Case management for casualties of war

Purpose: To describe how case management can improve the transition between services for returning servicemen injured in war zones who often have very complex and multiple injuries. Context: Reviews a project undertaken for the Ministry of Defence in the UK. Data sources: Case management across secondary and primary care—studies; Literature relating to care of casualties from war zones; Statistical evidence on casualty numbers and type of injuries. Case description: This presentation will focus on the care of injured personnel evacuated back to the UK. Case management is to be implemented to improve the patient care pathway and make the transition between war zone, hospital and primary care fully integrated. (Preliminary) conclusions/Discussion: Care is often not co-ordinated, systems inadequate and patients returning as operational casualties have particular needs in terms of health care delivery which can be overlooked, particularly in relation to mental health needs. Case management provides a structured and co-ordinated pathway between the different services to enable continuity, a smooth transition and improve patient outcomes. However, implementation of case management will present many challenges in this environment as the case managers works with the service personnel within an NHS model of health care delivery. Within the NHS alone, integration is difficult as case managers strive to manage organisational differences between health and social care. When you add on the complexity of service personnel who have been injured whilst in a war zone, cross boundary working becomes even more difficult to manage effectively. Case management has the potential to be the one link that brings services together in a fully integrated way.