Chapter 15

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Medical Branch Officers

November 2007 Edition

CHAPTER 15

MEDICAL BRANCH OFFICERS

(MOD Sponsor: MDG(N))

CONTENTS

SECTION I - MEDICAL OFFICERS

1501. Medical Officers1502. Registration as a Medical Practitioner1503. Medical and Dental Documents1504. Daily Sick Book1505. Medical Stores1506. General Health of the Ship1507. Local Medical Services1508. Communicable and Notifiable Diseases1509. Psychiatric Illness1510. Health Lectures1511. Supervision of Food1512. Water Supplies1513. Clothing1514. Medical Examination of Persons Suspected of Offences under the Service

Discipline Acts1515. Regulations on Medical Evidence at Court-Martial1516. Naval Medical Officers of Health

SECTION II - OFFICER IN MEDICAL CHARGE

1531. Ships with no Medical Officer1532. Daily Sick Book Maintenance when no Medical Officer is Borne1533. Medical Stores in Ships not Carrying a Medical Officer1534. Ships with no Medical Branch Rating1535. When no Dental Officer is Borne

SECTION III - DENTAL OFFICERS

1551. Dental Officers1552. Registration as a Dental Practitioner1553. In Action

SECTION IV - QARNNS OFFICERS

1571. Status1572. Nursing Officers1573. Nursing Officers in Naval Establishments

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CHAPTER 15

MEDICAL BRANCH OFFICERS

SECTION I - MEDICAL OFFICERS

1501. Medical Officers

1. Responsibility. The Medical Officer is responsible to his Commanding Officer for thetreatment of the sick or injured, the maintenance of health and the prevention of diseaseand for the effectiveness of the medical organization for action.

2. Disclosure of Information. Healthcare professionals in the Armed Forces areresponsible to their Commanding Officers for the treatment of the sick and injured, themaintenance of health and the prevention of disease. In rare circumstances, informationmay have to be disclosed to the Commanding Officer without the consent of the patient orcontrary to his wishes. The patient should also be informed that confidentiality would bebreached in his interest, or the ‘public interest’. Further information can be found inBR 1991 Art 0908.

3. Instructions. Detailed instructions for Medical Officers are contained in BR 1991,Instructions for the Royal Navy Medical Service.

1502. Registration as a Medical Practitioner

1. All Medical Officers must be on the principal list of the register of the General MedicalCouncil. It is the responsibility of individual officers to ensure that they are re-registeredannually.

2. Omission or erasure from the principal list for any reason is to be reported to 2SL/CNH(Medical Director General (Naval)) immediately.

1503. Medical and Dental Documents

1. The Medical Officer (or Commanding Officer where there is no Medical Officer) is theonly person authorized to be in possession of medical documents which are “RestrictedMedical”. Medical and dental staff may have access to these documents in the course oftheir duty.

2. Instructions for Medical Officers concerning the completion and disposal of medicaldocuments are contained in BR 1991.

1504. Daily Sick Book

1. Except in HM naval bases and shore establishments, the Medical Officer is to keep aDaily Sick Book (B Med 33) which is to contain the names of all the sick on board andwhich he is to submit to the Commanding Officer as required.

1505. Medical Stores

1. Detailed instructions for the issue, accounting and survey of medical stores and for thecustody of controlled drugs are contained in JSP 340, Joint Service Regulations forMedical and Dental Material Supply and Accounting, and in BR 1991 Chapter 24.

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1506. General Health of the Ship

1. The Medical Officer should be attentive for any circumstances likely to affect thehealth of the ship generally. Should he suspect the presence of disease or indisposition inany person, he is at once to deal with the matter as may be requisite. He is to reportimmediately to the Commanding Officer any factor in living or working conditions whichappears likely to reduce the efficiency of a part or whole of the ship’s company. All mattersaffecting the health or efficiency of numbers of men are to be discussed with the highermedical authority within his immediate line management without delay. (See alsoChapter 8.)

1507. Local Medical Services

1. The Medical Officer is to maintain contact with local health authorities, generalpractitioners and consultants involved in the care of naval personnel. He is to advise 2SL/CNH (Medical Director General (Naval)) of any deficiencies in the services provided.

1508. Communicable and Notifiable Diseases

1. Procedures to be adopted in relation to communicable diseases and to reporting ofnotifiable diseases and conditions are contained in BR 1991 or in JSP 375 and JSP 442.

1509. Psychiatric Illness

1. The utmost care is to be exercised in cases of suspected serious psychiatric illness orcases of deliberate self-harm or suicide. Guidelines for dealing with cases are containedin BR 1991 and PLAGOS.

1510. Health Lectures

1. General. Health lectures are to be given to the entire ship’s company. A record of suchlectures is to be made in the First Aid Training Log. (See BR 1991.) The subject matter oflectures is left to the discretion of the Commanding Officer, as advised by the MedicalOfficer, except that the prevention of sexually transmitted diseases is to be included.

2. Special. When it appears likely that the ship’s company will be exposed to risk ofmalaria, dysentery or any communicable disease, special lectures on the prevention ofthese diseases, afloat and ashore, are to be given. Health lectures must reflect informationgiven in NMOH(F)’s Operational Brief Directives.

1511. Supervision of Food

1. The wholesomeness of food supplied on board is an important part of the MedicalOfficer’s responsibilities, concerning which he is to collaborate with the Supply Officer. Heis to pay attention to food hygiene standards and in particular to perishable foods such asmilk, ice cream, meat products, fruit and vegetables (see BR 1991). If he has reason tosuspect food poisoning he is to inform the Commanding Officer in order that aninvestigation may be made. In all cases, or suspected cases, of food poisoning, aFMED 85 is to be raised. Specialist Environmental Health Advice is available from theNMOH(F) office.

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1512. Water Supplies

1. In collaboration with the Engineering Officer, the Medical Officer is to concern himselfwith the safety of potable water on board. Instructions for the receipt of drinking watersupplies and the routine testing of potable waters are contained in BR 820, Provision ofSafe, Potable Water for Ships and Establishments.

1513. Clothing

1. Suggestions for suitable clothing to be worn in varying climates are to be made by theMedical Officer to the Commanding Officer. (See also Chapter 8.)

1514. Medical Examination of Persons Suspected of Offences under the Service Discipline Acts

1. Guidelines for the conduct of medical examinations and the legal requirement forconsent to examination and the provision of intimate samples are detailed in BR 1991.(See also BR 11, Manual of Naval Law and extant Defence Council Instructions andPLAGOs 0403 - Rape and other serious offences).

1515. Regulations on Medical Evidence at Court-Martial

1. Regulations concerning medical evidence at court-martial are contained in BR11Manual of Naval Law.

1516. Naval Medical Officers of Health

The Naval Medical Officer of Health is to undertake CINCFLEET ship, submarine, RM andunit inspections as required by Fleet Safety Management System. He is also to visit allships and establishments within the Command Area as he considers necessary to assessthe current standards of environmental and occupational health and to make anynecessary recommendation for their improvement.

1517 - 1530. Unallocated

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SECTION II - OFFICER IN MEDICAL CHARGE

1531. Ships with no Medical Officer

1. In ships with a medical branch rating but no Medical Officer, the Commanding Officerwill nominate the Logistics Officer as Officer in Medical Charge who will be responsible forall non-clinical matters including the management and administration of the department,Medical Organisation for Action and to act as the Medical Stores Officer (MSO).

2. In ships in which a Medical Officer is only borne for short periods, it is at the discretionof the Commanding Officer whether the duties of Officer in Medical Charge should betransferred to the Medical Officer.

1532. Daily Sick Book Maintenance when no Medical Officer is Borne

1. The medical branch rating of any vessel (including coxswains) is to keep a Daily SickBook (B Med 33) in which Medical Officers visiting the vessel are also to enter anynecessary particulars, including diagnosis and treatment. The Commanding Officer is tosight the Daily Sick Book weekly.

2. Where an officer or rating reports sick with an illness or injury that may impair theefficient functioning of his duties the Commanding Officer is to be informed immediately.

1533. Medical Stores in Ships not Carrying a Medical Officer

1. Charge of Medical Stores. The Officer in Medical Charge is to act as the MedicalStores Officer (MSO) and is to have charge of the medicines and medical stores which willbe supplied in accordance with BR 1991 Chapter 24.

2. Replenishment of Medical Stores. The Officer in Medical Charge is to take care toreplenish the medicines and stores as necessary and to maintain and render theappropriate accounts in accordance with JSP 340, Joint Service Regulations for Medicaland Dental Material Supply and Accounting, and BR 1991. Chapter 24.

3. Drugs. The following instructions are to be observed in regard to drugs, the use ofwhich is covered by the Misuse of Drugs Act.

a. Security. Syringe ampoules containing controlled drugs and all othercontrolled drugs which may be issued to vessels not carrying a Medical Officerare supplied as a personal charge to the Commanding Officer and are to bekept under lock and key. An appropriate account is to be maintained inaccordance with BR 1991 Chapter 24.

b. Stock Control. When controlled drugs are demanded, the demand is to showthe quantity of the drug, if any, already held on board, and is to be signed bythe Commanding Officer. The stock held on board is not normally to exceedthe authorized scale and the Fleet SO1 (Primary Care) is to ensure that anadequate reason is given on the demand to justify a total holding in excess ofthe scale.

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c. Return of Controlled Drugs. When undergoing refit or transferring to thereserve, ships are to return all controlled drugs and poisons in accordancewith BR 1991 Chapter 24.

d. Royal Fleet Auxiliaries and Merchant Ships. In Royal Fleet Auxiliaries andmerchant ships attached temporarily to the Royal Navy and not carrying aMedical Officer, the Master of the ship shall be deemed to be a personauthorized to be in possession of these drugs, so far as is necessary to complywith the requirements of the Naval Service or with the Merchant Shipping Acts.It shall be lawful for him, subject to any condition prescribed by the Secretaryof State, to administer and supply these drugs to any member of the crew, inaccordance with instructions prepared and approved by the Admiralty Boardof the Defence Council or in the Merchant Service, by the Department of Tradeand Industry. The keeping of a record of these drugs in the Ship’s Log shall bedeemed to be in compliance with the requirements of these regulations for thekeeping of records.

1534. Ships with no Medical Branch Rating

1. Medical Stores Account. Accountable medical items are to be placed on theappropriate PLR and managed in accordance with current storekeeping regulations.

1535. When no Dental Officer is Borne

1. Periodic Dental Examination. In ships and establishments in which no Dental Officeris borne the Medical Officer or Officer in Medical Charge is to ensure that periodic dentalexamination of all service personnel under his medical charge is carried out and recorded.The Regional Principal Dental Officer should be consulted as necessary.

2. Dental Treatment. Known requirements for dental treatment of ship-borne personnelshould be reported in advance to the next port of call which has dental facilities, giving theprobable period during which the patients will be available.


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SECTION III - DENTAL OFFICERS

1551. Dental Officers

1. The Dental Officer is responsible to Director Defence Dental Services, through thePrinciple Dental Officer, for the treatment of dental disease or injury, the maintenance ofdental health and the prevention of disease.

2. Detailed instructions for Dental Officers are contained in BR 1991.

1552. Registration as a Dental Practitioner

1. All Dental Officers must be on the register of the General Dental Council. It is theresponsibility of individual officers to ensure that they are re-registered annually.

2. Omission or erasure from the register for any reason is to be reported to HQ DefenceDental Services immediately.

1553. In Action

1. In action and other emergency situations as required by the Commanding Officer, theDental Officer is to place himself under the direction of the Medical Officer and carry outsuch duties as may be assigned to him.


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SECTION IV - QARNNS OFFICERS

1571. Status

1. Queen Alexandra’s Royal Naval Nursing Service is a discrete and integral part of HerMajesty’s Naval Forces and its members are subject to the Naval Discipline Act 1957 andto regulations and instructions laid down for naval personnel. (See Para 0102 andPara 0121.)

2. Professional accountability for members of Queen Alexandra’s Royal Naval NursingService is through their governing body, the Nursing and Midwifery Council (NMC); anyprofessional training required to perform their primary task is provided by Defence Schoolof Health Care Studies (DSHCS). The satisfactory performance of their work is theresponsibility of MDG(N) through the Matron-in Chief QARNNS.

1572. Nursing Officers

1. Detailed instructions for QARNNS officers are contained in BR 1991.

2. Registration as a Nursing Practitioner - All Nursing Officers and Nurse Ratingsmust be on the appropriate part of the Nursing and Midwifery Council (NMC) register. It isthe responsibility of the individual officer to ensure they are re-registered in accordancewith NMC policy. Omission or erasure from the register for any reason is to be reported toMatron-in Chief QARNNS immediately.

1573. Nursing Officers in Naval Establishments

1. Nursing Officers in naval establishments other than Defence Medical Education andTraining Agency (DMETA) facilities are directly responsible to the Principal or SeniorMedical Officer and professionally accountable through the NMC.

Chapter 15

Documents

Transcript of Chapter 15