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FOREWORD

As part of its duty of care to the armed forces, the MoD has no fault compensation and occupational pension arrangements.  An important consideration often affecting pension paid for disorders is the presence or absence of a causal link to service.  To produce consistent equitable outcomes SPVA is committed to decision making based on evidence and reflective of contemporary medical understanding of the causes of disorders.  In support of this aim MoD has commissioned the synopses of causation, covering a range of injuries and disorders likely to be seen in service personnel and veterans.  Their focus is on causation and prognosis.

The synopses have a common format of Definition, Clinical features, Aetiology, Treatment and Prognosis.  All have a Glossary and they are referenced.  They were written by medical practitioners independent of MoD and its Agencies based on literature search at the standard of a textbook of medicine and generalist review articles and validated by senior clinical experts nominated by the Royal Society of Medicine.  They reflect generally accepted contemporary medical understanding not an MoD perspective.  Aimed at a wide lay and medical audience they are about the level of a review article or standard major postgraduate text.

I am most indebted to Professor Marjorie Davis, Department of Medical Education, University of Dundee and her staff and to Dr Tony Fisher, medical writer, Medical Text, Edinburgh who were responsible for identifying potential authors and linking them to topics and for editing and quality assurance of the subsequent papers.  Professor Davis will also conduct an evaluation.  I must also thank Professor Robin Williamson, Emeritus Dean and Dr J Scadding, Royal Society of Medicine whose help in nominating validators was invaluable.

In the future individual synopses will be amended as soon as practicable and in light of emerging significant changes in understanding.  As with standard text books routine review of the first edition of the collected papers will take place in four to five years. 

Rear Admiral Trevor Spires
Chief Executive
Service Personnel and Veterans Agency