The Naval Service recovery PaThway - NFF · Naval Service recovery Pathway (NSrP) This leaflet, principally aimed at the individual, outlines the Naval Service’s policy for the

The Naval Service recovery PaThway

The Recovery Pathway > Point of Injury / Illness > Medical Treatment > Recovery Plan > Medical Grading > Recovery Activities > Medical Board > Return to Duty > Discharge on Medical Grounds

references

BR3 Chp 33 – Recovery PathwayBR3 Annex 24B – Carers’ ForumBR3 Ch 57 – WarningsBR 1919 Chp 8 – Naval Service Medical Board of Survey (NSMBOS)534 Section 6 – Resettlement Provision on Medical DischargeRNTM 011/16 – IRPRNTM 212/16 – IRP JPA CompetenceRNTM 166/16 – Case Conference ProcedureRNTM 244/16 – WIS definition post JMES harmonisationCasualty & Recovery Management Intranet Site via ‘the Helm’: Personal Family & Community Support > Naval Service Casualty & Recovery Management

Naval Service recovery Pathway (NSrP)

This leaflet, principally aimed at the individual, outlines the Naval Service’s policy for the management of personnel Wounded, Injured or Sick (WIS) i.e. those awarded a JMES code of M-5 or M-6. It explains the key roles and responsibilities of all those involved in the recovery process to ensure that the activities, events and support that contribute to an individual’s recovery are optimised; this process is known as the NSRP. This leaflet should be read in conjunction with the full NSRP Policy in BR3 Chp 33.

what is it?

The NSRP is the generic term used to describe the process by which the Naval Service manages the recovery of WIS personnel.

who is covered?

This policy is applicable to all NS, FTRS (FC) and mobilised reserves who are awarded a JMES code of M-5 or M-6.

who is involved?

The individual – It is your recovery and it is your duty to fully engage with all aspects of your recovery to ensure the best possible outcome is achieved.

The Do/Tp comd – Your DO/Tp Comd has a responsibility to assist you with your recovery through regular contact and helping you develop your Individual Recovery Plan.

Medical officer (Mo) – The MO directs all medical and rehabilitation activities related to your clinical recovery and will contact you regularly to check your progress.

The chaplain – The Chaplain is always available to discuss any issue that you may have with your downgrade or recovery and sits outside your Chain of Command.

royal Navy royal Marines welfare (rNrMw) – Recovery for some can be straightforward, for others a complicated and prolonged experience where the pressures on your family can be intense, in these circumstances RNRMW are available to assist. If you need specialist welfare support, call the RNRMW Portal on 02392 728777/9380 28777. Remember, RNRMW will not engage unless you want them to.

Further questions?

If you have any questions about this policy and how it affects you, talk to your MO, DO/Tp Comd, the NCHQ CRM team 02392 628684/628952 or check out the Casualty and Recovery Management intranet site via the ‘Helm’ here: Personal Family & Community Support > Naval Service Casualty & Recovery Management.


Naval Service recovery Pathway (NSrP)

DO/Tp Comd:

MO:

Chaplain:

Allocated RNRMW Worker:

UPO:



overview of the Naval Service recovery Pathway

Individual reports to DO, Tp Comd or LM with ‘downgrade chit’ Individual Recovery Plan (IRP) (HARDFACTS)* initiated in consultation with individual

Individual remains in Unit(most shore establishments and some front line units)

Individual assigned to Personnel Support Group/Recovery Cell (Ships/Submarine), Recovery Troop or NSRC Hasler

Individual care pathway reviewed regularly by DO / Tp Comd / LM and recovery assessed; IRP updated as required

Recovery progressing Recovery not progressing / case becomes complex

Continue in Unit and reassessed in set timeframe

Case discussed at Carer’s Forum or equivalent

Continue in Unit with additional support and reassessed in set timeframe

NSCC Case Conference Initiated

JMES reassessed and individual upgraded or attends NSMBOS and NSMEB. Placed in highest suitable permanent medical category or

transitions to civilian life

Remain in Unit with additional support or

assigned to PSG/NSRC Hasler

IRP CLOSED

* The IRP, ‘owned’ by the individual, is to be updated regularly and overseen by the DO, Tp Comd or LM. It is to cover HARDFACTS considers Health, Accommodation and Relocation, Drugs and Alcohol, Finance and Benefits, Attitude, Thinking and Behaviour, Children and Family, Training, Education and Employment, Supporting Agencies.

Individual receives M5 or M6 JMES code downgradeEntry into Naval Service Recovery Pathway


Be it a physical or mental injury or other diagnosis, the moment a Naval Service person becomes wounded, injured or sick (WIS) i.e. is awarded a JMES code of M-5 or M-6, the individual enters the Naval Service Recovery Pathway (NSRP).

The NSRP is to deliver a conducive military environment within which all serving WIS personnel get the appropriate support to enable an effective return to duty or transition to a properly supported and appropriately skilled civilian life; the NSRP is the generic term used to describe the process by which the NS manages the recovery of WIS personnel.

What do I need to do?

Individual: You will receive a medical downgrade certificate from your MO which you should present to your DO/Tp Comd at the earliest opportunity. Your MO will have discussed your clinical pathway; your DO/Tp Comd will now discuss how best this can be achieved by use of the Individual Recovery Plan (IRP) which will cover HARDFACTS (Health, Accommodation and Relocation, Drugs and Alcohol, Finance and Benefits, Attitude, Thinking and Behaviour, Children and Family, Training, Education and Employment, Supporting Agencies). From the point of injury or illness your focus should be your recovery; working with your DO/Tp Comd to produce an IRP is the best way to achieve this.

If you are re-assigned from your unit on receiving a medical downgrade e.g. to a Personnel Support Group (PSG) or Recovery Troop, you should ensure that your new DO/Tp Comd is fully aware of the situation, any limitations you have and that an IRP is drafted if not already held.

If you are away from your unit at point of injury/illness, you must notify them as soon as possible and arrange to see your MO and DO/Tp Comd when back in unit.

DO/Tp Comd: An IRP is required for all NS WIS personnel and, once completed, an IRP JPA competence is to be raised for the WIS individual. The management of an individual through recovery is a unit executive function and a key principle of the Divisional/Regimental system; should recovery not progress, the case should be raised at the unit Carers’ Forum with a view to calling a Naval Service Casualty Cell (NSCC) Case Conference if further assistance is required.

Point of injury / illness

The Defence Medical Service (DMS) is responsible for providing and assuring the quality of healthcare delivered to Service Personnel; rehabilitation is delivered through a comprehensive system at both Defence and NHS centres.


Individual: Your focus remains on your rehabilitation in support of your recovery pathway.

DO/Tp Comd: When an individual is medically downgraded and WIS, their clinical treatment and recovery pathway activities are to take primacy over all other duty activities. The aim is to get the individual fit and returned to duty or to support their transition to civilian life.

Medical Treatment


WIS personnel who remain broadly employable and with less demanding recovery needs are to remain in their Parent Unit and be managed through the Divisional/Regimental system; if recovery is not progressing the case should be referred to the Unit Carers’ Forum. Should the unit be unable to support the individual and provide an appropriate recovery pathway, a Naval Service Casualty Cell (NSCC) Case Conference is to be called which may recommend/signpost additional support at unit level or re-assignment to a specialist Recovery Unit depending on the individual’s personal circumstances. Those WIS personnel with the most complex or significant recovery needs may be assigned to the Naval Service Recovery Centre (NSRC) Hasler, in HMS DRAKE.

In order to maximise rehabilitation and recovery opportunities available, every NS WIS person should develop a diary of activities with their DO/Tp Comd in support of their own bespoke IRP. The level of detail in the plan should relate to the expected length and complexity of their recovery pathway.


Individual: You need to take ownership of your IRP; set and record clear goals and think about how you might achieve them. The MO will have discussed your clinical pathway and any rehabilitation activity that is required; this needs to be woven into your employment and recovery/transition plan. The plan may include courses and activities that will enhance your recovery or aid your transition but these are always secondary to your clinical treatment and rehabilitation. This is your chance to influence your recovery and get the most from the support available to you; you should take time to reflect on the success of the differing stages of your recovery and record this in your IRP. Remember, you must discuss your IRP regularly, and at least monthly, with your DO/Tp Comd and get medical and executive approval before commencing any support activities.

DO/Tp Comd: You are to work with the individual to develop their IRP in order to enhance and focus their recovery. Recovery goals should be agreed and recorded on the IRP and WIS individuals should be encouraged to reflect on these when the IRP is reviewed.

Whilst downgraded, WIS individuals may be employed in accordance with JMES restrictions and caveats, however, whilst on the ‘recovery pathway, rehabilitation and recovery should take precedence over all other activities/duties. If recovery isn’t progressing as expected, you should consider raising the case for discussion at the unit Carers’ Forum and/or requesting a NSCC Case Conference. At all times, discuss progress/options with the WIS individual. If the individual is sick-on-shore you are to establish contact within 10 days and maintain contact throughout the period of absence to ensure the WIS individual is supported throughout all stages of recovery; a home visit should be conducted by day 21 of the period of absence and at least monthly thereafter.Consider contacting Royal Navy Royal Marines Welfare (RNRMW) if specialist welfare support is required. You should review the IRP at least monthly.

recovery Plan



Personal recovery Goals

1.

2.

3.

Date course

Battle Back MAC (mandatory after 6 month in NSRP)

Training courses

Discussion/reflection/Key Upcoming events

Date Notes

“I have reviewed my recovery plan and am content that it reflects my recovery goals and that the plan is achievable.”

“I have reviewed this plan and am content it is achievable and will result in the best outcome possible.”

WIS Signature:

Date:

WIS Signature:

Date:

individual recovery Plan contract

Name rank / rate Service Number Service

RN/RM/RAF/ARMY

Parent Unit Date assigned Joined From JMeS code

irP version / Date Do / Tp comd


All NS personnel will have a Joint Medical Employment Standard (JMES) grading; WIS NS personnel are those that receive a grading of M-5 or M-6. There may be caveats associated with the medical downgrade and these should be discussed with the MO as they detail what employment/activities a WIS individual can undertake.


Individual: Understand what you can/can’t do and engage with your DO/Tp Comd to develop a meaningful IRP. If you are not progressing along your ‘pathway’ you should speak with your DO/Tp Comd with a view to raising your case at the Unit Carers’ Forum. Your award of a M-5 JMES code does not, in most instances, mean that you cannot be employed and you should look to work and engage with recovery activity alongside any rehabilitation the MO has directed

DO/Tp Comd: The MO will award an individual with a JMES code and employment caveats. Ensure that you understand these fully and discuss with the MO if you are in anyway unsure. Work, in most cases, can be undertaken but within the bounds of the medical caveats set.

Medical Grading

recovery activities

Recovery is different for all. It can be a lengthy process with intense periods of treatment interspersed with periods of inactivity or very straightforward and uncomplicated where the WIS individual can be productively employed, between medical interventions, in unit. Either way, appropriate support to enable an effective return to full duties or transition to a properly supported and appropriately skilled civilian life is to be provided and there are numerous approved recovery activities that can be utilised to contribute to these goals.

This could be personal or professional development training or other Defence Recovery Capability recovery courses, some of which are residential. The Battle Back Multi-Activity Course (MAC) at the National Sports Centre, Lilleshall, seeks to increase self-confidence, improve motivation and ability to deal with stress together with developing a positive mental attitude. Attendance on MAC is encouraged early in the recovery pathway; it is mandatory after 6 months.


Individual: Each individual’s recovery pathway is different and, depending on the complexity and length of your downgrade and the JMES code and caveats that you have been awarded by the MO, the employment, training or activities you can undertake will be specific to you. In most cases, continuing to work between clinical interventions may be the most appropriate and conducive military recovery environment for you although there may be further activities you can undertake which will support your rehabilitation and boost your confidence and self-esteem as your recovery progresses. If you have been told that you will attend the Naval Service Medical Board of Survey (NSMBOS) you can start your resettlement activities early and before you attend the Board. Remember, this is your IRP; you need to establish and record clear goals and discuss how you will achieve them with your DO/Tp Comd. In addition, the IRP should be used to reflect on the success of the differing stages of your recovery. Remember though, before embarking on any recovery or resettlement activity, you must undertake a medical risk assessment and have approval from your DO/Tp Comd to attend.

DO/Tp Comd: There are many courses and opportunities available to assist WIS personnel through their recovery although, for many, continuing to work between clinical interventions may be the most appropriate and conducive recovery environment. The IRP should be developed with a return to duty/transition to civilian life in mind and tailored appropriately. All recovery or resettlement activity is to be approved by the CoC, after medical risk assessment, and is to be recorded on the IRP.



The MO will decide if an individual should be presented the NSMBOS, held at the Institute of Naval Medicine in Alverstoke, and raise the appropriate paperwork. A date will be set and the individual will have the opportunity to attend in person. If the NSMBOS recommend invaliding out of the Service or retention in a permanently reduced medical category, the case will be forwarded to the Naval Service Medical Employability Board (NSMEB) who will make the final recommendation.


Individual: Your focus remains your rehabilitation and recovery but you also need to think about life after service. Your MO/Sickbay will be able to brief you on the NSMBOS process and your role in it; you will be asked to write a personal statement (FMed 24). As soon as you are told that you will be presented to the NSMBOS, you are entitled to commence resettlement activity. Arrange, via your DO/Tp Comd, to visit your Naval Resettlement Information Office (NRIO) for an initial interview and ask to be registered with the Career Transition Partnership (CTP).

DO/Tp Comd: If a member of your Division/Troop is attending NSMBOS (BR 1991 Chp 8), ensure that they have been briefed by Sickbay and that they fully understand the process. Once an individual has been told that they are likely to be medically discharged, you need to raise a Transition Assessment Form (TAF) (JSP 534 Section 6) and direct them to the NRIO. If the individual has barriers to employment and requires additional resettlement support, a Specialist Employment Consultant (SEC) may be appropriate; discuss this with NRIO. Many charities offer resettlement support, however, before agreeing an individual can engage in any activity/course, consult the NRIO. If the individual is retained in Service, the resettlement ‘clock’ is reset.

Medical and employability Boards


return to Duty

Wherever possible, the Naval Service’s intent will be for a Service Person to return to duty.


Individual: There is no set route back to full duties but your MO and DO/Tp Comd will be able to advise. A Graduated Return to Work (GRoW) programme may be appropriate but must be authorised by your CoC prior to commencement.

DO/Tp Comd: Each individual’s recovery and return to duty is different. You will need to work to the bounds of the GRoW programme, if applicable, in consultation with the MO to bring the individual back to work. In the event that the individual should fail to meet the requirements of the GRoW, they should be referred back to the MO. The IRP should be updated throughout as a record of decisions/actions. When the individual is ‘upgraded’, the IRP can be closed and forwarded to CRM in NCHQ.

Discharge on Medical Grounds

While some individuals will be able to return to duty, this is not always possible or necessarily the best option for them. Individuals who are going to be medically discharged will need to change aspects of their recovery plan to focus on what they need for their transition to civilian life and future career.


Individual: All NS personnel leaving the Service will go through a resettlement package which can include employment courses, work placements, training and education; the earlier you engage with your resettlement the better. If you are being medically discharged with an injury or illness that means you have significant barriers to employment, you may be entitled to access a Specialist Employment Consultant (SEC) through CTP (Assist).

Many charities offer resettlement support programmes and mentoring schemes; a quick internet search can pay dividends. Before applying to attend any resettlement course always check with your DO/Tp Comd or NRIO.

DO/Tp Comd: Individuals discharged from the Service on medical grounds may be ill prepared for life ‘outside’ and will require additional support as they make the transition to civilian life; some charities offer a mentoring scheme which can assist transition. When an individual is informed by the NS Medical Employability Board (NSMEB), the IRP can be closed and forwarded to CRM in NCHQ.



recovery Points of contact

casualty and recovery Management (crM) Nchq

CRM WO1 RN Mil: 93832 8864/Civ: 02392 628864CRM WO1 RM Mil: 93832 8952/Civ: 02392 628952

Email: [email protected]

Naval Service recovery ceNTre (NSrc) haSler

Mil: 9375 65366/67991Civ: 01752 555366/557991

PorTSMoUTh PerSoNNel SUPPorT GroUP Mil: 9380 27338/27213Civ: 02392 727338/727213

DevoNPorT PerSoNNel SUPPorT GroUP

Mil: 9375 65324/65357Civ: 01752 555324/555357

FaSlaNe recovery cell

Mil: 93255 3282/7529Civ: 01436 674321 3282/7529

rNaS yeovilToN career MaNaGeMeNT cell

Mil: 93510 5393/4018Civ: 01935 455393/4554018

rNaS cUlDroSe career MaNaGeMeNT cell

Mil: 93781 2357/2304Civ: 01326 552357/552304

Termoli Troop (40 cdo)

Mil: 93780 4518/4461Civ: 01823 362461

Kangaw Troop (42 cdo)

Mil: 93788 7299Civ: 01752 727299

harden Troop (45 cdo)

Mil: 93387 2231Civ: 01241 822231/822237


Third Sector Support

Many 3rd Sector organisations offer support for serving WIS with the Royal Navy and Royal Marines Charity, Help for Heroes and The Royal British Legion being the key strategic partners.

There are over 2000 charities supporting WIS personnel and Service Leavers, a useful list can be found here: http://armedforcescharities.org.uk/

Some of the main charities are listed below, but it is not exhaustive and new charities are forming all the time; a simple internet search may find an appropriate source for assistance.

RNRM Charity - https://www.rnrmc.org.uk/

Naval Families Federation - http://www.nff.org.uk/

Royal Navy & Royal Marines Children’s Fund - http://rnrmchildrensfund.org.uk/

Royal Naval Association - http://www.royal-naval-association.co.uk/

Royal Marines Association - https://royalmarinesassociation.org.uk/

Help for Heroes - http://www.helpforheroes.org.uk/

The Royal British Legion - http://www.britishlegion.org.uk/

SSAFA - https://www.ssafa.org.uk/

White Ensign Association - http://www.whiteensign.co.uk/

NHS England – Healthcare for the Armed Forces - http://www.nhs.uk/NHSENGLAND/MILITARYHEALTHCARE/Pages/Militaryhealthcare.aspx

Combat Stress - http://www.combatstress.org.uk/

Forces in Mind - http://www.fim-trust.org/

Big White Wall - https://www.bigwhitewall.com/Register/register-new.aspx#.V_dIDELR-Ch

Career Transition Partnership - https://www.gov.uk/guidance/career-transition-partnership

Regular Forces Employment Association - http://www.rfea.org.uk/jobseekers/wounded-injured-sick/

Greenwich Hospital - http://www.grenhosp.org.uk/

Veterans UK - https://www.gov.uk/government/organisations/veterans-uk

Future for Heroes - http://www.f4h.org.uk/

Money Force - https://www.moneyforce.org.uk/

Joint Services Housing Advice Office - https://www.dghp.org.uk/armed-forces-help-2/joint-service-housing-advice-office

navygraphics 16/1025

Documents

The Naval Service recovery PaThway - NFF · Naval Service recovery Pathway (NSrP) This leaflet, principally aimed at the individual, outlines the Naval Service’s policy for the