Veterans’ Health: The year in review

The past 12 months have brought a host of changes and initiatives aimed at improving veterans’ healthcare. Dr Dan Corkery details the most significant updates GPs need to know.
 
The 2021 Australian Census was one of significance for the Department of Veterans’ Affairs (DVA), as it featured the first ever question about service in the Australian Defence Force (ADF).
 
The results, released throughout 2022, showed more than 581,000 Australians have served or are currently serving in the ADF.
 
One in 20 (5.3%) households have at least one person who has served, with over a quarter (28%) living across south-east Queensland. Knowing where veterans live and work is essential to targeting veteran health education and services and DVA is committed to using this information to improve services and support for the veteran community.
 
Formation of DVA’s GP Advisory Group
An important veterans’ health initiative for 2023 was the formation of the DVA GP Advisory Group (GPAG).
 
Its purpose is to facilitate engagement and collaboration between DVA and the general practice community, allowing DVA to hear from GPs, practice nurses and practice managers at the forefront of clinical care.
 
GPAG members consist of highly experienced GPs and other practice staff, many of whom are veterans or veteran family members themselves. This group solicits feedback and input from others all around Australia and workshops solutions to practical clinical problems.
 
‘GPAG has been a great forum for DVA to hear from general practitioners and receive on the ground advice and feedback to assist us in improving support for veterans,’ DVA’s Chief Health Officer and GPAG Chair, Professor Jenny Firman said.
 
The group meets quarterly and will continue to identify the needs of providers in promoting veteran health issues and improving healthcare services for veterans and their families.
 
Open Arms accepting direct referrals from GPs
Open Arms – Veterans and Families Counselling, a military-aware mental health support service founded by Vietnam Veterans, can now accept direct referrals from GPs.
 
With patient consent, Open Arms is able to inform GPs if their patients have accessed its psychological services, and can provide progress updates and closure letters upon completion of treatment. 
 
Open Arms is committed to working in partnership with health systems, including GPs, psychiatrists and other community agencies to ensure comprehensive support for the veteran community.
 
‘GPs are the cornerstone of our health system and Open Arms is a key resource for veterans and their families which provides mental health, couple and family counselling at no cost,’ Open Arms National Manger Leonie Nowland said.
 
‘By strengthening our referral pathways for primary care we hope to reach even more veterans and families in the community whilst supporting the important work of GPs.’
 
There are several ways GPs can refer a patient to Open Arms for support, and more information is available on the Open Arms website.
 
Improvements made to compensation forms
DVA is committed to making it easier for GPs to provide services to Veteran Card holders. As part of this commitment, the department is working to streamline and minimise the information asked of GPs when completing DVA compensation forms. The first phase saw 19 forms reviewed and subsequently reduced to seven.
 
In addition to condensing the number of forms, DVA has made key terms and clinical definitions clearer to understand, used more consistent terminology, and reduced the number of signatures required, with practitioners now only needing to sign the last page of the form.
 
DVA’s Principal Medical Adviser – Compensation, Dr Fletcher Davies, understands the limited time GP’s have for administrative tasks.
 
‘No one goes into medicine to complete paperwork, so when it’s needed, it’s important that we get it right,’ he said.
 
‘These improvements aim to speed up the claim process for veterans, and free up GP time for the provision of care.’
 
DVA will continue to work towards streamlining compensation forms with the review completed in the first half of 2024 and the second wave of revised forms being released in late 2024.
 
Veterans’ Health education updated through the RACGP
Late in 2022, the RACGP Syllabus and Curriculum was updated to include veterans’ health alongside military medicine. This means all GPs require a basic level of veterans’ health knowledge at the point of Fellowship.
 
The syllabus explores fundamental concepts in military medicine, occupational health, and how to care for current and ex-serving ADF members. The Military Medicine and Veterans Health Specific Interest Group (SIG) is one of the oldest in the college, with nearly 500 members.
 
In March 2023, a full edition of RACGP Check was devoted to Veterans’ Health topics. Six months after its release, more than 1000 GPs have successfully completed the cases. It includes five presentations of increasing complexity and showcases how to clinically care for veterans, while negotiating the DVA compensation system.
 
Release of National Veteran HealthPathways
The Hunter New England and Central Coast Primary Health Network (PHN), in partnership with DVA, has released two national HealthPathways tailored to veterans’ needs that can be used by all PHNs.
 
These HealthPathways cover issues facing veterans and their families, and how to access DVA programs and supports services. They are the first veternans-focused pathways ever created at a national level.
 
More than 20 PHNs have already adopted one or both of these pathways, which are designed to be localised in each region.
 
The partnership will continue to look at new pathways and initiatives to support the veteran community, and their health providers, in navigating the civilian primary health care system.
 
Tripling of the Veteran Access Payment
On 1 November, the Veterans’ Access Payment (VAP) was tripled for GPs who bulk bill patients with a DVA Veteran Card. This increase is part of the Federal Government’s 2023–24 investment in DVA and aims to improve Veteran Card holders’ access to GPs. New item numbers are also now available.
 
The tripled VAP will apply to face-to-face general practice consultations greater than six minutes, including home visits for people who are homebound and consultations in residential aged care facilities.
 
Additionally, the tripled VAP will apply to video and telephone GP consultations longer than six minutes. For video and telephone consultations longer than 20 minutes, patients need to register in with MyMedicare through their usual practice.
 
For more information on VAP and other incentive payments, visit the DVA website.
 
DVA programs continue to support veterans’ health
The Coordinated Veterans’ Care (CVC) Program provides funding for proactive care coordination for Veteran Gold Card holders with chronic health conditions and Veteran White Card holders with chronic DVA-accepted mental health conditions.
 
Providers and participants work as a team to improve the participants’ healthcare in a general practice setting.
 
A comprehensive care plan is developed upfront and reviewed every 90 days, and GPs are assisted by a care coordinator – usually a practice nurse. DVA has commissioned an independent evaluation of the CVC Program to measure the benefits of the program, including clinical outcomes and wellbeing, and provide options for program improvement.
 
GPs who wish to provide feedback can contact Kelly Batsiokis, Senior Consultant at Abt Associates via Kelly.Batsiokis@abtassoc.com.au.
 
DVA can also fund access to psychiatric assistance dogs for veterans with PTSD.
 
These highly trained dogs aim to assist veterans with their clinical recovery goals, including detecting signs of distress and helping alleviate the symptoms. This popular program launched in September 2019 and has placed more than 200 assistance dogs with eligible veterans.
 
Information on these and other programs available to veterans can found on the DVA website.
 
Looking forwards, the Royal Commission into Defence and Veteran Suicide is providing DVA with an opportunity to learn and strengthen its approach to supporting the mental health and welfare of veterans and families.
 
Responding to recommendations in the Interim Report (2022), and Final Report (expected in 2024) will remain a core focus for DVA over the coming years.
 
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