Defence chiefs urged to tackle rise in illness among troops

Defence chiefs must do more to tackle a sharp rise in the number of British troops in Afghanistan suffering from illness and minor injuries, the National Audit Office said today.

The treatment of badly wounded personnel is "highly effective" but thousands of working days are being lost to potentially preventable less serious complaints like stomach bugs and sprained ankles, the public spending watchdog found.

The NAO also warned that hospitals in both Afghanistan and Britain were under growing pressure from the large number of troops being injured in bloody fighting in Helmand Province.

It said the Ministry of Defence and Department of Health needed to carry out more detailed planning for possible scenarios involving a big increase in casualties.

The warning comes as it emerged that the Ministry of Defence was to announce an increase in the number of ward beds at its rehabilitation centre, at Headley Court in Surrey, from 66 to 96.

Rates of minor injury and illness among troops deployed to Afghanistan nearly doubled between 2006 and 2009, increasing from 4% to 7% of the total, the NAO found.

In Iraq the rate went up from 5% to 9% over roughly the same period.

The watchdog estimated that 6,700 days were lost in Afghanistan between October 2006 and September 2009 because of the increase.

Possible reasons for the rise could include the intensity of operations, basic living conditions at some forward operating bases or improved reporting of medical data.

But the NAO noted the MoD's limited data meant it could not judge the significance of these individual factors.

It said: "The rising rates demonstrate that the department needs to do more to assess which prevention measures should be improved to halt the increase."

The spending watchdog also raised concerns about contingency planning for what to do if Afghanistan casualty numbers overwhelm the specialist military facility at Selly Oak Hospital in Birmingham.

There is a voluntary agreement in the West Midlands to maximise the number of injured troops cared for at Selly Oak by diverting civilian trauma patients to other hospitals in the region.

If there is no room for military casualties at Selly Oak, they will be treated first in hospitals in the region, then nationally.

The NAO report noted: "There is scope for improvement, for example by modelling the capacity required under different casualty scenarios and defining clear indicators for when each level of contingency would be required."

A total of 522 UK service personnel were seriously injured on operations in Iraq and Afghanistan between October 2001 and October 2009, with the peak in July last year.

British troops have attended medical facilities about 125,000 times for treatment of minor injuries and illnesses since 2006, and some 6,900 have been evacuated back to the UK since 2003.

The cost of medical care as a result of Britain's military operations was £71 million in 2008-09, the report estimated.

NAO head Amyas Morse said: "The good news is that my report has found that treatment for seriously injured personnel is highly effective.

"Alongside this positive finding, we point out the need to continue to improve contingency planning for facilities in the UK in the context of a longer term conflict, and the importance of increased efforts to prevent disruption due to rising levels of short term illness."

Edward Leigh MP, chairman of the Public Accounts Committee, welcomed the report's findings on the quality of care provided to injured servicemen and women.

He added: "It is also good to hear that the Ministry of Defence has finally got around to improving its contingency plans for providing extra capacity in the UK.

"These plans are by no means perfect though, and the MoD should plan properly for the capacity required under all casualty scenarios, including the most pessimistic.

"Given that the Selly Oak military hospital now has unrivalled expertise, we will be seeking reassurance that the quality of care for service personnel will remain high, even if Selly Oak becomes full.

"Disease and minor injury are currently having only a small effect on the capability of our forces but current figures show a rising trend in rates, a near doubling in three years.

"The MoD needs to find out why and improve prevention measures."

Welcoming the NAO report, Veterans Minister Kevan Jones praised the "first class" treatment given to injured servicemen and women.

He said: "We proved we have the capacity to cope with an increase in casualty numbers in our response to the Panther's Claw operation last summer and we have contingency plans in place to deal with the unexpected.

"We will study the NAO's recommendations and provide a detailed response in due course."

Surgeon Vice-Admiral Philip Raffaelli, who was recently appointed as Surgeon General, added: "We cannot afford to rest on our laurels and are working hard to build upon the success we have achieved in combining the best NHS expertise with our Defence Medical Services.

"All of our military and civilian medical staff - those in Afghanistan, the teams who transfer our injured personnel back to the UK, and those in our facilities back home - do a fantastic job looking after our troops and providing the outstanding care that they deserve.

"I welcome the fact that the NAO has recognised their achievements."