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Social Work and Social Policy: Helping military families thrive: supporting veterans, their families and military spouses to deal with limb loss and find employment

Dr Nick Caddick, Dr Lauren Godier-McBard, Dr Hilary Engward, Professor Matt Fossey, Kristina Fleuty

Research by ARU's Veterans and Families Institute (VFI) has improved policy and service provision for the families of ‘limbless’ veterans, and has led directly to new policies and funding designed to promote employment opportunities for military spouses and ‘Early Service Leavers’ (ESLs).

The goal of the 'Thriving Families' research was to transform how veterans’ and their families’ needs for rehabilitation, as well as economic and social inclusion, are met by the military and society.

Explore ARU researchers' original work via our open access repository, ARRO

Research summary

Three projects formed part of the VFI’s Thriving Families research programme, funded by the Forces in Mind Trust (FiMT).

The projects are:

  • Caring for the carers
  • Supporting spouse employment
  • Improving employment outcomes for Early Service Leavers (ESLs). 

The UK currently has nearly 3,000 veterans with one or more limbs missing as a result of either military service or post-service injury/illness, with 333 of these losing limbs in conflicts since 9/11.

The VFI’s research is, internationally, the first to consider families’ experiences of supporting a veteran with limb loss. This research, led by Dr Engward and supported by Prof Fossey and Kristina Fleuty, designed an original Grounded Theory study to understand families’ perspectives on living with limb loss, carrying out 72 detailed interviews with veterans and their family members.

The second project in the VFI’s Thriving Families research programme focused on employment opportunities for military spouses. According to the MoD, the difficulty partners and spouses of military personnel experience in pursuing career opportunities is among the biggest factors influencing personnel retention.

Spouses face difficulties due to frequent relocations, lack of employment opportunities in remote base locations, and lack of access to affordable childcare. With the number of UK military spouses estimated at 64,000, this amounts to an economic and social disadvantage faced by a sizable but neglected constituency.

The VFI’s evaluation of the MoD’s Spouse Employment Support Trial was the first UK research to examine attempts to support spouses in overcoming barriers to employment. The researchers carried out in-depth interviews with 30 spouses and 23 of their in-service partners, findings offered compelling evidence that employment support helped increase spouses’ confidence, provided new skills, and helped them to feel valued by the military.

The third project examined employment outcomes for ESLs, defined as recruits who leave the military prior to serving four years, or at any point via compulsory discharge. Research has identified ESLs as a group are potentially vulnerable to mental health problems and unemployment. Every year, approximately 4,000 recruits leave the military as ESLs.

The MoD’s Future Horizons Programme (FHP), launched in 2011, was designed to help ESLs transition into civilian employment, and was delivered through a model of individual support provided by contracted services from the Career Transition Partnership (CTP). The research examined vulnerabilities among ESLs and sought to understand how ESLs could be supported during and after their transition to civilian life.

Man with prosthetic leg sitting at a desk with a woman

Summary of the impact

  • Expanded services of Blesma - 'The Limbless Veterans' charity to include separate assessments and support for family carers of veterans
  • Informed materials for trainee GPs, other healthcare professionals, and veterans about healthcare and experiences of persons with limb loss
  • Influenced the development of MoD support for the careers of spouses and civil partners of military personnel


Blesma – ‘The Limbless Veterans’ is the UK’s leading specialist limb loss charity. VFI research on families’ experiences of living with limb loss has transformed the services provided by Blesma to veterans and their families.

The research has been key to the charity’s long-term planning and central to its efforts at 'adopting and sustaining good practice'. Blesma Support Officers, who made 2,362 visits in 2019 alone, have since assessed coping levels of veterans and their family carers separately, allowing the provision of relevant support for both. The BSOs’ practice has been enhanced through formalising support to families as part of their remit.

According to Blesma, there are around 500 limbless veterans with ‘active issues’ at any one time. In the majority of these cases, it is not just the veteran who requires support, but also the family.

Each of the families visited since the introduction of the Model has benefited from support informed by the VFI’s ‘Caring and Coping’ report, meaning that the innovative LLSM reached at least 17% of the nearly 3,000-strong limbless veteran community by the end of July 2020.

The Model continues to be used by Blesma and the BSOs, with families benefiting from ongoing support informed by the VFI’s research.

Read more about more about blesma, the limbless veterans.

Since 2018, all new Blesma members (and existing Blesma families, where appropriate) have been given the Caring and Coping booklet which explains the Model and what caring for and coping with limb loss might be like across five stages of the life course.

Limbless veterans and families visited by Blesma testified to the value and significance of the new approach because it distinguishes between how families and veterans cope: 'It’s the carer that takes the brunt of it all'.

In 2018 the LLSM was incorporated within the National GP Registrar Training Programme about Veterans’ Health that all trainee GPs must engage with during their training; several components of this training are delivered by Blesma.

As a direct result of the research findings, a pain Q&A crib sheet was also developed with a specialist consultant in veteran pain to assist both persons with limb loss (PWLL) and health professionals in explaining the nature and impact of phantom pain.

The VFI’s research played a pivotal role in MoD decisions on spouse employment by confirming the need for career support among the UK’s 64,000 military spouses, also validating the model of support (i.e., bespoke careers consultancy, training, and job-finding workshops).

Specifically, the evaluation report’s finding that support improved spouses’ confidence in seeking employment directly influenced the UK Secretary of State for Defence’s decision to introduce a new fund for supporting the careers of spouses and civil partners of military personnel.

This fund supported the development of a new Partner Career Support Programme designed to empower spouses to be more confident in seeking employment. The VFI's recommendation also included that training should include online and distance learning formed a key part of the statement of requirement.

In 2019, the MoD recognised the value of the VFI’s research, inviting Prof Fossey to sit on the Partner Employment Steering Group, a national committee which has direct access to cross-government policy discussions on partner employment opportunities.

Prof Fossey’s contributions to this group led to the creation of a new online platform, Forces Family Jobs – a job-finding website specifically for military, Fossey also requested that the MoD take steps to support spouses during the COVID-19 pandemic.

Read more about read more about national policy development on spouse employment support.

Right Management (the career and talent management company responsible for delivering the CTP contracted services) benefited commercially from the research in that the policy decision led to an expanded contract with the MoD. They acknowledged that the research “was instrumental in validating the concept of Future Horizons”.

See also

Read the full REF 2021 impact case study for UoA 20: Helping military families thrive: supporting veterans, their families and military spouses to deal with limb loss and find employment.

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