UK Air Ambulances having it off??? [Archive]

Pittsextra

27th May 2013, 18:59

Sorry the night air ambulances thread was drifting but is there a point to suggesting that some of these "charities" are benefiting more than just the people they aim to pick up?

If you follow this link:-

Find charities - Charity Commission (http://www.charitycommission.gov.uk/find-charities/)

You can enter the charity number and find the % spending on salaries, admin and other spending V what gets spent on the main aim - i.e flying a helicopter to save victims.

It makes terrible reading. For instance Midlands AA spends just £258K (3% of the total) to raise its funds whilst The Air Ambulance service spends £2.3M!! (42% of the total raised)..

It does make you wonder.

Edit to add this:-

Service Services expense Running Expenses Expense % total funds

Cornwall £1,800,000.00 £827,000.00 28%
Derby/Rutland/Leic £2,300,000.00 £2,900,000.00 42%
Devon/Exeter £1,880,000.00 £2,550,000.00 35%
Dorset £1,000,000.00 £1,760,000.00 24%
East Anglian £3,100,000.00 £2,000,000.00 31%
Essex £2,800,000.00 £2,100,000.00 42%
Great Northern £2,955,000.00 £1,276,000.00 23%
Great Western £1,067,000.00 £194,000.00 14%
Hampshire £1,300,000.00 £1,130,000.00 35%
Kent £4,300,000.00 £2,370,000.00 31%
Linconshire £1,566,000.00 £748,000.00 29%
London £1,818,000.00 £928,000.00 29%
Magpas £446,900.00 £215,855.00 33%
Midland £3,100,000.00 £258,000.00 3%
North West £3,157,000.00 £937,000.00 17%
Thames Valley £1,545,000.00 £2,191,000.00 42%
Welsh £3,400,000.00 £2,128,000.00 37%
Yorkshire £2,200,000.00 £759,000.00 18%

misterbonkers

27th May 2013, 20:32

Midland £3,100,000.00 £258,000.00 3%????

£258,000,000 is a tad more than 3% so your sums are wrong on that one.

You have to spend money to get money. That's the fact of life. If you don't then you won't. 30% seems the norm.

But that said some of the money is, in my opinion, wasted. On an inaugural flight of their 'new' aircraft one charity flew a massive detour with the new aircraft in order to get some scenic snaps. Now I know what the DOC of that particular aircraft is (its not just the fuel!) and lets just say the detour will have been in excess of £1000...!

Secondly I only know of one person in the helicopter industry who earns £130,000 and drives a £70,000 Jaguar and he is Chief Exec of an AA Charity - not a bad earner eh? Liken that to comparable helicopter companies who only operate a handful of helicopters!

The problem here is if just one AA gets bad press then funding will dry up on the whole and that IS NOT a good thing as these charities do an excellent job providing fantastic care often in difficult circumstances.

Pittsextra

27th May 2013, 20:38

Hi - sorry for the confusion but the numbers are separate.. i.e In Midland AA case they raised whatever but I'm saying the value of providing the AA bit was £3.1M whilst the expenses side of the rest of the charity was £258K. So that reads £3.1M of value to the community for £258K of expenses...

Edited to add the accounts of Midlands AA:-

http://apps.charitycommission.gov.uk/Accounts/Ends18/0001143118_AC_20120331_E_C.pdf

and Derby and Leics AA:-

http://apps.charitycommission.gov.uk/Accounts/Ends74/0001098874_ac_20111231_e_c.pdf

It is a pretty amazing difference and given there is a group body I'm surprised there are not conversations being had.

SilsoeSid

27th May 2013, 22:13

How do 'The Children's Air Ambulance' (TCAA) sit amongst all those figures?

Pittsextra

28th May 2013, 08:01

The childrens air ambulance is within the numbers for Derby and Leics..

jayteeto

28th May 2013, 08:04

Geography has a lot to do with things. Highly populated areas traditionally find fundraising easier and cheaper. However we are all learning from these figures that some people have no shame. This reflects society in general, some people identify easy money and exploit it, others have a concience.
I just wish the press would take this one up.

misterbonkers

28th May 2013, 08:22

Jayteeto. I agree with you but the problem is that if the press takes it up then funding will probably dry up. Not good.

jayteeto

28th May 2013, 08:24

True, i would hope they would say most charities are good, but that spoils a story

SARWannabe

28th May 2013, 08:42

The press have taken hold of this in the case of TCAA (the important one I'm sure we all agree?) BBC News - Air Ambulance Service's fundraising and spending criticised (http://m.bbc.co.uk/news/uk-england-21290338) i'm sure there was also a TV piece made on the issue.

[email protected]

28th May 2013, 09:17

Interesting that the BBC link of SAR wanabees has another story at the bottom about ECMO teams - it makes it sound like a new capability but SAR helos have been taking ECMO teams around the country for many years.

jayteeto

28th May 2013, 09:28

There were few ecmo kits that fitted small aircraft, this has been addressed and specialised ac fits are available. A 'new' capability makes better news!

[email protected]

28th May 2013, 11:05

Well, if that new kit and the new AA night capability mean no more 6 to 8-hour ECMO transfers for SAR then whooppeee!;)

206 jock

28th May 2013, 13:19

I'm not going to get drawn into this thread or the other, but just in an attempt to ensure that no-one goes off at a tangent, every charity has a Board of Trustees, all unpaid and with no personal interests in the financial performance or direct relationships with management team personnel. Their job is to provide oversight of the management team, including budgets, incomes and outgoings. The trustees have no individualauthority, but as a group, their word is God. Oh and there is some personal liability that goes with it......

I am a trustee (for over 6 years standing) of one of the charities detailed in Pittsextra's list above, along with several other people much smarter than me (including finance directors, solicitors etc). Trust me, one of the measures that we scrutinise every time we meet is the ratio of income to fulfillment of charitable objects.

There is a scheme of delegation in place, whereby the management team can approve certain purchases, but for anything above their 'ceiling', it has to be referred upwards. And of course the salaries/benefits of the management team is approved at Board level. We benchmark senior manager salary - did you know that the average CEO salary for a 'sports' charity CEO in 2012 was £75,820pa? And an animal charity? £77k. Medical/health/sickness is £62k. Make of that what you will.

Oh and Pitts, you might want to look at charity numbers 1001064 and 1143118 together, before setting the Midlands Air Ambulance up as an icon of how it should be done ;-). Charitable spending of £6.3m, spend on income generation etc of £6.38m! Not sure what that does to your ratio, but does show that there are lies, damned lies and statistics. I have no idea why they choose to run two charities. None of my business!

Pittsextra

28th May 2013, 13:42

Jock given the involvement can i ask on what metric these trustees measure value? Especially given the wide range seen in the data and your comment regarding:-

"Trust me, one of the measures that we scrutinise every time we meet is the ratio of income to fulfillment of charitable objects"

Also what about transparancy between the charities and the beneficial owners of the commercial entities they interact with.

Thats before you come to the operators of the aircraft themselves.

Edited re: Oh and Pitts, you might want to look at charity numbers 1001064 and 1143118 together, before setting the Midlands Air Ambulance up as an icon of how it should be done ;-). Charitable spending of £6.3m, spend on income generation etc of £6.38m! Not sure what that does to your ratio, but does show that there are lies, damned lies and statistics. I have no idea why they choose to run two charities. None of my business!

Simply looks like this is the reason? AS FROM OCTOBER 1ST 2011OUR CHARITY NUMBER HAS CHANGED TO 1143118. FOR FUTURE INFORMATION ON MIDLANDS AIR AMBULANCE, PLEASE REFER TO THE NEW CHARITY NUMBER

The funds got spat across and retained for future use see here from the accounts:-

Other
incoming resources:

Funds transferred

from
Midlands Air Ambulance Trust 5,846,258 5,846,258

.... To be honest if as you say you are a trustee of these things the fact you are oblivious to these things kind of says it all...????!!!

If i was a trustee with the childrens AA I'd want to know how my office expenses are 10x those of Midland AA.... Then I'd ask who we pay rent to...

206 jock

28th May 2013, 13:54

I'm not going to get drawn into this thread or the other

And you wonder why.....

I've been called many things, but obvious...never:O

Pittsextra

28th May 2013, 13:55

Yes sorry for the typo... now having given us the big speach how about a straight answer to a straight question.

Thomas coupling

28th May 2013, 14:01

206 Jock,

Don't post if you don't want to become involved.

I say this to you. I ran a police/hems outfit for many many years as Chief Pilot. I did the maths for procuring the a/c (direct purchase, not lease), for comparing turnkey with other options. I knew the salaries of everyone working there including the Insepctor who ran the whole caboodle. I knew the running costs down to the last penny and presented this to the CC each and every year for his public audits.
When you describe what you come across as a trustee suggests to me that you have swallowed the band wagon pill......

£75,000 to run a one / two ship operation is ridiculous - try £45000.
Turnkey - possibly the most expensive form of operating ever. The helicopter lease company is most certainly laughing all the way to the bank here with YOUR money. IF you had any business acumen you would recommend someone sat down and costed the purchase and running of their outfit as a stand alone outfit. Overheads would HALVE overnight. But no-one wants the hassle of logistics/PBH/SBH and all that is associated with running their own show. After all it's someone' else's money (public) and the boss is only getting £75000 for his efforts:eek:
If I told you the running costs of a modern police outfit by comparison - you'd choke on your muesli and cafe latte :uhoh:
[And the reason for the disparity - one is publically audited and the other isn't].

206 jock

28th May 2013, 14:07

If i was a trustee with the childrens AA I'd want to know how my office expenses are 10x those of Midland AA.... Then I'd ask who we pay rent to...

So would I! I'm certainly not associated with TAAS in any way. I'm not sure what your big question is, it seems to be shrouded in innuendo.

TC, sounds great. Why don't you step up to the plate and change the world for your local operation? I'm sure they'd want you on the inside pissing out rather than the other way round.

Pittsextra

28th May 2013, 14:18

Jock - the question was:-

"on what metric these trustees measure value? "

I don't think that was vague or shrouded in anything!

What seems slightly odd on first look is that you have an association and yet there are obviously big gaps between the organisations, yet this isn't a new field of operation.

Thomas coupling

28th May 2013, 14:33

206Joke: ooooooh meeeeow.

I thought you weren't being draaaaaaaaaaawn in old boy.

Methinks you (as a trustee) are the problem and not looking for a solution to the problem perhaps. But don't let me draw you in. :suspect:

206 jock

28th May 2013, 15:20

TC, not only are you a source of endless wit, but you can pick apart a whole strategy based on something you did many years ago and something else you thought you read on an internet forum! Damn hot, you're wasted on the helicopter industry.

But don't let me draw you in. Don't worry, I won't.

Pitts, the AAA is an umbrella body but isn't an organisation providing leadership to the sector. Many charities are members, some are not (including TAAS) - if they tried to adopt a leadership role, more charities would leave, simple as that. 'My' charity is a member and we regularly review the benefit of continuing.

Pittsextra

28th May 2013, 15:32

Hey Jock - why the resistance to join a group that allows a dialouge across the sector?

Anyway what about the "what metric is used to measure value"..

206 jock

28th May 2013, 16:10

I cannot speak for what individual charities regard as important, but it appears that some have a different view of what is right - for example, the CEO of TAAS (and presumably, his trustees) seems to believe that there needs to be a new model of service based on regional deployment - I happen to disagree with him as a) all evidence points to local fundraising for a local service is what works and b) because I'm not convinced that 'what is right for patients' is driving his agenda :hmm: .

I certainly don't want to paint a picture of love and harmony in the AA sector, there are lots and lots of agendas at play. All I can say is that the charity I am involved with is well run and the focus is on providing excellent services to the patient, in line with our charitable objects.

I'm not avoiding your point on value, but I'm not sure what you are getting at.

Pittsextra

28th May 2013, 17:19

Jock given the total market is in reality a few charities and a handful of operators how hard can it be??

I'm not sure what you trustees do when the Marks and Spencer luxury biscuit selection get pulled out several times per year but how hard can it be to benchmark against each other, and actually if the aim is to provide the best value for money then as a trustee I'd have thought you'd want to do that.

I'd want to know that my AA was paying the correct rate for its EC135, MD900, etc (Especially since half the time you are actually dealing with the same operator - how hard would that be to see that you're paying the same for your 135 as the next guy is from Bond??) I'd want to ensure that my overheads were inline with the rest, and actually I'd be pushing to meet with the other operators / charities to standardise the format of reporting so that it was as easier for me to read-across all charities.

The compensation to some of these entities is on a par at director level to FTSE250 organisations and yet these things have revenues in the £2-4m range; that is a joke.

You asked what I was getting at and I suppose the title of the thread says it all - are UK AA having it off? Looking at a range of P&L's some most certainly are and actually long term it will blow up in the face of AA collectively as one or two bad apples will turn the public off.

You might also notice that despite me asking several times you still haven't answered the question "what metric is used to measure value"...

I was thinking you might be able to offer something like £X per rotary hour is the industry mean and we are within X% of that. Or X% of income generation spending to income received... etc....

Finally if you believe in the "because I'm not convinced that 'what is right for patients' is driving his agenda" statement re: TCAA then wouldn't you consider it a good thing to reveal what you believe his agenda is, and if that isn't noble to raise it as a worry/complaint?

Hedski

28th May 2013, 21:19

206Jock,

When you say the board of trustees of an air ambulance has no direct relationships with management team personnel what do you mean exactly?
I'm curious as 2 members of LAA board are directly involved with the management of the operation.

FairWeatherFlyer

28th May 2013, 22:47

206 jock, applause for your contribution of time to the charity sector, ignore the personal snipes from the geniuses of t'Internet.

On the subject of benchmarking, it's something my industry is rightly obsessed with and notoriously bad at. Apples need to be compared with apples. On the financial side, my company only started benchmarking against competition about 5 yr ago on departmental internal revenue of circa 1bn GBP and we are still comparing apples with pears :(

Remember there are only two types who can truly run an organisation efficiently: anonymous commentators on Internet and tabloid journalists.

Hedski

28th May 2013, 22:55

Benchmarking would be nice for HEMS pilots. Now Multi-Crew night ops are entering the fray how about paying Multi-Crew wages given there's a mass exodus to the North Sea. Even the IR guys operating 2 crew in the south eastern based red machine have not had a proper rise in wages in line with the rest of the helicopter industry for many years.......:ugh:

End rant.

jayteeto

29th May 2013, 08:59

Fairweather, classic line, so true

Thomas coupling

29th May 2013, 09:26

I would agree also. Look at all the CEO's of banks and big businesses who are retiring/resigning/falling on their swords during the spring clean this economic crash has brought about.
It really would seem anyone could run businesses better than the so called 'experts'. One doesn't necessarily need to be business savvy - try charismatic and sciolistic perhaps.........................:suspect:

Hughes500

29th May 2013, 10:00

TC

Not sure all the police authorities could hold their hands up as being efficient. Can think of one who employed 2 full time engineers to look after 1 x 105 and then 1 x BK117. The machines were either that unreliable or people weren't doing that much, nice work if you can get it ???
There are a lot of people on here who don't have a clue about running an operation, they need to speak to those who have to write the cheques from their own account, then they will really know how much these things cost !

Pittsextra

29th May 2013, 10:31

From myside its less about being an expert in the operation and more a question of "why is X AA able to operate for so much less than Y"... the costs are nothing about helicopters tbh as in the context of AA the helicopter running bit is classed as charitable spending.

Thomas coupling

29th May 2013, 10:44

Hughes500 long time no see?
To be fair and in defence of the "Police Authorities" (who don't exist now that the Police Commissioners have arrived), it isn't them who hire and fire. In the example you gave (D and C Air Support many many years ago, I suspect), the PA would have approved the advice of the then UEO. He subsequently went on to become quite influential elsewhere.
In those days the police were still learning about how to run helo ops including the overheads etc.
Nowadays there is no way on earth that PA's would be seen to waste money because of all the scrutiny associated with their funding. Also - don't forget: they talk to each other, and this is the big difference - all their dirty washing is aired in public whereas with the air ambulances, they dont and it isn't :eek::eek:

SilsoeSid

30th May 2013, 11:31

The childrens air ambulance is within the numbers for Derby and Leics..

I know that it doesn't take much, but I'm confused, how does that work?

Isn't the financial link and extrapolation of figures between TCAA and Derby/Rutland/Leic mentioned in post 3 (http://apps.charitycommission.gov.uk/Accounts/Ends74/0001098874_ac_20111231_e_c.pdf) a bit thin, as the only mention of TCAA in that report is, "In October 2011 we instigated talks with the Childrens Air Ambulance, a formal transfer of undertakings occurred on 1st January 2012."

Can you not get the figures from it's own page?

1111780 - THE CHILDREN'S AIR AMBULANCE
THE CHILDREN'S AIR AMBULANCE WILL PROVIDE "FREE" LIFESAVING FLIGHTS TO ANY CHILD BETWEEN THE AGES OF NEWBORN AND 16 YEARS WHO REQUIRE IMMEDIATE TRANSFER TO A "HOSPITAL OF EXCELLENCE" IN ORDER TO RECEIVE LIFESAVING TREATMENT. (http://apps.charitycommission.gov.uk/Showcharity/RegisterOfCharities/CharityWithPartB.aspx?RegisteredCharityNumber=1111780&SubsidiaryNumber=0)

...or looking at its own website; TCAA | About Us | The Air Ambulance Service (http://www.theairambulanceservice.org.uk/about-us/our-services/the-childrens-air-ambulance) ... as TCAA are using TAAS's charity number, they should be part of

1098874 - THE AIR AMBULANCE SERVICE
OPERATOR OF TWO HELICOPTER EMERGENCY SERVICES, AND THE CHILDREN'S AIR AMBULANCE TRANSFER SERVICE. (http://apps.charitycommission.gov.uk/Showcharity/RegisterOfCharities/CharityWithPartB.aspx?RegisteredCharityNumber=1098874&SubsidiaryNumber=0)

...who used to be;
1144929 - TAA SERVICE
Other names
THE AIR AMBULANCE SERVICE (OLD NAME)
T.A.A.S (OLD NAME) (http://apps.charitycommission.gov.uk/Showcharity/RegisterOfCharities/CharityFramework.aspx?RegisteredCharityNumber=1144929&SubsidiaryNumber=0)

...So, who is;
1138457 - LUCY AIR AMBULANCE FOR CHILDREN CHARITY
LUCY AIR AMBULANCE FOR CHILDREN CHARITY HAS BEEN SET UP TO BE THE FIRST, DEDICATED AIR TRANSFER SERVICE FOR NEONATAL AND CHILDREN UP TO 16 YEARS OLD ACROSS THE UNITED KINGDOM. (http://apps.charitycommission.gov.uk/Showcharity/RegisterOfCharities/CharityWithoutPartB.aspx?RegisteredCharityNumber=1138457&SubsidiaryNumber=0)

Anyhoo, pitts, any chance of a separate TCAA %-age breakdown as in post 1?
I keep getting the charity bags through the door and seeing the collection pots next to 'self standing air ambulance' collection pots and wonder what's going on!

Pittsextra

30th May 2013, 12:09

Hey - i took their charity number off their site but I think there has been some formalisation of things, from the TAAS accounts:-

“In October 2011 we instigated talks with the Childrens Air Ambulance, a formal transfer of undertakings occurred on 1"January 2012. We also created a new identity in The Air Ambulance Service to reflect our new national chanty status, and in April 2012 effected a formal change of the charity's name.”

Although if you punch the number 1111780 into the charitycommission site (link in first post) it looks pretty grim... £563k raised, which cost £427k to get and £61k spent on charitable spending...and even that seems to be debatable when you look at the accounts ,especially since no helicopter existed at the time.

To quote the accounts prior to the "merger":-

An appropriate aircraft has been identified to service the needs of the Children's Air Ambulance service.
Research is on-going to ascertain the acquisition and fitting out of appropriate medical equipment and
furnishings.

No leasing arrangement for an aircraft has been entered into at the time of publication

It seems a grubby business.

Tq Monster

30th May 2013, 12:45

And it's not just "is this burning sensation normal"?

The Children's Air Ambulance, is there a real need? I may be a little cynical but I get the feeling that it is just a marketing ploy to tug on the heart strings.

Having done a little research, I have found that there are very few Children's hospitals Nicu's Picu's around the country with dedicated helipads. Also that the amount of transfers/repatriations are so low that it could easily be covered (already are) by the Air Ambulance community as it stands.

I'm all for giving sick children a ride in a helicopter and my views may be tainted by previous incarnations of the Children's Air Ambulance, but when there is so much discussion about AA funding and how the money is spent. Why has nobody asked if we need another one?

homonculus

30th May 2013, 20:28

Sorry TM

I am no apologist for this charity but inter hospital paediatric transfers are well demonstrated to be necessary and to save lives. Both neonates and children need transfers to specialised units. We have national guidelines for standards and these transfers need specialised staff and equipment not available on HEMS

You are correct that that many hospitals do not have dedicated helipads some 30 years after it was made a national requirement to consider their provision, but this effects adult transfers as well and is not in itself a reason to deny these patients dedicated transfers.

[email protected]

30th May 2013, 21:08

Yes, SAR helos often use Regent's Park as an LS for some London hospitals.

air pig

30th May 2013, 22:13

I am no apologist for this charity but inter hospital paediatric transfers are well demonstrated to be necessary and to save lives. Both neonates and children need transfers to specialised units. We have national guidelines for standards and these transfers need specialised staff and equipment not available on HEMS

You are correct that that many hospitals do not have dedicated helipads some 30 years after it was made a national requirement to consider their provision, but this effects adult transfers as well and is not in itself a reason to deny these patients dedicated transfers.

There are not just helicopter transfer companies/charities available, there is a fixed wing capability in the UK within the private sector such as AirMed at Kiddlington who have undertaken many neo-natal and paediatric transfers and also CEGA undertake these operations. In fact Airmed undertake international neo-natal and paediatric repatriation work. A team two days ago brought a baby back from the USA, and in conjunction I believe with the RAF been to Bastion to bring a baby home and have moved patients from the North-west to the London area. Sometimes helicopter transfer is too slow for long distance transfers of paediatric and neo-natal patients.

air pig

30th May 2013, 22:18

Yes, SAR helos often use Regent's Park as an LS for some London hospitals.

Speaking to a doc the other week from the transfer team at GOS/CATS, who said the RAF are absolutely superb when undertaking this sort of transfer, also an ECMO transfer into the NW ECMO centre in Manchester a team a long time ago said the same of a team from 202 Squadron from Leconfoeld.

Thank you.

homonculus

30th May 2013, 22:51

Rotary is not too slow - these transfers are never emergencies in the medical sense although they may be urgent. Minutes do not matter and we work hard to prevent rushing. However beyond a certain distance the cost and (almost) door to door transfer of rotary is balanced by fixed wing. We have been operating both for almost thirty years.

Sadly military aircraft are not ideal. They may be free to the NHS at point of use, they may fly when civilian aircraft cannot, and they may be big, BUT vibration levels are physiologically damaging to sedated patients, noise levels make monitoring more difficult. The lack of fixed equipment results in problems with security, power and gas provision plus in practical terms a less comprehensive module. The medical teams can never have the familiarity and experience of the airframe that they do with their own aircraft and it remains a hotch pitch

The SAR posters will attempt to shoot me down, telling me how many 'successful' transfers they have undertaken, but the level of medical care will always be compromised. This country should have dedicated ITU inter hospital transfer systems. We don't use tanks instead of ground ambulances and nor should we use SAR because the state refuses to meet its responsibilities. We undertook such transfers for almost 20 years but the NHS repeatedly refused to pay

[email protected]

31st May 2013, 05:10

The SAR posters will attempt to shoot me down, telling me how many 'successful' transfers they have undertaken, but the level of medical care will always be compromised yet they keep on tasking us to do them and, when time is of the essence, getting that person to the specialist medical care they need appears to be the correct clinical decision or we wouldn't be asked in the first place.

homonculus

31st May 2013, 06:15

You are absolutely correct. For 20 years, faced with a free transfer from SAR or paying a couple of thousand pounds for a dedicated system, hospital managers took the free option. Basically they refused to pay until there was no alternative.

What you are doing is indeed better in many cases than no transfer at all. However the taxpayer is suffering a bigger hit and patient care cannot be as good.

The need for transfers has fallen due to developments in intensive care and to a degree the destruction of specialised units by politicians. Nevertheless I believe some 300 transfers a year do not occur because the NHS wants to save money. Some of these go by road to the potential detriment of the patient. Others simply don't happen. England and Wales.would be adequately covered by two helicopters and one fixed wing (ignoring maintenance)

Hughes500

31st May 2013, 06:54

TC

have been around but so busy in the past 4 months haven't had time to do much else ! My concern over the whole AA thing is they seem to be getting away from the concept of getting someone to hospital and best medical support asap. I know the mil called it the golden hour and they now take a whole trauma team to the casualty in Afgan, but that is for the guys and gals being blown up. It seems that AA's over here are going down the same way, why ? Don't see too many people being blown up over here. So why have a very very expensive machine now being twin pilot IFR capable when a much cheaper and probably more efficient system with perhaps a greater number of machines could be utilised otherwise we will be seeing CH47's with a mini hospital in the back being deployed
I would love to know how many shouts end up being needed ? What I mean is the patient would have either died or been seriously impaired for the rest of their life if it wasn't for a helicopter. I can remember one incident with a broken leg on a rugby field where we got an air ambulance, great for the kids to see but !!!!!!!!!!!!

One35

31st May 2013, 11:04

My concern over the whole AA thing is they seem to be getting away from the concept of getting someone to hospital and best medical support asap. I know the mil called it the golden hour and they now take a whole trauma team to the casualty in Afgan, but that is for the guys and gals being blown up. It seems that AA's over here are going down the same way, why ? Don't see too many people being blown up over here.

I'd dispute that the approach taken by the MERT in Afghanistan isn't relevant in the civilian sector back home. Trauma is trauma, whether it's as the reult of an IED or an RTC and we'd be foolish to ignore the impressive results achieved by the military.

It's also worth remembering that the concept of taking extended care to the patient, in addition to taking the patient to a definitive care centre, has been evident in civ practice for a number of years and has been shown to work. London HEMS is a prime example.

Apologies for the thread drift.

homonculus

31st May 2013, 17:19

The improvements in Afghanistan have in the main been driven by money. . For example every casualty is met by a CT scanner and consultant radiologist. The ability to evacuate to the UK etc etc. And the money to train every member of the medical ream for weeks before deployment whereas in the UK managers wont stop clinical work for training.

The prehospital team has been improved by including a doctor, but this really just follows the Sheffield study which showed the only benefit they could demonstrate from HEMS was the occasional medical intervention in the field if the helicopter carried a doctor.

The main difference IMHO is that in the theatre of war you get sadly recurrent major trauma and in most cases an embedded first responder who can task HEMS. In civilian scenarios many patients have quite minor injuries and there is a political requirement to decide the response at notification with minimal information, so most HEMS missions do not improve outcome

This is as mentioned off thread as the issue is whether we need massive complex machines. There is no evidence they will improve patient outcome.

Hughes500

1st Jun 2013, 07:18

Is there any information out there that actually breaks down the number of missions that actually have saved a life instead of backing up an under resourced land ambulance. I get the impression an AA is launched for relatively minor injuries. Certainly a CP of an AA gives me that impression

Flaxton Flyer

1st Jun 2013, 09:50

I get the impression an AA is launched for relatively minor injuries. Certainly a CP of an AA gives me that impression

Then perhaps that AA should be taking a good look at their launch protocols and how they are applied...

homonculus

1st Jun 2013, 10:42

The only proper audit of 'lives saved' is some 20 years old and called the Sheffield study. It demonstrated that HEMS with doctor as in London saved 1-5 lives a year at a cost then equivalent to heart transplantation. This would now be more like three times a heart transplant. It failed to demonstrate lives saved for paramedic HEMS. Sadly no service has produced any peer reviewed data in the mainstream medical literature that I am aware of - happy to be proved wrong

HEMS do not task themselves. The decision to launch is taken by the ambulance service. Some services have a specific controller who oversees this. Some services will task in order to meet government targets on arrival time - so they may send a helicopter to a minor problem because they have no land based ambulances or because the land based service would take longer than the target time they have to meet. I know of one service that uses or has used midwives and first aiders to meet the targets, so if you cut your finger you may get the local butcher with a bandage or a twin engined IFR helo solely on the basis of what is available to the controller. Welcome to the logic of the NHS

FairWeatherFlyer

14th Dec 2013, 11:47

More developments in salaries/transparency:

Analysis: Fat cats? The bigger picture of senior salaries | Third Sector (http://www.thirdsector.co.uk/news/1224165/)

And from the tabloids:

Charities set to be forced to be more open about how much they pay their top executives - Telegraph (http://www.telegraph.co.uk/news/politics/10516542/Charities-set-to-be-forced-to-be-more-open-about-how-much-they-pay-their-top-executives.html)

Geoffersincornwall

14th Dec 2013, 17:55

At the risk of a little thread drift those who have contributed to this thread may like to read about how we dealt with the very first UK AA's dispatch protocols.

I am giving a series of talks as an AA fund raiser and book promotion and produced a booklet to accompany them. This describes how the project came about and is available as a download from the blog section of my website and I think that some parts of the tale will surprise you. Visit Geoff Newman (http://www.geoffnewman.co.uk) - ignore the book sales part, go to the blog and download the booklet.

In those days we faced a different set of problems and could only dream of being able to raise the funds raised across the UK today. Imagine what it was like starting off with not a single penny in the pot.

G.

Geoffersincornwall

22nd Dec 2013, 15:41

Thanks to the large number of folk that downloaded my booklet and gave me valuable feedback. If there are any more questions about that fascinating period please don't hesitate to PM me.

G.

PS. I'm particularly interested in discussing the approach we had to dispatch criteria compared to what we see today.

DeltaNg

23rd Dec 2013, 08:01

I think that the secondary mission (surveyed site -> hospital) is very much underused these days due to a) the time it takes to achieve patient to hospital b) the cost c) the aims & ethos of the charity.

Geoffersincornwall

23rd Dec 2013, 14:00

Are you saying that the road situation is now such that an emergency vehicle can be 'returned-to-service' in an acceptable time frame?

Maybe that's the case in some areas - that's progress. Maybe not so easy to achieve in the more difficult rural areas.

In which case is this business of 'policy' overshadowing the possibility of using the AA in it's role as 'force-multiplier'?

ie, being operated for the maximum benefit of the Ambulance Service as a whole.

Is there an argument therefore, in favour of a review of current dispatch criteria? Are we using the potential of the AA to its maximum?

G

jimf671

19th Jan 2017, 15:23

A few words about the AA approaches that I have come across.

Just yesterday I came across a project that is expected to bring more diagnostic capability to the flightsuit pocket of air ambulance medical staff.

One manager from a rural UK air ambulance district has been annoying some of his air ambulance colleagues from more populated areas by stating that the only valid reason for having an air ambulance is rural location and distance.

Norway has only six SAR helicopter bases but a network of 12 helicopter air ambulance bases (& 7 FW) with some enhanced capability and typically flying with pilot, doctor and paramedic (sometimes rescuer). The Doctor and Paramedic are trained to provide aircrewman services during different phases of the operations. One mode of operation is to insert a paramedic at the casualty's location, possibly using long-line, so that there is medical aid until the SAR helicopter arrives to extract with its winch. Getting help to the casualty's side in the minimum time seems to be given a very high priority and then extraction can take place when the appropriate resources are available.

hargreaves99

25th Mar 2024, 13:58

From Private Eye Magazine, March 2024

https://cimg9.ibsrv.net/gimg/pprune.org-vbulletin/962x1000/1_13de63a926a54a413086763558e82fe9036987e6.jpg

Northernstar

25th Mar 2024, 17:29

Wonders will never cease. Is this the first instance of a UK HEMS charity being proven to be at fault? There are certainly many high profile charities with royal links who behave in similar fashion when it comes to the rule of law, just culture and bare bones proper procedure.
As we have said before one need not look far to find abuses of power and position amongst charities. Maybe Private Eye will start to dig further.

Sir Korsky

25th Mar 2024, 17:45

Out of interest, in the UK, what proportion of ' medical missions ' are scene flights vs hospital transfers for the typical operator ?

P1tchlink

25th Mar 2024, 19:43

I find it interesting that the ‘whistleblower’ is making so much noise on this technicality over a CV inaccuracy, when the noise may cause the charity commission to happen across the ramifications of some of the decisions he made just before resigning, particularly where it comes to service capabilities/availability.

[email protected]

26th Mar 2024, 13:16

Doesn't say much for the integrity and quality of those charged with running such important charities - this sort of thing will make people hesitate to put money in the tin if they think it isn't being used properly.

gipsymagpie

26th Mar 2024, 22:03

Out of interest, in the UK, what proportion of ' medical missions ' are scene flights vs hospital transfers for the typical operator ?
It's relatively rare from my understanding. Scottish do it relatively frequently however (remote islands) and Wales has a transfer team but not much call for it otherwise. The crews and role fit are more oriented to HEMS not Air Ambulance

The charities commission has made it considerably easier in recent times to check up on how your charity spends their money.

It ranges from the inefficient:
https://cimg0.ibsrv.net/gimg/pprune.org-vbulletin/1080x1645/screenshot_20240326_220450_chrome_a0305bb018df89e411286ba3ef 6a8377d00174cb.jpg
To the efficient:
https://cimg3.ibsrv.net/gimg/pprune.org-vbulletin/1080x1623/screenshot_20240326_220710_chrome_48c07d0c6aac465aa85b0efc0b 3232e9e2aa8e82.jpg
Take a moment to check what your local one is doing.

AeroAmigo

27th Mar 2024, 14:23

My local Air Ambulance is unfortunately the one shown as demonstrably inefficient. To anyone ITK why would over two-thirds of total expenditure be on raising funds? To add, this particular Air Ambulance has two heli's and two bases that are very well established and have been operating for years.

gipsymagpie

27th Mar 2024, 15:21

Northernstar

28th Mar 2024, 08:00

Those numbers tell a tale. Although the number of employees earning within certain pay brackets or bands also tells a tale.

A charity previously earning more than the vast sum they are attempting to raise now, including by direct approach to government for tax payer funding, spending more than 50% on fundraising with so many employees and several in the 6 figure bands is ludicrous. One wonders if the charity commission look at those elements in detail.

https://register-of-charities.charitycommission.gov.uk/charity-search/-/charity-details/801013

Hughes500

28th Mar 2024, 10:03

well just look at a certain ex political leader who earns north of £ 600k !!!!!!! working for a charity, where is people's moral compass ?

Thud_and_Blunder

28th Mar 2024, 12:11

I have always been aware of the 'interesting' approach by "The Air Ambulance Service" [sic] to fund-raising, expenditure and emoluments, but I was taken aback by the number of high-paid "helpers" in Northernstar's link. Educational. On another subject: do TAAS still call every flight - including positioning, air-tests and the like - a "mission" for their annual stats?

It might be helpful to the public if charities could be obliged to print those pie-graphs nice and clearly next to their collection boxes and tins, in the hope that people might be a little more enquiring over where their hard-earned donations are actually going. Defo time to do some moral-compass-swings, methinks.

nowherespecial

29th Mar 2024, 05:40

Caution, alternative take on the charity sector.

I have no affinity or allegiance for or to any EMS operators, for profit or non profit, in the UK but I think there are several other ways of looking at these statistics and it's important to know exactly what is loaded into the 'admin' and what is loaded into the 'charitable activities' parts of these pie charts.

Some of these charities will load all their 'costs' into the admin, potentially including pilot and AME salaries, doctors. The 'money spent on charitable activities' could be direct flight costs only including fuel, landing fees, pbh etc. I'm not excusing anyone but I think it's important to have the full picture and realistic expectations as I doubt very much if the pie charts are as simple as 'office based' vs 'aircrew/ engineers'. I also doubt these stats are reported the same way by each charity.

Where I do take some issue with the comments made above is the rather odd insistence that somehow the 'support staff' should somehow work for free or minimal compensation because it's a charity. I would be curious to know how various posters expect these people to feed themselves and pay rent/ mortgages? IUsing the 'it's a charity' logic, should the flying staff also work for free? While I understand that the donating public should know how much of their donated money gets spent directly, around 50% is fairly good by charity standards. Feel free to look up the UN and large charities like Children in Need as a comparison. Fundamentally, if you want credible, qualified, full time and competent staff, you have to pay for that. What's the alternative? Pilot's doing the CEO job part time and engineers shaking buckets at the station on down time?

Using the London AA as the provided example, it's a 16m GBP revenue business and the top earners (likely medical director and CEO) are making 140k tops. That's a North Sea S-92 captain's salary. Running an organisation with 205 staff (including more than half who do work for free) is a very responsible job. I think 140k is actually quite low personally for that level of responsibility. I guarantee the Medical Director can earn significantly more in private practice or the NHS.

Read the financials at the end. Great insight: https://register-of-charities.charitycommission.gov.uk/charity-search?p_p_id=uk_gov_ccew_onereg_charitydetails_web_portlet_ CharityDetailsPortlet&p_p_lifecycle=2&p_p_state=maximized&p_p_mode=view&p_p_resource_id=%2Faccounts-resource&p_p_cacheability=cacheLevelPage&_uk_gov_ccew_onereg_charitydetails_web_portlet_CharityDetail sPortlet_objectiveId=A14286736&_uk_gov_ccew_onereg_charitydetails_web_portlet_CharityDetail sPortlet_priv_r_p_mvcRenderCommandName=%2Faccounts-and-annual-returns&_uk_gov_ccew_onereg_charitydetails_web_portlet_CharityDetail sPortlet_priv_r_p_organisationNumber=801013

My 5c worth anyway.

hargreaves99

29th Mar 2024, 08:09

Let's not forget that some AA's in the UK make their pilots pay (or the pilots offer free working days) in exchange for LPC/OPCs, some (eg London) expect pilots to self-fund type ratings for just a summer of work.

gipsymagpie

29th Mar 2024, 11:19

Caution, alternative take on the charity sector.

I have no affinity or allegiance for or to any EMS operators, for profit or non profit, in the UK but I think there are several other ways of looking at these statistics and it's important to know exactly what is loaded into the 'admin' and what is loaded into the 'charitable activities' parts of these pie charts.

Some of these charities will load all their 'costs' into the admin, potentially including pilot and AME salaries, doctors. The 'money spent on charitable activities' could be direct flight costs only including fuel, landing fees, pbh etc. I'm not excusing anyone but I think it's important to have the full picture and realistic expectations as I doubt very much if the pie charts are as simple as 'office based' vs 'aircrew/ engineers'. I also doubt these stats are reported the same way by each charity.

Where I do take some issue with the comments made above is the rather odd insistence that somehow the 'support staff' should somehow work for free or minimal compensation because it's a charity. I would be curious to know how various posters expect these people to feed themselves and pay rent/ mortgages? IUsing the 'it's a charity' logic, should the flying staff also work for free? While I understand that the donating public should know how much of their donated money gets spent directly, around 50% is fairly good by charity standards. Feel free to look up the UN and large charities like Children in Need as a comparison. Fundamentally, if you want credible, qualified, full time and competent staff, you have to pay for that. What's the alternative? Pilot's doing the CEO job part time and engineers shaking buckets at the station on down time?

Using the London AA as the provided example, it's a 16m GBP revenue business and the top earners (likely medical director and CEO) are making 140k tops. That's a North Sea S-92 captain's salary. Running an organisation with 205 staff (including more than half who do work for free) is a very responsible job. I think 140k is actually quite low personally for that level of responsibility. I guarantee the Medical Director can earn significantly more in private practice or the NHS.

My 5c worth anyway.
I agree that it may not be apples for apples in those statistics but the difference in the two charts above is stark. I am fairly sure pilot and engineering costs cannot be included in the "generating income" costs even if part of a contract with an aviation provider and why would the charity do so anyway as it's to their disadvantage.

The cost to deliver one aircraft in those two organisations is roughly the same - £4 million per airframe.

I absolutely support the work of the delivery side of the Air Ambulance sector, but some of the shenanigans mentioned above about pilots paying for their own training and the appalling ineffectiveness of that one particular organsiation should be highlighted to the people making donations. It is a gross outlier across the sector (go ahead, check my working) and has been doing as badly for years (it only put 19% of it's expenditure into charitable activities one year).

[email protected]

29th Mar 2024, 14:34

If they are paying the people who take no physical risks in their working day £140K, why aren't they paying the people in the aircraft who are exposed to constant risk more money?

hargreaves99

29th Mar 2024, 14:43

Thud_and_Blunder

29th Mar 2024, 15:31

I took Northernstar's link idea one stage further and had a quick look at another non-blue-light UK emergency service charity: the RNLI (Link here (https://register-of-charities.charitycommission.gov.uk/charity-search/-/charity-details/209603))

They managed to spend over 75% of their total for last year (£177.2m of £233m) on charitable expenditure, with just under 24% going toward fund-raising expenses. They had one person being paid £140k-150k and 2 earning £150k-200k. I know there is a huge element of apples vs pears here (lower crew costs for starters; I shouldn't think the RNLI has any need for a medical director, and aircraft maint is possibly in a different order of magnitude compared to boats), but I think the RNLI model is one the many disparate Air Ambos could learn from. Just keep Gov't money out of it - we would never want to see another farce like the National Police Air "Service" debacle, would we?

Am now going to have a ferret around a charity using the name (County Air Ambulance) previously carried by the Midlands Air Ambulance, to see what they actually do with their income. Fascinating stuff - thanks again, Northernstar :ok:

Hughes500

29th Mar 2024, 18:40

£ 140 k for a N Sea Captain , really ?

hargreaves99

29th Mar 2024, 18:43

north sea co-pilot 60-90k
captain 90-120k
captain with overtime/TRE/TRI/line trainer/overtime - 120k+

jeepys

29th Mar 2024, 18:54

north sea co-pilot 60-70k
captain 90-120k
captain with overtime/TRE/TRI/line trainer/overtime - 120k+

North Sea co-pilots will go up towards bottom end of Captain salary.

[email protected]

29th Mar 2024, 19:14

North Sea co-pilots will go up towards bottom end of Captain salary.
Bloody demanding that straight line A to B flying......:E

hargreaves99

29th Mar 2024, 19:15

The demanding bit is having to live in Aberdeen, or commute to and fro, and put up with the deadly boring flying and adherence to a myriad of procedures.

206 jock

29th Mar 2024, 20:43

Because it's all a massive gravy train for the people at the top, while the public get fleeced because they think a big shiny sexy thing is going to swoop down and save them, when in reality they are 100 times more likely to die from a stroke, heart attack or dementia than any lack of an Air Ambulance.
Well that's quite a series of assumptions. And insulting to those people who - unpaid- represent the 'checks and balances' of the charities. I have no current skin in the game but spent 13 years as a trustee of an Air ambulance charity and can tell you that your assertion is wide of the mark.

Most of the income for the charity I was involved in came from their lottery. Most people's perspective was that £1 a week was a small sum to pay for supporting a service that anyone could need at any time. The secret is to get enough people to sign up, of course.

Pittsextra

30th Mar 2024, 11:17

What does Midland Air Ambulance Trading limited do?

MINself

3rd Apr 2024, 20:15

To add some perspective, the Trustees are all well meaning, unpaid volunteers, trying to support the charities, however they are hampered by what they are told, or not told, of the day to day workings. The information they are fed comes from the CEO with no analysis from the Trustees, except occasional meetings with a diluted snap shot of the state of things in general terms.

The Trustess are completely reliant on information for their deliberations and decisions from the CEO, so the conflict of interest will always exist as Trustess are asked to make decisions given part facts depending on how they need to be guided to get to the right decision

Jock - the question was:-

"on what metric these trustees measure value? "

I don't think that was vague or shrouded in anything!

What seems slightly odd on first look is that you have an association and yet there are obviously big gaps between the organisations, yet this isn't a new field of operation.