Staff and patients at Headley Court work together towards a single aim: to help servicemen and women rejoin their unit and get back to work as quickly as possible.
Most soldiers are young, fit and highly motivated and feel frustrated about being unable to do the job they have trained so hard for and leaving their friends behind on the frontline.
Staff at Headley Court, the armed forces' dedicated rehabilitation centre, understand the soldiers' mentality. Treatments focus on getting service personnel fit for operational duty.
Day one for a patient at Headley Court feels like the first day back at the office. Days are tightly structured and soldiers are expected to abide by the military’s strict code of conduct.
“We focus on vocational rehabilitation,” says Lieutenant Colonel John Etherington, clinical director at Headley Court, which is officially known as the Defence Medical Rehabilitation Centre (DMRC). “Everything we do here is about returning people to work. Most patients want to return to active duty and their units want to have them back.”
Since the start of military operations in Afghanistan and Iraq, Headley Court has received much media attention.
Improvements in artificial limb technology and rehabilitation treatments are behind many stories of remarkable recovery. The double or triple amputee soldier with prosthetic limbs has become one of the enduring images of the present conflicts.
Road to recovery
For most combat casualties, Headley Court is the final stage of the recovery process. It has 360 military and civilian staff. The facilities, set in 85 acres of landscaped gardens, include a hydrotherapy pool, swimming pool, four fully equipped gyms and a state-of-the-art limb-fitting and amputee centre.
A patient can receive an artificial limb within two days of a first appointment with Headley Court’s limb laboratory technicians.
The latest prosthetics, such as the C leg, are fitted with microchips, and movement can be refined using Bluetooth technology.
Several patients have been fitted with the British-designed iLimb. This is a ‘bionic hand’ with five motors (one for each artificial finger), giving it a more sophisticated grasp than most prostheses.
Amputees often have more than one prosthetic limb, each one designed for a particular activity, such as walking, bathing, running or skiing.
Headley Court has 96 inpatient beds for the most serious cases, including limb loss, brain and spine injury or a combination of both. These patients can spend up to nine months receiving treatment at Headley Court.
There are a further 120 residential places for patients on three-week rehabilitation courses for muscle, bone and joint injuries, which can be either work or sports related.
Team of experts
All patients are initially seen by a team of experts from different medical fields who together agree on the course of treatment. The team includes specialist medical officers, nurses, fitness instructors, physiotherapists, occupational therapists, speech and language therapists, cognitive therapists and social workers.
“We've adopted a multi-disciplinary approach that has made a real difference in the speed and quality of recovery,” says Lieutenant Colonel Jonathan Houghton, a consultant rheumatologist at Headley Court.
Preparation for the combat casualty’s gradual return to active duty also begins here. Returning to work is central to the Headley Court ethos.
“We look at what work they can do within their unit,” says vocational occupational therapist Fatima Catarro. “We see work as a part of rehabilitation.” Their duties will depend on their physical and mental capabilities.
A typical day for an inpatient starts at 8.30am and ends at 4.30pm. During the day, patients have one-to-one and group therapy sessions, working on different areas of their recovery.
Lieutenant Colonel Houghton describes the determination of patients to get fit. “The psychological approach of our guys is remarkable after injury,” he says. “Their dedication is quite humbling.
“We had a marine who was a triple amputee. He worked so hard to get back in shape. Every day he’d be sweating away in the gym strengthening his back and abdominal muscles. He was an inspiration for patients and staff.
“Soldiers are surviving injuries that they wouldn’t have survived in the past. We now see double and triple amputees. Rehabilitating patients with such complex injuries has created new challenges and has pushed the boundaries of what we can do.”
For patients, it means there’s life in the service after even the most severe injuries. Paratroopers Corporal Stuart Hale and Sergeant Stuart Pearson were among the first amputees to return to the frontline in Afghanistan in November 2007 after being treated at Headley Court.
Operation Battle Back
New adventure training programmes help both physical and psychological recovery. The Battle Back initiative offers courses on adaptive skiing, kayaking, mountaineering and athletics among other activities.
“Often it’s the first adventurous activity they’ve done since being wounded,” says Lieutenant Colonel Fred Hargreaves, who set up Battle Back. “It can greatly improve their state of mind.”
Several patients have shown real sporting potential. The best of them will be given the chance to do more training and could eventually be selected to compete for Great Britain at international level.
Not all injured personnel resume service after their recovery. Some may be medically discharged while others may want to pursue different opportunities. Those preparing to return to civilian life are also given support.
“We assist them in preparing for life outside the forces,” says Lieutenant Colonel Houghton. Help is available in areas of training and employment, financial compensation for injuries, welfare and housing, and learning to drive.
Most valuable asset
The thousands of servicemen and women who make up the armed forces are its most valuable asset and everything is done to retain them.
“The armed forces has invested a lot of money in recruiting and training these individuals so it wants to keep them,” says Lieutenant Colonel Etherington. “The amount of experience that injured personnel have built up cannot easily be reproduced in a new recruit.”
More importantly, there is a sense of a debt of gratitude owed to injured service personnel.
“We owe these people the best possible rehabilitation whenever they sustain an injury, whether it is through fighting the Taliban or playing football for the service,” says Lieutenant Colonel Etherington.
“That’s what has inspired us over the past four or five years. It would be unacceptable for them to get second-class treatment.”