Defence Medical Services: Latest review finds 'significant improvements'

A Care Quality Commission review of the Defence Medical Services (DMS) has found high standards of medical care for frontline service personnel, with some concerns about aspects of non-frontline care.

 Although their directly-managed services are not subject to the same enforcement powers as NHS and independent care services, the DMS had requested that the Care Quality Commission (CQC) base this review on the regulatory model for inspection used for assessing health and adult social care provision in England.

This review looked at the recommendations that the previous Healthcare Commission made when it reviewed the DMS in 2008.

The CQC inspected land bases in the UK, Germany, Cyprus and Afghanistan, as well as Type 45 destroyers HMS Daring and HMS Dragon and Trident submarine HMS Victorioust. While there was high praise for trauma care and general health care, the inspectors had concerns about some aspects of non-frontline care.

They spoke to 200 patients, analysed 550 responses from our patient survey and interviewed over 500 military and civilian clinical staff across the DMS.

The inspectors focused on:

  • the care and treatment people receive.
  • how patients are involved in their care.
  • infection control.
  • nutritional needs.
  • how services keep people safe.
  • how the staff are supported, trained and supervised.

Key findings

The Commission found areas of good practice across all of the services that it inspected.

"Significant improvements" had been made across the DMS since the Healthcare Commission’s review in 2008, particularly to governance and assurance systems.

Areas of good practice

The review also identified good practice in:

  • care provided to casualties.
  • training of staff.
  • design of field hospitals.
  • rehabilitation for injured personnel.

Deficiencies found by the review

However, it found the following issues in the primary health care services it provided.

  • The buildings where primary medical services are delivered remain a major problem.
  • Concerns over safeguarding arrangements are still apparent.
  • Documentation and information systems are in need of improvement.

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