MW re-emphasised the benefits of the Communications pilot which was up and running and how it would assist committee work. He explained to members how to get onto to the Veterans & Families Research hub where the pilot is hosted.

Health

Dick Hurwood as Sub Committee (SC) head reported:

The rollout of Veterans’ accredited GP practices was continuing but the impact of Covid-19 on primary care as it re-configured for the pandemic meant that the programme had slowed considerably. Given that currently only 10% of practices had achieved accreditation, there was a question mark over whether the programme was achievable. A question had also been raised about a recent government statement that special equipment was being provided to GP surgeries as part of this roll out.

Discussions were taking place within the national VAPC Health forum on our roles regarding veterans’ mental health issues. The following were being considered:

• advising on mental health service provision for veterans (ideally we would talk with users and providers of services to serving personnel as well as the NHS)
• raising awareness of services provided (for example, Veterans Gateway, GP practices, Samaritans).
• monitoring the effectiveness of services (are they easily contactable; is there similar provision across the UK, and if not how to influence this; waiting lists; numbers treated; and outcomes).

All the roles are administrative except provision and outcomes, where clinical input and a holistic approach are needed.

Discussions have also taken place with the operational lead for the new High Intensity Service that is being piloted in the Midlands.

The three types of service now on offer in the mental health arena on our area are:

• Transition, Intervention and Liaison Service (TILS) which can be accessed by individuals or via NHS primary care. It is a psychological treatment capability, the equivalent of IAPT (Improving Access to Psychological Therapies) for civilians
• High Intensity Service (HIS) is being piloted in four of the seven areas in England: the North East, North West, Midlands and London. It is a “crisis” service for those seeking immediate support.
• Complex Treatment Service is a secondary service, with referral through TILS/HIS. St Andrews covers the Midlands and East of England.

Liaison with the NHS is vital as these roles are developed; in the East Midlands our POC is Ellen Martin.

It is still apparent that despite the centralization of AF management within NHS (E) there are still aspects of its control where localism drives behaviors and hence, outcomes. We need pilots underway to be able to demonstrate, at both regional and national level, their benefits in terms of improved outcomes for members of the AF community. This will give us concrete examples of good practice to discuss with senior NHS leadership teams with whom we wish to engage.

The Veterans Hearing Clinic initiative with UHL was stalled waiting for the Business Case to be developed. This highlighted a concern we have that the NHS had a lack of agility, mainly within the management structure, to bring pilots on stream quickly to meet the demands of the veteran community.

Policy and Governance

The Chair as Policy & Governance SC head identified that the impact of Covid-19 on routine meetings meant that there was a continuing reduction in AFC Partnership Board activity across the region. Efforts continue to try and ensure that the secretaries of the Boards received the latest updates in terms of the various Centre initiatives and relevant research reports on the veteran community to share with stakeholders. Only 1 physical meeting had taken place in the last quarter (in Northamptonshire) and had been poorly attended, despite the new Lord Lieutenant for the County being in attendance. Two successful virtual meetings had occurred in the Leicester, Leicestershire and Rutland region.

Welfare

DT re-iterated in his written report that in any engagement with 3rd sector organisations we need to adopt the mantra of “Identify, Assess, Report” so that we can help partners build up a database of their capabilities, addressing both breadth and depth, in order to assess their resilience and effectiveness in supporting the veteran cohort they were targeting.

ELC review

An independent review of the Enhanced Learning Credit scheme was undertaken by a dedicated sub-committee. It was initiated as a result of the relatively poor take-up of the scheme in our area. Their analysis is that the scheme is no longer fit for purpose in the modern workplace and needs to embrace the new holistic view of transition articulated in JSP 100. As a result of the review, the Head of the Defence Transition Service (DTS) has provided us an introduction to the MoD policy team within the Chief of Defence People area - (Training, Education, Skills, Recruitment & Resettlement (TESSR). It was highlighted that work had commenced earlier in 2020 on a review of all the learning credit funding streams but this work has stalled pending the appointment of a new policy lead in TESRR. The team will engage once the Education Policy position is filled within TESRR. Harriet Garvey TESRR is our point of contact for this engagement activity.

Transition

Within Lincolnshire, a pilot project has been established to address the mentoring needs of Service Leavers (SLs) who wish to pursue a self-employment route in their post-military career. Working with the Institute of Directors Defence Ambassador, alongside the Regional Employment Engagement Director, DTS and the Federation of Small Business’s Defence Lead the pilot, supported by a coalition of the willing, intends to provide mentoring support to Veterans/SL’s, possibly over a period of several years. A series of meetings are planned to establish the coalition and it is hoped that workshop activity will be able to occur at one of the Main Operating Bases in Lincolnshire.

Covenant in the Community Conference

A number of members attended the virtual Covenant in the Community Conference on 14 Oct 20. A summary of the Conference activities is at Attachment 1.

Veteran interaction with CJS in Derbyshire

Members are attempting to improve the interaction between Veterans and the Criminal Justice System in Derbyshire. Within the East Midlands, the County is unique in not having a Project Nova team in place to support the police and other statutory authorities in addressing the specific needs of the Veteran community in this domain. Engagement has all been virtual to date but has included the Derbyshire police, the Covenant policy lead within the County Council as well as the regional SSAFA lead on this issue. The team awaits the outcome of the Covenant grant funded study into the needs of the Veteran community in Derbyshire before further engagement activity occurs.

Recruitment update

A total of 8 candidates had been identified for committee member posts in the East Midlands. An Independent Panel member had been approached and accepted the invitation to participate. An MOD member from the VWS had also been appointed. Interviews were planned to take place in early December.

Engagement with ASDIC

The Chair had engaged with the National Director of the Association of Service Drop In Centres. With the current restrictions on face to face interactions, most of these facilities were closed. However, once the new normal of social interaction is established, our intent will be to engage with the various regional coordinators to gauge attendance at these centres and identify opportunities for engagement by members with the veteran community.

Any other business

Remembrance Sunday

The Chairman highlighted that the formal elements of Remembrance Sunday were to be cancelled and even informal events at a community level were identified as unsuitable because of the social distancing measures that were in place.

Consultation Activity

Outwith of normal committee business, a short notice request was received to provide commentary on the New Redundancy Scheme for AF personnel to align with the terms of the new Armed Forces Pension Scheme (AFPS15). It was seen by the committee as a step in the right direction to ensure that Veterans are treated fairly, particularly for those whose service is terminated before the end of their commitment period. However, we were concerned that a reduction in the factor for final relevant earnings for the calculation of the award compared with previous schemes was a savings measure imposed by the MoD. We are concerned that there is a risk that those personnel who have been placed on AFPS15 are being short changed compared to those on previous schemes. Members of the AF placed in this position have not seen any reduction in their efforts to provide a vital service to the nation and the unique nature of that service has not changed.

Date of next meeting

The next meeting is planned to take place at 10.30 am on 18 Jan 2021 at PWOG Grantham. However, if the constraints imposed by COVID-19 were still extant, the aim would be to hold the meeting on Zoom hosted by the Chairman.

Signed on email by Barry Smith CBE BA - Chair EMVAPC