Fleet Headquarters MEDICALLY ASSESSING THE ROYAL FLEET AUXILIARY SEAFARER GRAEME NICHOLSON Cons OM Navy Command HQ SHARON KITWOOD Occupational Health Nurse.

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MEDICALLY ASSESSING THE ROYAL FLEET AUXILIARY

SEAFARER

GRAEME NICHOLSONCons OM Navy Command HQ

SHARON KITWOODOccupational Health Nurse RFA

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This presentation expresses the views of the speakers and not necessarily the policy or views of the MoD

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ROYAL FLEET AUXILIARY SEAFARERS

NAVY COMMAND HQ1 x Cons OM1 x RFA MSO

1 x GP1 x RFA Med Tech

RFA OH TEAMRFA OH Nurse

Admin Support StaffMed Information Control

First Aid Trainer

Support to Med Techs at sea

RFA OH and Fitness policy

Recruitment,fitness for sea

Sickness absenceIll health

retirement

RFA Med Techs at sea

RFA HQ RFA Personnel

In House ADs

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Who are we?• 16 ships (11 post SDSR)

– From 10,000 to 41,000 tonnes• 2,300 personnel• Medical Technicians on all ships• RN MOs when deployed or on long

passages– RFA ARGUS (dormant hospital) – RN

MO plus RN Medical Assistant

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Personnel• MOD civilians• 2300 unionised employees

– Deck, supply, engineers, communicators, force protection

• Average age 42 (officers) 39 (ratings)• 107 females (4.6%)• Average length service 10 years• Home base worldwide

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What do we do?

• Keep the RN at sea by supplying fuel, spares, food, equipment e.t.c

• Vert-rep and helicopter operations• Counter-piracy operations• Disaster relief• Boarding operations (drug-busting)• Support Mine-counter measures vessels & submarines• Land Royal Marines to a hostile beach• Self-defence and damage control

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Why are we different?

• Deploy to conflict areas and disaster zones

• Fire-fighting roles and training• Damage control and CBRN• Aviation operations• Must be able to operate like the RN as

well as with the RN

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Fitness for Sea• Fitness standards based on holding an in-date,

unrestricted ENG1 medical certificate• Restricted certificates can be tolerated for limited

periods.• May use any appropriate AD.• In house ADs post illness / injury and for

problematic cases• Primary care from civilian GPs• Emergency and urgent care as well as OH from RFA

and RN

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Fitness for Sea

• If landed then can be medically evacuated back to UK via RAF system

• Med Techs produce letters for GP

• Plans to produce end of tour GP note

• RFA OH Nurse follows up those landed or reporting illness with GP / Specialist

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Working Patterns

• 4 months at sea, 2 months leave

• Then either back to sea or courses

• Shift patterns at sea are different for different ranks and trades

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Joining OH Screen

• Every time seafarer joins a ship.• Height, weight, bp, urinalysis, ENG1, PMH,

medications', allergies and lifestyle.• If considered unfit after medical advice,

landed from the ship• Total medical discharges in 2009 – 132

– Aero-medivac 32– Own way passage 90

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Joining OH Screen

• Failures at OH screen reported to RFA OHN and Navy Command Medical HQ

• Problems with ENG1 also reported

• Discrepancies between ENG1 and seafarer’s medical state reported to MCA.

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Common Problems Reported

• Untreated hypertension

• Urinalysis – blood, protein and sugar

• Unresolved illnesses / injuries

• Obesity (and unfitness)

• Inadequate medication supplies

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Fitness Testing

• The RN fitness test:– Timed 1½ mile run (age & gender related pass

times)– Shuttle run (Multi-stage fitness test)– 1 mile walk with time, weight and heart rate

changes fed into a VO2 max calculation

• Consideration given to whether RFA should introduce these test.

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Healthy Living Campaign

• Introduction on 1 Jan 11.

• Menus marked with fat, sugar and calorie content

• Encouragement to exercise and lose weight (ship-board gyms and PT)

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Healthy Living Campaign

• BMI and waist circumference at OH screen.

• Cardiac risk calculated against NICE guidance

• Those at v high risk considered for landing by CO (until lose weight)

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Any questions?