Providing Medical Support to Light Footprint Operations

Medical staff with the UK's Army Medical Services rush a mock casualty into a resuscitation suite during a training exercise

Medical staff with the UK's Army Medical Services rush a mock casualty into a resuscitation suite during a training exercise.

Photo by Sgt Rupert Frere/Crown copyright 2013


"Light Footprint Operations" (LFO) are a concept under development in relation to EU military led operations. Past EU military operations have been as diverse as mentoring and capacity building in Somalia, providing security during elections in the Democratic Republic of Congo, to providing training in Mali.

Traditional military medical support is designed for larger formations and draws on a heavier supporting infrastructure. Smaller missions could require a different type of support. With the potential for the EU to conduct operations with limited numbers of people, the LFO approach to international missions could become the preferred policy response of both national and international organisations.

In any military operation, the aim of medical support is to meet medical needs and give deployed civilian and military staff the confidence to do their jobs effectively, knowing that they will be looked after. The medical planning challenge for an LFO is that, whilst the population at risk is smaller, the hazards and risk are broader and less specific.


The aim of the study was to identify options for providing effective medical support to LFOs. The research team assessed the appropriate level of support and defined the technology, resources and skill sets necessary to achieve this level of support. The results of the study will predominantly be used to help develop doctrine but will also include practical recommendations.

Other aims of the study included:

  1. Proposing a concept of LFOs, including understanding the required medical need
  2. Analysing the current and potential future technology and resources that could be used to provide medical support to LFOs
  3. Proposing overarching standards to define Medical Support to LFOs, which favour multinational pooling and sharing solutions; and
  4. Recommending how multinational cooperation could lead to updated standards in the field of Medical Support


The study used both quantitative and qualitative data collection and analysis, including:

  • A literature review
  • Key informant interviews
  • A survey
  • A stakeholder workshop; and
  • Case studies.


  • There are a number of issues and challenges associated with the provision of medical support to LFOs in a European Common Security and Defence Policy (CSDP) context.
  • Current medical support practices to LFOs are varied. Despite there being robust standard operating procedures, agreements and doctrinal requirements of medical capabilities in place, each national medical treatment facility works to its own national clinical standard based on a country’s priorities, socio-economic development and Armed Forces.
  • Medical personnel categories were not always the same across missions, and different responsibilities and role definitions were associated with particular roles. Half of the respondents to the survey conducted as part of the study indicated that the differences in training and experiences among the medical personnel are a significant issue for the EDA participating member states at the moment.
  • The development of common standards was seen by the EDA participating member states as a welcome initiative, allowing countries to have increased confidence in the medical support provided by other countries. However, it was recognised that this would need to adhere to the national laws of the member states and international laws and regulations. In addition, standardisation may encounter resistance from medical personnel, as it could be perceived as a means of control over their practices and profession.
  • Due to cost constraints, countries are facing pressures to prioritise missions and resources. More than half of the study’s respondents considered high costs as the main challenge in the deployment of medical capabilities to CSDP missions.
  • New technologies can improve the resilience of soldiers and enhance medical support for LFOs, but further development and monitoring is required to ensure that they are fit-for-purpose during military operations.


  • Introduce changes to the current EU doctrine, which make a clear requirement for medical support provision for LFOs and seek to facilitate the overarching harmonisation and standardisation of medical support practices.
  • Improve harmonisation and standardisation for greater interoperability between armed forces medical support. An overarching EU Operational Patient Care Pathway could set out, in detail, the clinical requirements for EU missions, a common standards framework, and a set standard of clinical requirements against which both planning and provision can be based.
  • Consider opportunities for multinational cooperation in the development and deployment of new technologies to benefit medical support in a military context.
  • Seek to develop and nurture engagement and cross learning between the military and civilian medical community. There are a number of lessons that can be learned across the communities which would benefit the medical support provision. Furthermore, the EDA could further explore how the civilian military skill sets and experiences could benefit both communities.