Since 2001, the main treatment centre for military patients injured overseas has been the Royal Centre for Defence Medicine (RCDM) at the University Hospitals Birmingham (UHB) NHS Foundation Trust.
The partnership with UHB was set up because the medical needs of the armed forces are "best served in an acute care hospital that manages severe trauma on a daily basis", according to a 2008 House of Commons Defence Committee report (PDF, 1.2MB).
The main arrival points for military casualties are Birmingham International Airport and RAF Brize Norton, with which UHB has good transport links.
UHB runs the new £545 million Queen Elizabeth Hospital Birmingham (QEH), which will replace the Queen Elizabeth and Selly Oak hospitals during a phased closure.
The hospital is highly experienced in treating the most common types of injuries to service personnel, such as polytrauma (where someone has suffered multiple traumatic injuries).
Centre of excellence
UHB, which has an annual budget of more than £400 million, has around 6,500 staff across 40 disciplines. This is one of the widest ranges of specialisms offered by any hospital in the UK.
As well as providing healthcare for more than 200,000 people living in south Birmingham, UHB provides specialist services for patients across the UK, including trauma, burns, plastic surgery, neuroscience, cancer and cardiology.
UHB has been rated "excellent" for clinical care and "excellent" for financial management by the Care Quality Commission (2009/10).
Military medical staff are fully integrated throughout UHB and treat both military and civilian patients. In 2008, the House of Commons Defence Committee of MPs concluded that UHB gave armed forces personnel "world-class" care.
Military casualties
Casualties arriving from Camp Bastion in Afghanistan for treatment at QEH are either placed on a trauma ward or taken straight to intensive care, depending on the severity of their injuries.
By the time the patient arrives, members of the clinical team at the QEH have already planned their treatment using images, scans, lab results and medical notes sent ahead from Camp Bastion.
The QEH military ward is in a designated trauma and orthopaedics ward where up to 32 military patients are cared for in single rooms or four-bed bays.
The ward has additional features for the use of service personnel only. These cater for their specific requirements and boost the military atmosphere.
It has more staff (both military and civilian) than a normal NHS ward, a quiet room for relatives, a communal space for patients to gather and a physiotherapy suite.
Patients get regular visits from military liaison officers, who deal with their day-to-day needs and maintain links with their units.
Ministry of Defence hospitals
Military hospitals were phased out from the mid-1990s because there were not enough patients and too few cases for military medical staff to maintain their skills.
To meet the demand for military healthcare services and training requirements for military medical staff, five Ministry of Defence Hospital Units (MDHUs) were set up within NHS hospitals.
Under the MDHU arrangement, military medics work alongside NHS staff, providing medical, nursing and other clinical treatments to NHS and military patients.
Some service personnel are treated in wards managed by military doctors, but others are now treated by civilian staff.
This integration allows military patients to get the best possible treatment available in the NHS, and allows the Defence Medical Services (DMS) to take advantage of NHS expertise.
