Intended for healthcare professionals

Feature Military Medicine

Long road to recovery

BMJ 2010; 340 doi: (Published 18 February 2010) Cite this as: BMJ 2010;340:c647
  1. Helen Macdonald, associate editor
  1. 1BMJ, London WC1H 9JR
  1. hmacdonald{at}

    The UK government has recently announced proposals to improve care for seriously injured serving soldiers and veterans. Helen Macdonald looks at the challenges of rehabilitation

    Providing injured soldiers with long term care is an increasingly complex challenge. With advances in medical care, more soldiers are surviving—sometimes unexpectedly—and living with multiple severe injuries from which they may have previously died.

    Figures from Defence Analytical Services and Advice (DASA) which records defence statistics in the United Kingdom, show a rise in the numbers injured. In all, 508 people (military and civilian) were wounded in action and treated in field hospitals in Afghanistan in 2009. This compares with 85 in 2006, 234 in 2007, and 235 in 2008. The severity of the injuries has also increased. Of those admitted to field hospitals in 2009, 75 were seriously injured and 83 very seriously injured. Before 2005 only a handful of patients had very serious injuries. Up to 25% of seriously injured survivors are unexpected survivors according to National Audit Office estimates.1

    Currently, badly injured soldiers are flown back to the UK for acute care at the Royal Centre for Defence Medicine at Selly Oak and then transferred for rehabilitation at the Defence Rehabilitation Centre at Headley Court. The unit has 66 ward beds, although under secretary for defence Kevan Jones announced details for an extra 30 ward beds earlier this month. His announcement coincided with a National Audit Office report highlighting that defence medical services, although “highly effective,” are approaching capacity and calling for contingency plans to deal with the pressure from the ongoing conflict. The office estimates that £71m was spent on medical care as a result of military operations in 2008-9.1

    New challenges

    Until 2006, most soldiers treated at Headley Court were recovering after road traffic injuries, parachuting incidents, or musculoskeletal injuries. …

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