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Health and safety

Dreadnought update: progress for Union on recovering disrupted seafarer medical service

1 October 2025

Nautilus International's longstanding campaign to protect the Dreadnought seafarer health service has led to progress at the highest levels of government, with a commitment now in place to resolve access issues affecting members in Scotland and Northern Ireland — and to improve service delivery in England and Wales.

The Dreadnought Medical Service unit, delivered via Guy's and St Thomas' NHS Foundation Trust in London, offers specialist medical treatment for seafarers. The service exists to ensure they receive timely care, enabling them to return to work swiftly and maintain the medical certification required for sea service.

Although the Dreadnought was originally intended as a UK-wide service, seafarers in devolved nations have, in recent years, faced barriers to accessing it.

Nautilus International's head of professional and technical David Appleton explained. 'It's largely down to changes in the NHS funding model. In the past, dedicated funding was set aside for the Dreadnought. But under the current system, if someone is treated outside their local area, the treating provider must recover costs from the patient's home health authority.'

This has created challenges in Scotland and Northern Ireland, where healthcare is devolved and cross-border reimbursements have become complex.

After years of lobbying, Nautilus has now secured ministerial-level recognition of the issue. Following engagement with the Department for Transport (DfT) and the Maritime and Coastguard Agency (MCA), the Union was able to present a formal proposal to shipping minister Mike Kane before his replacement during a cabinet reshuffle.

'We received confirmation that the government supports priority treatment for seafarers; recognises that there are issues with the service as it stands; and that those issues need to be resolved. What's been proposed is that the MCA and DfT will work towards implementing devolved Dreadnaught medical services in Scotland and Northern Ireland to resolve the funding issues, so that seafarers resident in those areas are able to receive priority treatment.' Mr Appleton said.

The campaign has also highlighted concerns from members in England and Wales, who have reported not receiving priority treatment. In many cases, healthcare professionals were unaware of the service's purpose or the urgency of the referrals.

'Since services were reinstated after the Covid-19 pandemic, seafarers in England and Wales also haven't been receiving the service that they would hope to,' Mr Appleton added. 'As part of our negotiations with Department for Transport and MCA, we have ensured that the actual definition of what a priority service is can be addressed. That has been agreed upon by the minister, and we'll be looking to ensure that with that definition we can hold those delivering the service to account and ensure that they're giving seafarers what they're supposed to.'

Although it will take some time for arrangements in the devolved nations to take effect, the Union is buoyed by the government's clear commitment to maintaining a priority service for seafarers and will continue working closely with officials and stakeholders to ensure implementation.


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