Introduction

British armed forces Service personnel with medical conditions or fitness issues which affect their ability to perform their duties will generally be referred to a medical board for a medical examination and review of their medical grading.

This may result in the patient being downgraded to allow for treatment, recovery and/or rehabilitation.

The Medical Deployment Standard

The Medical Deployment Standard (MDS) awarded can be on a temporary or permanent basis. The definitions of MDS categories are as follows:

Standard	Outline
Medically Fully Deployable (MFD)	Personnel medically fit for duty with no employment limitations.
Medically Limited Deployable (MLD)	Personnel medically fit for duty with minor employment limitations. MLD personnel may have a medical condition or functional limitation that prevents the meeting of all MFD requirements.
Medically Not Deployable (MND)	Personnel medically fit for duty with major employment limitations. MND personnel are not fit to deploy on Operations but may be deployable on UK based exercises and should be able to work effectively for at least 32.5 hours per week.

Reserve Personnel

Most Reserve personnel do not come into contact with MOD healthcare on a regular basis as their care is provided by the NHS. Therefore, if these personnel incur an injury or illness which would result in a change of MDS, the MOD will not be aware until that person is called up for service/mobilised or unless they inform the MOD as they are required to do by Reserve regulations.

Some Reserve personnel are entitled to care from the MOD (such as FTRS (FC)).

Others

Generally, MDS applies to all regular Service personnel and select reserve personnel. MDS does, generally, apply to entitled or non-entitled civilians, Foreign Service or non-UK military personnel.

The Joint Medical Employment Standard

The Joint Medical Employment Standard (JMES) is awarded by medical staff in order to inform commanders and career managers of the deployability and employability of Service Personnel. It describes the deployability, functional and geographical employability and specific medical limitations.

The Medical Employment Standard

The Medical Employment Standard (MES), an element of an awarded JMES, relates to an individual’s employment in their branch/trade duties and is expressed as numerical degrees in four functional areas, indicated by the letters:

• A (Air)
• L (Land)
• M (Maritime)
• E (Environment and Medical Support).

The medical fitness for duties in Air, Land, Maritime environments and additional Environment and Medical Support considerations are as follows:

MES Code for Air	Description
A1	Fit for flying duties with restriction.
A2	Fit for flying duties but has reduced hearing or eyesight.
A3	Fit for duties in the air within the stated employment of MedLims.
A4	Fit to be flown in a passenger aircraft.
A5	Unfit to be taken into the air.
A6	Unfit for any duties in the aviation environment.

MES Code for Land	Description
L1	Fit for unrestricted duty.
L2	Fit for high readiness roles with minor limitations.
L3	Fir for limited duties but with some restriction subject to MRA.
L4	Fit for certain deployed roles into well-established MOB locations subject to Consultant Occupational Physician MRA.
L5	Unfit for deployment. Fit for branch/trade and limited UK operations.
L6	Unfit for service in the land environment.

MES Code for Maritime	Description
M1	Fit for unrestricted duties.
M2	Fit for restricted duties afloat within the limitations as stated.
M3	Fit for restricted duties in a vessel in harbour or alongside within the limitations as stated.
M4	Fit to be carried as embarked forces in transit.
M5	Fit for restricted duties ashore within the limitations as stated.
M6	Unfit for any duties in the maritime environment.

MES Code for Environment	Description
E1	Fit for worldwide service in all environments.
E2	Fit for unrestricted duties but with a medical risk marker.
E3	Restricted employment outside the UK due to medical support or environmental requirements.
E4	Only to be employed out of the UK where there is access to established, ‘NHS equivalent or better’, primary and secondary healthcare.
E5	May be employed within the UK only.
E6	Pregnancy/maternity.