I developed these without realising what Marc had already posted -- any similarity is entirely coincidental...!
I've also realised that it looks a LOT like the insignia the Canadians are just getting rid of...! Oh well... (!).
OK, my take on a merged UK defence medical service, incorporating all the healthcare elements of the Royal Navy, the Army and the Royal Air Force.
I figure that this would be one single separate military health service, much the ame as the Belgian or South African model. Within the overall "umbrella" of the Royal Defence Medical Services, there would be three main components: the medical service, the nursing service and the dental service.
The medical service would comprise four main groups:
1. the doctors (medical officers);
2. other trained and registered healthcare professionals (some in Officer roles, some in NCO roles -- although potentially with a commissioned career path for all professionally trained healthcare staff);
3. military clinical support staff (i.e. with general military medic training but who have not undertaken or completed recognised training to practice specific statutorily registered healthcare profession);
4. non-clinical medical support staff (officers and ORs).
The nursing service would incorporate all military nursing staff, including all fully-trained and registered nurses and nursing assistants. There would be a commissioned and NCO career path for trained nurses and an alternative NCO career path for nursing assistants.
The dental service would comprise all the dentists (dental officers) and their associated clinical and support staff (although purely non-clinical support staff would now be badged with the overall medical support branch of the medical service).
Inevitably, the politics of such a merger would be rather tricky in the real world -- fortunately, I don't have to deal with that...! This is still a uniformed military service and all personnel would be expected to undergo standard military training for their roles. Just as with the current forces, additional military training to undertake medical roles with commando or airborne forces would be available on a competetive basis.
Operational uniform is relatively easy -- it's just whatever is uniform of the day wherever medical service staff are attached. Formal uniform for the merged service took a bit more working out. As barracks and clinical dress (not to mention formal parade dress) bears no resemblance to operational combat dress it was not felt necessary to be constrained by uniform colour. Inevitably a number of compromises had to be agreed by the merging services although the process also allowed for some innovations through the opportunities for development that arose as the mergers were planned.
The details of the formal uniform (main colour, branch colours, badges, grade titles, etc.) were the subject of much debate. Dark grey was seriously considered as a main colour, in order to give the medical service a unique identity of its own but, in the end (following a number of trials) the final agreement was dark blue. Formal service dress would be a single-breasted four-button, four-pocket tunic with open collar and shirt and tie -- not unlike Army or RAF service dress. Matching trousers (or skirt) and peaked service cap would complete the uniform. This could be worn without a belt for daily wear, with a fabric belt for formal wear and with a Sam Browne belt for parade dress (gold sash for OF-7 to OF-9 for ceremonial wear).
Clinical uniforms and day-to-day dress would include a simplified "working dress" version of the uniform for all branches with plain dark blue trousers (without stripes) and white shirts with pockets and shoulder straps (short sleeve without tie for clinical work; optional long sleeve, with or without tie, for admin).
The formal tunic may be worn with this order of dress if required (with a tie and either no belt or a cloth belt) but the more practical option is a military-pattern sweater with sleeve pen-pockets and shoulder straps. Dark blue would be the standard basic colour but, in keeping with Army tradition for barrack dress, branch-coloured sweaters would be optional: cherry for medical staff, green for dental staff, grey for nursing staff, royal blue for health professions and black for support staff.
Army practice was to restrict the use of coloured sweaters to WO and above but it was agreed that the option would be made available to all grades in the new combined service. Rank for all grades would be worn embroidered on soft shoulder slides. Dark blue would be the basic colour for soft shoulder slides but if a coloured sweater is worn then the slides should match the sweater and coloured backing behind the rank markings would not be required.
Senior officers entitled to wear gorget insignia would be able to wear miniature clip-on versions of these on shirt collars (per established Army practice) when not wearing a tie.
For general ward work, nursing staff would wear navy trousers with white ward tunics (male and female patterns) for nursing staff with silver-grey trim for ORs and dark blue trim for WOs and Officers up to OF-2; officers of OF-3 and above would have the option of dark blue ward tunics with silver-grey trim (although it is anticipated that they are more likely to wear undress white shirts (with or without tie). Rank would be embroidered on silver-grey shoulder slides for ORs and dark blue slides for WOs and Officers. Dental assistants would wear the same pattern of tunics with emerald green trim and shoulder slides. Where appropriate, ORs from the other health professions (e.g. radiographers, physiotherapists) would wear the same tunics with Stewart blue trim and Stewart blue shoulder slides.
A generic RDMS (or RDDS / RDNS) badge would be worn as an embroidered patch above the left breast pocket of the ward/clinical tunic, with the name and role of the individual on the right. The appropriate branch badge would also be worn on the sweaters, on a backing to match the garment. Badges for the other health professions would differ slightly in that they would incorporate the emblem of the individual's profession.
The intention was to have one basic standard format of cap and collar badges for each set of grades (ORs; Warrant Officers and junior Officers; Senior Officers; Flag/General Officers) but which could be adapted for each separate branch / staff group. Additional badges for trades and qualifications would be developed over time. Specific badges such as RAF flight surgeon, flight nurse and ambulance attendant wings would be retained almost unaltered.
For the main branch, the Army's established RAMC medical "dull cherry" colour was retained; the RN's medical scarlet was felt to be not otherwise distinguishable from all the other army units with navy caps and scarlet detailing. Some scarlet details were later added to the dull cherry such as welts and crown piping on caps -- see pics!
For the separate groups that were the health professionals and the non-clinical support personnel, two sub-branches were created within the main Royal Defence Medical Service: the health professionals would wear dull cherry but with Royal (Stewart) blue as their distinguishing colour. Their badges would replace the Staff of Aesculapius with a serpent forming a ring and a separate set of symbols would be created for each profession that would be placed in the centre of the ring. Non-clinical staff would use the standard badge but their distinguishing colour would be black alongside the dull cherry.
Nursing staff would wear dark salmon and silver grey and dental staff would wear the emerald green of the Army's RADC but with highlights of the orange worn by RN dental officers. (Note: I've just spotted small errors in both the chart for the RDDS and the illustration of the dental officer; neither is quite right as what I actually intended was a green lanyard to go with the green cap band and trouser stripes but retaining the RN orange backing behind the rank bars. I'll correct the images at some point).
Rank would essentially be Army / RAF pattern for Other Ranks as this currently applied to the majority of ORs in service; Warrant Officers would be retained in two grades (WO1 and WO2) with the usual Royal Arms for WO1 and the RM/RN usage of Crown & Wreath for all WO2. OR-1 and OR-2 grade personnel would, provisionally, be titled Medical Assistants and the first supervisory grade at OR-3 would, provisionally, be titled Leading Medical Assistant. The term "Private" was felt inappropriate and, while the Army and RAF both have corporals, there was no agreement to also include the use of Lance-Corporal.
This would initially require some clarification as the current RN trade of Medical Assistant
is a highly qualified clinical role akin to a multi-role paramedic, but yet not accredited for registered paramedic status (something the UK forces have largely failed to address as UK civilian recognition of extended roles for health professionals has outstripped their military counterparts -- and incorporating parity with equivalent civilian professions and roles would be a core aim of the newly merged defence medical service). An current RN Leading Medical Assistant
(OR-3) would therefore actually assimilate to the new service in the rank of Corporal
(equivalent to a Leading hand, RN) and initially into the generic cadre of military-trained medics but with the intention of achieving civilian parity and paramedic registration for appropriately trained and experienced staff thereafter. It is initially anticipated that, based on training and experience, the new structure would incorporate all existing Army combat medical technicians (CMT3 to CMT1) and RN medical assistants into a structure for military medics that acknowledges a number of grades of training and skills and some form of incremental sleeve trade badges would indicate this. The generic "military medic" badge (Staff and wreath on cherry backing) would be worn on the upper right sleeve, alone or above rank chevrons but below the Crown, if worn) but the clinical grade/seniority trade badge would be worn on the forearm of the left sleeve, directly above the point of the cuff. Warrant Officers would not wear trade badges on the right upper arm and would not be required to wear the left sleeve grade badge but could do so if wished. Professionally trained NCOs would wear their chevrons on Stewart blue backing and the trade badge would be replaced with their profession's insignia, worn within a wreath.
Officer insignia and grade titles were hotly debated. Much as with the creation of the RAF a century before, there were many attempts to blend different elements but ultimately none were successful. The final solution was to use pin-on metal shoulder insignia on hard shoulder boards for service / No1 dress (or the embroidered equivalent on soft shoulder slides for general wear); these would take the form of "bars" which would be arranged in a pattern that essentially equated to RN and RAF insignia for all ranks up to OF-6.
Ranks above this would wear insignia based on the RN / Army symbol for Flag / General officers but which changed the crossed baton and sword for a crossed baton and Staff of Aesculapius, with a Crown above. Individual rank markings would be determined by a number of markers below this, per RN Flag Officer pattern. This was not the preferred option of many but was eventually agreed as this was felt to be most readily discernible to forces of other countries. In place of the usual Bath star of the Army or the eight-point star of the RN an alternative symbol was sought and the eight-point Maltese cross of the Knights Hospitaller was proposed. The cap badge would be the Army general / RAF air officer badge with the crossed baton and staff symbol. Uniform embellishments would include gorget patches and cap badges with the Royal crest for senior staff officers. Peak decorations would include embroidery for OF-2 and above in recognition of their professionally qualified status and oakleaves for OF-4 and above as OF-4 would be the basic grade for medical staff at the equivalent of civilian "Consultant" status -- or "Attending" in US terminology).
The Army almost won the day with its preference for military rank titles (Lieutenant, Captain, Major, Colonel, General, etc.) but in the end no formal final agreement was reached so a simple set of role-descriptor titles was temporarily agreed for all branches, based largely on a combination of the terminology used by the three forces' nursing services to describe roles rather than ranks (which was adapted for other officer grades) and also incorporating the already established "Director" role descriptions of senior officers within the current Tri-Service medical structure.
It is hoped that more military-sounding officer titles will be agreed in time but the role-descriptions are equally applicable to all branches of the new merged service, with the basic designations being "Medical Officer", "Dental Officer", "Nursing Officer", "Associate Medical Officer" for other profesions, including pharmacists, and "Medical Support Officer" for non-clinical staff. Designations of seniority will be prefixes that include "Junior" "Senior" "Principal" and so on.
The overall professional head of service will be the Director-General of the RDMS, with a number of other senior officers in the appointments of Deputy and Assistant Director-General. There will also be specific Directors for the Nursing and Dental branches.
OK, enough blurb -- here are some pics: