The Territorial Army may be celebrating its 100th birthday this April, but it is looking fitter and more agile than ever. Such is its vigour, in fact, that it is lending ever-closer and more valuable support to the regular army (shakier on its feet, perhaps, having been around for several hundred years longer).
People join the reserve force with different aims. Among professionals, they are likely to include acquiring new “soft” and “hard” skills.
In 2005, Liverpool John Moores, Leeds Metropolitan and Bradford Universities did research for the Ministry of Defence to assess the management abilities of reservists. The report suggested that they had developed the skills to address four major deficits in British management: leadership, process design, communication and team-focused culture.
Less scientific but more directly relevant to the NHS are observations from Colonel David Morgan-Jones, commanding officer of the TA’s 243 Field Hospital. When we catch up with him and others in his team only days before they fly out to Camp Bastion in Afghanistan, he is as generous in his praise of individual effort as he is critical of the management skills with which volunteers come equipped. “My greatest concern is with regard to junior management and leadership skills,” says Colonel Morgan-Jones, who is a doctor in his regular job. “Delegation skills can also be pretty poor among my NHS colleagues.”
He goes on to explain the way the field hospital works: “You have to multitask. We simply don’t have space for managers and clinicians, so we try to use clinicians who can manage,” he says. “The NHS tends to do things by consensus. When you’re up against it, you have to be able to tell people to get on with it and sort it out.”
This focus on robust leadership skills can be particularly intense during mobilisation, but other aspects of leadership are equally important. “You have to be able to relate to people and talk them through their experiences,” Colonel Morgan-Jones explains.
Malcolm Sperrin works with the TA as a medical support officer. Based on his eight years’ experience as a reservist, Professor Sperrin says: “I know a lot of people who’ve come out of the TA or the regular army and they’re seen as being the top achievers in management. After all, if you can motivate people even in situations where they are putting themselves in danger, that’s a huge skill.”
Helping to forge a link between the MoD, reservists and the workplace is the campaign Supporting Britain’s Reservists and Employers. Campaign director Tim Corrie gives a different perspective on involvement with the territorial army: “It’s difficult to learn about management on the kind of course you might be sent on in the UK. But in the TA, that learning process is experiential. Above and beyond all the transferable skills, there’s a positive ‘can-do’ attitude in the armed forces which tends to rub off on reservists.”
Just before deployment to Camp Bastion, there was a chance to see that ‘can-do’ ethos in action as 90 reservists were set the task of assembling a working field hospital from scratch. “People performed brilliantly, working in small departmental teams to create a fully functional, deployable hospital in just three-and-a-half days,” Colonel Morgan-Jones enthuses.
On his way out to Afghanistan with the field hospital is Captain Nick Raaff, a nurse with North Bristol trust. “About half my time with the NHS is spent as an acute pain nurse and the other half in post-operative anaesthetic care,” he says. This is his first overseas posting after joining the reserve force in 2000.
Mr Raaff agrees that the TA’s officer and skills training helps to broaden management capabilities. “It gives you greater confidence in front of a group of people and teaches you to manage resources as well,” he says.
Resource management is a vital skill in the field, Professor Sperrin points out. “The army places a very strong reliance on officers to manage projects and handle procurement.” They will be trained to be self-reliant and to use their own initiative to work a problem through, without external back-up, as the commanding officer puts it, “in the middle of bloody nowhere”.
Professor Sperrin adds: “The TA is the perfect training ground for the middle or upper-level managers. It takes you outside your comfort zone. So your skills are developed in two environments: one where you are comfortable, one where you are less comfortable. That is what management is all about.”
Junior staff in the reserve forces are likely to be given responsibility early on. Colonel Morgan-Jones points out that a junior nurse in the TA will work as a shift leader. Outside field hospitals, the campaign to support reservists cites the example of a platoon commander in his or her early 20s being given responsibility for managing a team of around 30 people.
For clinical personnel, the reserve force offers clear opportunities to acquire medical skills. As Mr Raaff explains: “You’re learning skills that are directly applicable to your job. The TA will fund many of those courses, as long as you can get the time off.” He has benefited from training that includes acute burns care, mass casualty management and battlefield life-support skills.
While specialists are welcome, they may be expected to slip into varied roles. Colonel Morgan-Jones explains: “You may be a nurse on a medical ward in the NHS, but in a field hospital, you could be helping with surgery patients one day and be part of a trauma team the next.”
Professor Sperrin points to poly-trauma as an area where army medics must have special skills. “While you may see discrete problems in a hospital accident and emergency department, such as a broken leg and a head injury, this is far more about a multitude of interdependent injuries, each of which may be life-threatening in its own right,” he explains.
Colonel Morgan-Jones adds: “Camp Bastion is probably the leading trauma-treatment hospital in the UK.”
It is Mr Corrie at the campaign for reservists who points out that demand for specialist surgical skills in the field means that these professionals amass experience during a single tour of duty which they would not see in a lifetime of working in the NHS.
At the opposite end of the clinical spectrum, the TA can offer particular benefits to trainees, whether they are doctors or nurses. Liz Camp is a student nurse at the University of the West of England, who opted to join the reserve force when she began her training a year ago.
As a private she has benefited from courses in areas such as teaching and presentation skills. This has helped her to gain familiarity with key clinical skills and apparatus such as intensive care equipment. The army also helped her to arrange a month-long placement as part of her training in one of its medical reception centres in Germany.
Ironically, while strict army hierarchies take some getting used to, says Ms Camp, being in the territorial army helps to dissolve some of the equally restrictive hierarchies in the health service. “In the TA, you can work and socialise with doctors, physiotherapists and people from all sorts of backgrounds,” she says. “Put everyone in walking boots and it takes away all those distinctions.”
If there are negatives, the reservists do not mention them. Colonel Morgan-Jones says: “One thing is that when they come back from full-time service to a slow, bureaucratic system, it can take individuals a while to adapt.”
Of course, return from mobilisation can bring other, more positive changes. “Going on tour is a very formative experience,” he adds. “No one comes back the same person.”
In reserve: Addressing employers’ concerns
Despite this, employers support the territorial army:
The MoD works hard to keep employers on side through its Supporting Britain’s Reservists and Employers (SaBRE) campaign. Although employers do not have to pay reservists during mobilisation (the military matches wages of up to£300,000 for some medical specialists) and can recover the costs of temporary staff, the MoD is very aware of the disruption losing a key member of staff can cause. Where possible, employers get notice, typically seven weeks, although employers of medical staff may know a year in advance.
If the employee’s absence is particularly damaging, exemption from the tour can be sought. SaBRE says 87 per cent of applications for exemption or deferral were accepted between January 2003 and September 2007. Naturally, employers have obligations too. It is illegal to sack someone because they are likely to be mobilised and they must get their job back on their return from duty.
Campaign to support reservists helpline, 0800 389 5459; or visit www.sabre.mod.uk