Glasgow's Helping Heroes: A Vital Service - Full Report
Abstract: This report is the final output from a two-year independent evaluation of SSAFA’s Glasgow’s Helping Heroes service. The research was carried out by the University of Stirling and Glasgow Caledonian University, and funded by Forces in Mind Trust (FiMT). Glasgow’s Helping Heroes (GHH) is a holistic service providing advice and support on issues affecting service personnel, veterans and their families in Glasgow, including housing and homelessness, employability and training, welfare benefits, financial and health issues. GHH is operated by SSAFA, the Armed Forces charity, in partnership with Glasgow City Council, helping them to meet the Armed Forces Covenant principle of ensuring that veterans are not disadvantaged by their time in service. This research aimed to do two things. Firstly, to assess the impact of the GHH service, using a Social Return on Investment (SROI) analysis. And secondly, to support GHH in developing an improved framework for future monitoring and evaluation. This report provides the findings from both of these aspects, identifying lessons for GHH and also for the wider military charity and veteran welfare sector.
Abstract: Context: In response to the opioid crisis, federal guidelines were implemented, including the Veterans Health Administration's (VA) Opioid Safety Initiative in 2013. The impact of policies on patients near the end of life is unknown. Objective: Examine temporal trends in opioid prescribing, pain, and opioid overdoses among Veterans near the end of life. Methods: Retrospective, time series analysis of VA decedents between October 2009 and September 2018 whose next-of-kin participated in VA's Bereaved Family Survey (BFS). Using multivariate regression to adjust for sociodemographic and clinical covariates, we examined temporal trends in outpatient opioid prescribing, uncontrolled pain based on BFS report, and opioid overdose-related hospitalizations, in the last month of life, overall and by clinical diagnosis (cancer versus non-cancer). Results: Among 79,409 decedents, mean daily outpatient opioid dose in morphine milligram equivalents in the last month of life decreased from 4.6 mg in 2010 to 2.1 mg in 2018 (adjusted change -0.20 mg/year; P