Long-term physical health needs of UK military veterans: evaluation of the Op RESTORE health navigation service
- 1Imperial College London, London, UK
- 2OpRESTORE, Imperial College Healthcare NHS Trust, London, UK
- 3Surgery and Cancer, Imperial College London, London, UK
Abstract
Introduction: The long-term physical health needs of UK veterans have not been well characterised. Veterans often present with physical health issues attributable to their time in service. Prior to 2016, no dedicated National Health Service (NHS) pathway existed to address these needs. Op RESTORE was established in 2016 to provide coordinated, specialist-led care for veterans with service-attributable physical health conditions. This study describes 10 years of service delivery.
Methods: A retrospective cross-sectional observational analysis of prospectively collected registry data was performed (2016–2025). Data were analysed using descriptive statistics and statistical comparisons performed against national datasets and between internal subcohorts.
Results: A total of 1794 referrals were recorded. Most patients were male Army veterans and presented a median of 15 years after military discharge. Most pathology was non-operational and only 11% of 487 veterans with a documented injury setting had injuries related to combat. Musculoskeletal pathology predominated (79% of 1081 with a confirmed pathway), particularly lower-limb (56%) and spinal injuries (31%). Obesity was highly prevalent (55% of 174 recorded body mass indexes), exceeding national age-matched rates. Mental health comorbidity was common (69%). 64% required navigation to a new clinical pathway. EQ-5D-5L scores improved significantly between referral and discharge from Op RESTORE (p<0.001).
Conclusion: Veterans accessing Op RESTORE predominantly present with delayed, chronic musculoskeletal and pain-related morbidity rather than acute combat-related injury. The long interval between military discharge and Op RESTORE presentation highlights a poorly documented and insufficiently monitored progression of service-related pathology over time. This represents missed opportunities for early identification, prevention and intervention. The high burden of multimorbidity and frequent need for specialist triage indicate gaps in standard NHS referral pathways for veterans. Coordinated healthcare navigation addresses unmet need and, in uncontrolled analysis, was associated with improved quality of life. Improved characterisation and longitudinal monitoring of veteran physical health could inform targeted, preventive and integrated service models.
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BibTeX
@article{sanchezthompson2026longterm,
title = {{Long-term physical health needs of UK military veterans: evaluation of the Op RESTORE health navigation service}},
author = {Natalia Laura Sanchez-Thompson and Amrutha Bhaskaran and Neil Brocklehurst and Amr Nimer and Beth Lambert and Philip Hall and Richard Swarbrick and Shehan Hettiaratchy},
journal = {BMJ Public Health},
year = {2026},
month = nov,
doi = {10.1136/bmjph-2026-005180},
url = {https://doi.org/10.1136/bmjph-2026-005180},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Long-term physical health needs of UK military veterans: evaluation of the Op RESTORE health navigation service
AU - Natalia Laura Sanchez-Thompson
AU - Amrutha Bhaskaran
AU - Neil Brocklehurst
AU - Amr Nimer
AU - Beth Lambert
AU - Philip Hall
AU - Richard Swarbrick
AU - Shehan Hettiaratchy
PY - 2026
DA - 2026/11/03
JO - BMJ Public Health
DO - 10.1136/bmjph-2026-005180
UR - https://doi.org/10.1136/bmjph-2026-005180
AB - Introduction: The long-term physical health needs of UK veterans have not been well characterised. Veterans often present with physical health issues attributable to their time in service. Prior to 2016, no dedicated National Health Service (NHS) pathway existed to address these needs. Op RESTORE was established in 2016 to provide coordinated, specialist-led care for veterans with service-attributable physical health conditions. This study describes 10 years of service delivery. Methods: A retrospective cross-sectional observational analysis of prospectively collected registry data was performed (2016–2025). Data were analysed using descriptive statistics and statistical comparisons performed against national datasets and between internal subcohorts. Results: A total of 1794 referrals were recorded. Most patients were male Army veterans and presented a median of 15 years after military discharge. Most pathology was non-operational and only 11% of 487 veterans with a documented injury setting had injuries related to combat. Musculoskeletal pathology predominated (79% of 1081 with a confirmed pathway), particularly lower-limb (56%) and spinal injuries (31%). Obesity was highly prevalent (55% of 174 recorded body mass indexes), exceeding national age-matched rates. Mental health comorbidity was common (69%). 64% required navigation to a new clinical pathway. EQ-5D-5L scores improved significantly between referral and discharge from Op RESTORE (p<0.001). Conclusion: Veterans accessing Op RESTORE predominantly present with delayed, chronic musculoskeletal and pain-related morbidity rather than acute combat-related injury. The long interval between military discharge and Op RESTORE presentation highlights a poorly documented and insufficiently monitored progression of service-related pathology over time. This represents missed opportunities for early identification, prevention and intervention. The high burden of multimorbidity and frequent need for specialist triage indicate gaps in standard NHS referral pathways for veterans. Coordinated healthcare navigation addresses unmet need and, in uncontrolled analysis, was associated with improved quality of life. Improved characterisation and longitudinal monitoring of veteran physical health could inform targeted, preventive and integrated service models.
SN - 2753-4294
ER -