In response to your request for an internal review, as part of our informal review process we have looked at and reviewed our response to your question below:

As written in the original response, the information requested is not held centrally by DASA and to obtain this information would require a review of each individual's medical records. This would incur disproportional costs¹. Under the terms of Section 12 of the FOI Act, this means that we are not obliged to comply with your request.

In addition, releasing details of the nature of the injuries sustained for each individual could lead to that individual being identifiable and this would not be publishable under exemption S40 (personal information) of the Freedom of Information Act 2000. The viewing of medical records would also enquire the informed consent of each individual.

The NOTICAS system that records information on Very Seriously Injured/Wounded (VSI) and Seriously Injured/Wounded (SI) does not formally capture details of the nature of injuries sustained, therefore we are unable to answer your question from this source either.

However following a review of our data we have cross referenced the 210 VSI and SI UK Military personnel to the Operational Emergency Department Attendance Register (OpEDAR). Whilst OpEDAR does not formally capture details on injuries sustained, it does capture the treatment classification for an injury and we can present the numbers of the VSI and SI casualties who have been treated by each classification.

The OpEDAR system records all patients who have attended or have been admitted through the A&E department of a UK Operational hospital. The treatment classification broadly groups the data by injury treatment type. OpEDAR captures information at the initial assessment.  It is possible for this to change over the course of treatment or for a patient to have multiple conditions, however, this information is not captured.

For the 210 VSI and SI casualties, 167 had an OpEDAR record. Of the 43 who had no record, 10 occurred prior to the UK field hospital being established in April 2006 and 33 were treated at coalition facilities. DASA do not hold any further information relating to the nature of the injuries of these 43 individuals.

Table 1 provides a breakdown for the 167 Military personnel who had both a VSI or SI NOTICAS record and a field hospital attendance record. The diagnosis field in OpEDAR is free text and varies in both quality and quantity of information. To provide more robust statistics DASA use the OpEDAR treatment classifications as an indicator of the nature of the injury.

DASA does not compile statistics on amputees, however in order to supply you with more details on the nature of injuries sustained we have consulted with The Academic Department of Military Emergency Medicine, at The Royal College for Defence Medicine, who have been able to provide the required information on amputees as a type of injury sustained whilst in Afghanistan.

For the period 7 October 2001 to 15 June 2009, 47 of the 210 VSI and SI casualties suffered a traumatic or surgical amputation ranging from the loss of part of a finger or toe up to the loss of an entire limb(s).

These figures refer to live UK Service personnel who were categorised as VSI or SI and have had an injury coded as amputation (traumatic), partial or complete, for either upper or lower limbs using the Abbreviated Injury Scale (AIS) Dictionary 2005 (Military Edition), and includes those who have had a surgical amputation performed either at a military field hospital or in hospital in the UK. It is possible that some amputees are not listed as VSI or SI and these have not been included here.

The NOTICAS reports raised for casualties contain information on how seriously medical staff in theatre judge their condition to be. This information is used to inform what the next of kin are told. VSI and SI are the two most serious categories into which personnel can be classified:

The OpEDAR database records all patients who have attended or been admitted through the emergency department of a UK operational field hospital. The database contains records of all patients who attended the emergency department for Operation Herrick from April 2006 up to June 2009 (the latest date for which DASA holds validated hospital records). 

We have now completed our informal review of our response to your request for information. Please confirm if you are content with this response, if not the further independent review will continue.

If requested, a further independent internal review will be conducted by the Head of Corporate Information, 6th Floor, MOD Main Building, Whitehall, SW1A 2HB (e-mail [email address]). Please note that any request for an internal review must be made within 40 working days of the date on which the attempt to reach informal resolution has come to an end.

If you remain dissatisfied following an internal review, you may take your complaint to the Information Commissioner under the provisions of Section 50 of the Freedom of Information Act. Please note that the Information Commissioner will not investigate your case until the MOD internal review process has been completed. Further details of the role and powers of the Information Commissioner can be found on the Commissioner's website, http://www.ico.gov.uk.

The information supplied to you continues to be protected by the Copyright, Designs and Patents Act 1988. You are free to use it for your own purposes, including any non-commercial research you are doing and for the purposes of news reporting.  Any other reuse, for example commercial publication, would require the permission of the copyright holder. Most documents supplied by the Ministry of Defence will have been produced by government officials and will be Crown Copyright. You can find details on the arrangements for re-using Crown Copyright from the Office of Public Sector. Information at: http://www.opsi.gov.uk/click-use/index.htm. 

Information you receive which is not subject to Crown Copyright continues to be

In keeping with the spirit and effect of the Freedom of Information Act, all information is assumed to be releasable to the public unless exempt. The MOD therefore will be simultaneously posting the information you requested, together with any related information that will provide a key to its wider context, in our online FOI Disclosure Log at http://www.foi.mod.uk.