The research conducted by the King’s Centre for Military Health Research at King’s College London examined the demographic, mental and physical heath profiles of former Service personnel accessing primary care.

The study builds directly on an earlier FiMT-funded study that demonstrated the feasibility of using Clinical Practice Research Datalink (CPRD) data by extending the data to Scotland and Wales to now cover all four nations of the UK. This included 4,364 former Service personnel from Scotland, 5,072 from Wales and 287 former Service personnel in Northern Ireland. Across both reports 138,457 former Service personnel were identified.

Evidence suggests that former Service personnel, more so than the general population, present with complex and interrelated mental, and physical health needs. Primary care records offer a uniquely valuable source of data for understanding these health patterns. Unlike surveys, primary care data covers large populations over time, without relying on self-reporting or being limited to specific geographies.

However, the quality of the findings relies on how consistently and accurately former military status is recorded in primary care settings such as in GP practices.

What the research found

Consistent with the earlier England study, musculoskeletal conditions, chronic respiratory conditions and depression were among the most commonly recorded health conditions amongst former Service personnel in all four nations.

The research also found variation between countries. For example, Former Service personnel in Wales had the highest (median) number of GP consultations per patient per year compared to the other nations, but also had an elevated recorded prevalence of osteoarthritis and post-traumatic stress disorder (PTSD) compared to the other nations. Meanwhile, former Service personnel in Scotland showed lower prevalence of depression than the other nations.

These health variations between different nations may reflect variation in data recording practices and ease of access to primary care across the UK, as well as differences in the health needs of former Service personnel populations in question. As health services differ in the four nations, each country operates under distinct policies and funding models, which can influence the frequency of GP contact.

In Northern Ireland there was a much smaller sample likely due to a lower coverage of CPRD amongst GP practices.

The importance of better data

The study’s use of primary care data is a major strength to present viable evidence for policymakers and clinical practitioners to use, but it relies on further improving the quality and consistency of the recording of former Service personnel in primary care and their demographic and lifestyle risk factors.

The report therefore recommends the following actions:

  • Continuing to improve identification of former Service personnel in primary care records across the UK. This can be done through more often ‘asking the question’ of patients to record their former military status. This can support more targeted planning of services such as Op Courage and Op Restore to support former Service personnel. Progress has already been made through initiatives like the ‘veteran-friendly GP Practice’ programme to help practices improve recording of data on military status.
  • Improving data completeness. This includes recording demographic (eg ethnicity), and lifestyle risk factors (eg BMI, smoking and alcohol use). This would enable more granular and accurate high-level policymaking supported by detailed analysis.

The full report can be found here.

Sharon Stevelink, Professor of Applied Epidemiology and Occupational Health at King’s Centre for Military Health Research, said:

“This study is the first to compare the demographic characteristics and health profiles of veterans in primary care across all four UK nations. It demonstrates both the potential of CPRD as a tool for UK-wide veteran health research, and the importance of improving data completeness to allow more reliable comparisons and more targeted support.”

Tom McBarnet, Director of Programmes at Forces in Mind Trust, said:

“GPs are often the first point of contact for veterans’ physical and mental health needs after leaving service. This research underlines the need to ‘ask the question’ and improve upon the completeness of data about the former military status of patients to better inform national health strategies. As such, this research helps support health systems and policymakers across all four nations to better understand and respond to the needs of the Armed Forces community.”