Medical Branch Officers BRd 2

CHAPTER 15

MEDICAL BRANCH OFFICERS

(MOD Sponsor: MDG(N))

CONTENTS

SECTION I - MEDICAL OFFICERS

1501. Medical Officers

1502. Registration as a Medical Practitioner
1503. Medical and Dental Documents
1504. Daily Sick Book
1505. Medical Stores
1506. General Health of the Ship
1507. Local Medical Services
1508. Communicable and Notifiable Diseases
1509. Psychiatric Illness
1510. Health Lectures
1511. Supervision of Food
1512. Water Supplies
1513. Clothing
1514. Medical Examination of Persons Suspected of Offences under the Service
Discipline Acts
1515. Regulations on Medical Evidence at Court-Martial
1516. Naval Medical Officers of Health

SECTION II - OFFICER IN MEDICAL CHARGE

1531. Ships with no Medical Officer

1532. Daily Sick Book Maintenance when no Medical Officer is Borne
1533. Medical Stores in Ships not Carrying a Medical Officer
1534. Ships with no Medical Branch Rating
1535. When no Dental Officer is Borne

SECTION III - DENTAL OFFICERS

1551. Dental Officers

1552. Registration as a Dental Practitioner
1553. In Action

SECTION IV - QARNNS OFFICERS

1571. Status
1572. Nursing Officers
1573. 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 the
treatment of the sick or injured, the maintenance of health and the prevention of disease
and for the effectiveness of the medical organization for action.

2. Disclosure of Information. Healthcare professionals in the Armed Forces are

responsible to their Commanding Officers for the treatment of the sick and injured, the
maintenance of health and the prevention of disease. In rare circumstances, information
may have to be disclosed to the Commanding Officer without the consent of the patient or
contrary to his wishes. The patient should also be informed that confidentiality would be
breached in his interest, or the ‘public interest’. Further information can be found in
BR 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 Medical
Council. It is the responsibility of individual officers to ensure that they are re-registered
annually.

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 the
only person authorized to be in possession of medical documents which are “Restricted
Medical”. Medical and dental staff may have access to these documents in the course of
their duty.

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

1504. Daily Sick Book

1. Except in HM naval bases and shore establishments, the Medical Officer is to keep a
Daily Sick Book (B Med 33) which is to contain the names of all the sick on board and
which 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 the
custody of controlled drugs are contained in JSP 340, Joint Service Regulations for
Medical 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 the
health of the ship generally. Should he suspect the presence of disease or indisposition in
any person, he is at once to deal with the matter as may be requisite. He is to report
immediately to the Commanding Officer any factor in living or working conditions which
appears likely to reduce the efficiency of a part or whole of the ship’s company. All matters
affecting the health or efficiency of numbers of men are to be discussed with the higher
medical authority within his immediate line management without delay. (See also
Chapter 8.)

1507. Local Medical Services

1. The Medical Officer is to maintain contact with local health authorities, general
practitioners 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 of

notifiable 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 or

cases of deliberate self-harm or suicide. Guidelines for dealing with cases are contained
in BR 1991 and PLAGOS.

1510. Health Lectures

1. General. Health lectures are to be given to the entire ship’s company. A record of such
lectures is to be made in the First Aid Training Log. (See BR 1991.) The subject matter of
lectures is left to the discretion of the Commanding Officer, as advised by the Medical
Officer, 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 of
malaria, dysentery or any communicable disease, special lectures on the prevention of
these diseases, afloat and ashore, are to be given. Health lectures must reflect information
given 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 Medical

Officer’s responsibilities, concerning which he is to collaborate with the Supply Officer. He
is to pay attention to food hygiene standards and in particular to perishable foods such as
milk, ice cream, meat products, fruit and vegetables (see BR 1991). If he has reason to
suspect food poisoning he is to inform the Commanding Officer in order that an
investigation may be made. In all cases, or suspected cases, of food poisoning, a
FMED 85 is to be raised. Specialist Environmental Health Advice is available from the
NMOH(F) office.

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1512. Water Supplies

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

1513. Clothing

1. Suggestions for suitable clothing to be worn in varying climates are to be made by the
Medical 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 for
consent 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 and
PLAGOs 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 BR11

Manual of Naval Law.

1516. Naval Medical Officers of Health

The Naval Medical Officer of Health is to undertake CINCFLEET ship, submarine, RM and
unit inspections as required by Fleet Safety Management System. He is also to visit all
ships and establishments within the Command Area as he considers necessary to assess
the current standards of environmental and occupational health and to make any
necessary 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 Officer
will nominate the Logistics Officer as Officer in Medical Charge who will be responsible for
all 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 discretion
of the Commanding Officer whether the duties of Officer in Medical Charge should be
transferred 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 Sick
Book (B Med 33) in which Medical Officers visiting the vessel are also to enter any
necessary particulars, including diagnosis and treatment. The Commanding Officer is to
sight the Daily Sick Book weekly.

2. Where an officer or rating reports sick with an illness or injury that may impair the
efficient 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 Medical
Stores Officer (MSO) and is to have charge of the medicines and medical stores which will
be supplied in accordance with BR 1991 Chapter 24.

2. Replenishment of Medical Stores. The Officer in Medical Charge is to take care to

replenish the medicines and stores as necessary and to maintain and render the
appropriate accounts in accordance with JSP 340, Joint Service Regulations for Medical
and 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 of
which is covered by the Misuse of Drugs Act.

a. Security. Syringe ampoules containing controlled drugs and all other

controlled drugs which may be issued to vessels not carrying a Medical Officer
are supplied as a personal charge to the Commanding Officer and are to be
kept under lock and key. An appropriate account is to be maintained in
accordance with BR 1991 Chapter 24.

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

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c. Return of Controlled Drugs. When undergoing refit or transferring to the

reserve, ships are to return all controlled drugs and poisons in accordance
with BR 1991 Chapter 24.

d. Royal Fleet Auxiliaries and Merchant Ships. In Royal Fleet Auxiliaries and
merchant ships attached temporarily to the Royal Navy and not carrying a
Medical Officer, the Master of the ship shall be deemed to be a person
authorized to be in possession of these drugs, so far as is necessary to comply
with 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 Secretary
of State, to administer and supply these drugs to any member of the crew, in
accordance with instructions prepared and approved by the Admiralty Board
of the Defence Council or in the Merchant Service, by the Department of Trade
and Industry. The keeping of a record of these drugs in the Ship’s Log shall be
deemed to be in compliance with the requirements of these regulations for the
keeping of records.

1534. Ships with no Medical Branch Rating

1. Medical Stores Account. Accountable medical items are to be placed on the

appropriate 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 Officer

is borne the Medical Officer or Officer in Medical Charge is to ensure that periodic dental
examination 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 personnel

should be reported in advance to the next port of call which has dental facilities, giving the
probable period during which the patients will be available.

1536 - 1550. Unallocated

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SECTION III - DENTAL OFFICERS

1551. Dental Officers

1. The Dental Officer is responsible to Director Defence Dental Services, through the
Principle Dental Officer, for the treatment of dental disease or injury, the maintenance of
dental 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 the
responsibility 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 Defence
Dental Services immediately.

1553. In Action

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

1554 - 1570. Unallocated

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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 Her
Majesty’s Naval Forces and its members are subject to the Naval Discipline Act 1957 and
to regulations and instructions laid down for naval personnel. (See Para 0102 and
Para 0121.)

2. Professional accountability for members of Queen Alexandra’s Royal Naval Nursing

Service is through their governing body, the Nursing and Midwifery Council (NMC); any
professional training required to perform their primary task is provided by Defence School
of Health Care Studies (DSHCS). The satisfactory performance of their work is the
responsibility 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 Ratings

must be on the appropriate part of the Nursing and Midwifery Council (NMC) register. It is
the responsibility of the individual officer to ensure they are re-registered in accordance
with NMC policy. Omission or erasure from the register for any reason is to be reported to
Matron-in Chief QARNNS immediately.

1573. Nursing Officers in Naval Establishments

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

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