Impact case study database

Following criticisms of the size and weight of body armour used during British military operations in Afghanistan (2008 to 2012), the UK MOD established ‘Virtus’, a GBP250,000,000 Defence Equipment and Support procurement programme that aimed to bring a next generation of integrated infantry load-carriage and body-armour system into service. Our research informed and impacted the design, specification and evaluation processes underpinning this programme. ( R1) provided the evidence underpinning the requirement for the new system to minimise breathing restriction, as well as the subsequent test and evaluation plan for this requirement. This directly resulted in the introduction of spirometry tests into the procurement process, to quantitatively assess the respiratory impairment imposed by any new body-armour ( S1). This body of research also demonstrated the negative impact of poorly-fitting body-armour on soldier performance. Findings were presented to the Army, and Defence Equipment and Support in July 2016 and underpinned the policy that ‘Virtus’ should fit the entire user population, resulting in the decision to increase the number of available sizes of body-armour plate from one to five ( S1). The impacts from this research contributed to the introduction into service in 2016 of a new, lighter, slimmer and more comfortable body armour and load-carriage system . This system received a 96% positive rating from troops, compared to 62% for its predecessor, has improved the wearer’s ability to perform a range of tasks, and has increased the fighting capability and protection of UK soldiers ( S2). Between 2016 and 2019, 52,000 sets of the new ‘Virtus’ body armour system were delivered ( S2), with a further 42,000 sets due to be delivered by 2021.

[Text removed for publication]. In recognition of our NFCI research expertise, Tipton was invited to join the MOD Surgeon General’s NFCI Research Steering Group, and Eglin and Tipton were invited to join the MOD’s NFCI Independent Senior Advisory Committee. According to Dr Hollis (Clinical Lead for NFCI in Defence Medical Services; British Armed Forces), ( R2) and our body of related research, disseminated through this group, has had ‘ *untold value to military patients and the Armed Forces medical community in offering their knowledge to the development of our services… documented progress and improvement in patient care has resulted’ ( S4). The impacts of improved diagnostic accuracy and patient care are significant. Between 1 April 2011 and 31 March 2018, approximately 250 (including 4 higher tariff [more severe]) claims for NFCI were awarded per year under the UK’s Armed Forces Compensation scheme. These awards totalled GBP11,527,400 with the majority to personnel of Black, Asian and Minority Ethnic descent. Since 2018, this has reduced to an average of 50 (0 higher tariff claims) claims per year ( https://www.gov.uk/government/collections/armed-forces-compensation-scheme-statistics-index).

At the other end of the temperature spectrum, heat illness resulted in 137 hospital admissions of British soldiers between 2007 and 2015, and 3 deaths in 2013. Approximately 140 soldiers per year are referred to the INM’s Heat Illness Clinic, to determine their fitness to return to duty following an episode of heat illness. ( R3), identifying a novel biomarker (myoglobin) for the detection of malignant hyperthermia, directly changed the Standard Operating Procedures of the Heat Illness Clinic with the assessment of myoglobin now included in their heat tolerance testing protocol ( S5). This change in clinical practice has improved the sensitivity of detection of individuals with malignant hyperthermia, a potentially fatal condition, and has enabled the INM to identify a number of patients at increased risk of heat illness, who would previously have been passed as ‘fit’.

( R4-6) have changed the employment policies and practices of occupational groups operating on land and water. Prior to the British Government lifting the exclusion on females serving in ground close combat roles in September 2017, females were not able to join the RAF Regiment, whilst the existing ‘fitness test’ used by this branch of the UK armed forces was not based on the role demands. ( R4) underpinned a new PES that was adopted by the RAF Regiment as an interim employment standard in October 2017. This policy change ensured that all RAF Regiment members who met the PES were physically capable of safely undertaking their role and that the RAF Regiment was compliant with UK employment and equality legislation. According to Squadron Leader Treweek, the introduction of the PES has ‘…resulted in physical training being tailored specifically to the requirements of the role, thus optimising the training pipeline, increasing first time pass rates and reducing injuries. The project has benefitted 2000 RAF Regt personnel and importantly, the introduction of this PES has enabled female recruits, who meet the PES, to enter the RAF Regt for the first time’ ( S6).

( R5) and ( R6) directly underpin RNLI policies that have been in place throughout the census period. ( R5) underpins the PES used by the RNLI to ensure that their Beach lifeguards possess sufficient fitness to perform tasks critical to the role ( S7). In 2019 alone, this PES supported 1,700 RNLI lifeguards to safely aid 29,334 people and save 154 lives ( S7). ( R6) underpins a competency- based fitness standard for RNLI lifeboat crew that ensures, through appropriate training, that the RNLI’s 6,000 crewmembers are physically capable of safely undertaking their critical job tasks ( S7). ( R5) has also had international impact. Lifeguard fitness standards supported by this research (Lifesaving Position Statement 07: Fitness Standards) are recommended by the International Life Saving Federation, which comprises more than 130 national life saving organisations across the world.

( R7) underpinned changes to the policies, practice, equipment and training of Surf Life Saving GB’s flood rescue response service, a third-sector group who undertook over 250 rescues during the 2016 floods in Cumbria and York. As a direct consequence of our research, since January 2019, flood relief technicians have used additional PPE for protection in cold environments and PPE with additional ventilation for hot conditions. In addition, work:rest scheduling has been introduced on hot days to protect workers from becoming dangerously hot and dehydrated, and additional technician training has been introduced to increase awareness of hydration monitoring and personal welfare when operating in hot and cold conditions ( S8). The dissemination of ( R6) through the Science of Flood Rescue meeting held at UoP in November 2018 led to the incorporation of this research into the UK Department for Environment, Food and Rural Affairs (DEFRA) Flood Rescue Concept of Operations (2019). This framework defines the national processes for flood rescue management and coordination, and now includes guidance on work:rest scheduling and the use of PPE, with the flexibility to layer up or down, depending on the task and environmental conditions ( S9).

Offshore helicopter services transfer the majority of the UK’s oil and gas industry workforce to and from offshore installations. Between 1976 and 2012, 31 people died from survivable water impacts in a helicopter, with the shortfall in cold-water breath-hold time, relative to helicopter egress time, implicated in this statistic. EUBS extend under water survival time to enable helicopter egress. ( R8) provided the empirical evidence underpinning the first safety standard for EUBS (CAP 1034), which specifies that EUBS must be easily and rapidly deployable (less than 12s with a single hand) and able to meet the shortfall in breath-hold time for helicopter egress, even in cold water ( S10). This standard has now been adopted by the UK Civil Aviation Authority (September 2014, ( S11)), the Irish Aviation Authority (March 2016, ( S12)), and incorporated into European Standard (EN-4856) in 2018. The benefits of this legislation are evidenced by Mark Swan (Director, Safety and Airspace Regulation, UK Civil Aviation Authority), who confirmed that it ‘ will contribute to lives being saved in the UK offshore industry in the years to come’ ( S11). The reach of this legislation is pronounced; EUBS that meet the new safety standard are mandatory for all helicopter occupants flying offshore over the UK Continental Shelf. In the UK alone, there are approximately 850,000 offshore helicopter passengers each year within the oil and gas industry. Everyone flying offshore must be trained to use EUBS meeting the safety standard, with 57,000 people receiving this training in the 6-weeks prior to introduction of the UK regulations ( S11).

In summary, original research from the UoP has: i) informed the design, specification and evaluation of a new body armour system; ii) improved the diagnosis and treatment of clinical conditions affecting workers in hot, or cold, environments; iii) defined new physical employment standards for a range of occupational groups; iv) changed occupational practices and operating procedures; and v) underpinned new UK and international aviation-safety standards and legislation. Together, these impacts have improved the protection, health, and safety of many thousands of workers across the world, undertaking a range of arduous, physically demanding roles, within defence, emergency services, the third-sector, and the oil and gas industry.