However, the miss mash or medical personnel, equipment and protocols, the lack of seemless medical care from aircraft to operating theatre, the shortcomings of some taskings and the opportunity to standardise and improve medical care on scene and use an expensive resource efficiently is begging for the medical aspects of HEMS to come under proper medical supervision and direction.
How do you see this working when SWAST, SECAMB, LAS, EMAS, EoEAS etc all use their own (different) protocols with which the HEMS services must loosely conform? Bristol, Wiltshire, Dorset, and Cornwall for example are very different charities with differing balances of trauma vs medical jobs, and differing access to hospitals. SWAST largely govern protocols of advanced doctor led practice surrounding medical procedures and the use of controlled drugs in those regions. SWAST have different policies to EMAS who may permit their doctor/paramedic teams to undertake different procedures autonomously.
The lack of uniformity stems from a lack of uniformity within different trusts of the NHS as a whole, which don’t all allow the HEMS organisations the flexibility to necessarily operate to what they would consider a best practice. Remember most of the doctors, and many paramedics in HEMS are employed by the NHS and not the charities.
That said, in my experience of working with a number of HEMS units throughout the uk, it appears to me that the average standard is incredibly high, with highly motivated individuals who are massively underpaid but take real pride in their role, and in the quality of service they deliver. Internal governance at many of the charities is highly professional and thorough, and they are always striving to optimise the incremental gains required to achieve the best possible outcome. Thankfully, because they are not directly subject to government cuts they have the resources to achieve this.