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Research

The Veteran Friendly Practice accreditation programme: a mixed-methods evaluation

Alan Finnegan, Kate Salem, Lottie Ainsworth-Moore, Rebecca Randles, Lauren West, Robin Simpson and Veronica Benedicta Grant
BJGP Open 2022; 6 (3): BJGPO.2022.0012. DOI: https://doi.org/10.3399/BJGPO.2022.0012
Alan Finnegan
1 Westminster Centre for Research in Veterans, University of Chester, Chester, UK
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  • For correspondence: a.finnegan@chester.ac.uk
Kate Salem
1 Westminster Centre for Research in Veterans, University of Chester, Chester, UK
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  • ORCID record for Kate Salem
Lottie Ainsworth-Moore
1 Westminster Centre for Research in Veterans, University of Chester, Chester, UK
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Rebecca Randles
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Lauren West
1 Westminster Centre for Research in Veterans, University of Chester, Chester, UK
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Robin Simpson
2 Hampton Surgery, Solihull, UK
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Veronica Benedicta Grant
3 Darley Dale Medical Centre, Matlock, UK
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    Figure 1. Factors influencing accreditation and outcomes of the programme. PHC = primary health care

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    Table 1. Survey distribution
    SerialSurvey distributionDate (2021)ResponsesPercentage increase %
    1Initial 50 surveys29 April
    2Remaining surveys11 May96
    3Reminder 118 May15965
    4Reminder 22 June18919
    5RCGP newsletter23 June
    6Reminder 324 June23223
    7Total responses232
    • RCGP = Royal College of General Practitioners.

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    Table 2. Descriptive statistics of quantitative results
    SerialThemeQuestionTotal responses, n‘Yes’ answers, n%
    1 Impact on practice Greater understanding of veterans 22919384
    2 More aware of veterans' needsVery awareAwareSomewhat awareSlightly awareNot at all aware232621183812227511651
    3 Impact of programme on practice (0 no impact–10 significant impact)231 (mode 5; mean; 5; median 5; standard deviation 2.53)
    4 Impact on veteran Age group most likely to engage18–3940–5960–79≥80All equally likely to engage230248943668103919330
    5 Veteran awareness of programmeVery awareAwareSomewhat awareSlightly awareNot at all aware231638767140317333117
    6  Veteran awareness of veteran-specific priority treatmentVery awareAwareNeutralSome awarenessUnaware23167559731833326328
    7   Perceived benefit to veteran of their GP having greater understanding of needsSignificant benefitSome benefitNeutralLittle benefitNo benefit231441224614519532062
    8   Impact of programme on veteran (0 no impact–10 significant impact)232 (mode 5; mean 5.60; median 6; standard deviation 2.35)
    9 Programme management Would recommend accreditation programme 23122899
    10 Accreditation processVery easyEasyNeutralDifficultVery difficult23260116533026502310
    11 Communication with RCGP during accreditation processVery goodGoodNeutralPoorVery poor23043127545119552420.4
      Preferred training material (multiple response question)Online moduleFace-to-face courseRCGP veteran-specific newsletterWebsite updatesOther (central resource database or contacts with veteran organisations)194631801396842777603
    • RCGP = Royal College of General Practitioners.

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    Table 3. Integrated findings from both quantitative and qualitative data
    ThemeQuantitative resultsQualitative findingsIntegration
    Programme delivery and implementationWell received by PHC staffEasy to become accreditedUseful information from RCGP, preference for online educational modulesNo qualitative data N/A, quantitative data provided insight into this area
    Impact on veteranPHC staff believed veterans aged 40–59 years most likely to engagePHC staff believed veterans were largely unaware of the programme and of veteran-specific priority treatmentGreater understanding of veterans needsGreater appreciation of veteran-specific servicesIncreased engagement with PHCSome improvement in help-seekingImportant for PHC staff to have an understanding of veteran-specific services to bridge the gap between patient knowledge and services availableQualitative findings expanded on quantitative data about age and how this might affect help-seeking
    Impact on practiceGreater appreciation and awareness of veterans' needsIncreased veteran registrationsGreater efforts to code correctlyBetter working environmentBecoming aware of veterans' needs has had a positive impact on motivation and commitment to identify veterans
    ChallengesCOVID-19Identifying veteransPoor secondary servicesKeeping up to dateIdentifying veteransPromoting accreditation statusFurther training needsCOVID-19 has impacted footfall, subsequently affecting communicating accreditation status to veteranFurther work required outside of PHC to complement veteran-friendly practicesFuture training should be aimed at all PHC staff, not just veteran leads
    Positive outcomesNo quantitative dataIncreased awareness of veterans' needsGreater understanding of veteran-specific servicesImproved understanding of the priority referral systemN/A, qualitative data provided insight into this area
    • N/A = not applicable. PHC = primary health care.

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    Table 4. Study recommendations
    Recommendations
    1. Educational provision. To evaluate the current online educational packages and update and improve accordingly. Educational material should target all practice staff.
    2. Specific development opportunities for veteran leads. Examples include developing networks across the primary care networks and connecting the veterans leads to their regional Armed Forces Covenant partnership committee.
    3. More time to fully assess the impact of the programme. As highlighted in the limitations section, the timing of the study during the COVID-19 lockdown period and the reduced footfall within PHC will have impacted on the results.
    4. Identify ways in which to better promote veteran-friendly accreditation.
    5. Raise awareness of veteran status in the veteran community.
    6. Research. Further studies could target help-seeking and engagement from certain demographic groups such as sex, age, minority groups, and families.
    7. There is clear evidence regarding the benefits of the programme to warrant continuation of the project and further funding.
    • PHC = primary health care.

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The Veteran Friendly Practice accreditation programme: a mixed-methods evaluation
Alan Finnegan, Kate Salem, Lottie Ainsworth-Moore, Rebecca Randles, Lauren West, Robin Simpson, Veronica Benedicta Grant
BJGP Open 2022; 6 (3): BJGPO.2022.0012. DOI: 10.3399/BJGPO.2022.0012

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The Veteran Friendly Practice accreditation programme: a mixed-methods evaluation
Alan Finnegan, Kate Salem, Lottie Ainsworth-Moore, Rebecca Randles, Lauren West, Robin Simpson, Veronica Benedicta Grant
BJGP Open 2022; 6 (3): BJGPO.2022.0012. DOI: 10.3399/BJGPO.2022.0012
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Keywords

  • health promotion
  • mental health
  • general practice
  • primary healthcare

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