Thanks SARWannabee. I dont want to hog this thread as there is a risk of repetition, but in medicine audit and research means properly set up studies with ethical committee approval, peer reviewed and published in the medical literature. Please PM me with examples if you can find any. Case reviews and discussions are not research. Lists of injuries and logs of times are not medical research.
You make my argument well in your last paragraph - by acknowledging the wide range of medical care across the country, you are in effect saying some are better than others. An integrated trauma system that the medical profession recommended in 1989 !!! would see HEMS as one link in the trauma chain. This would reduce autonomy (which is variability by another name) and allow better research, identifying weaknesses and improving standards as happens continually in the hospital setting
I think this is a theoretical argument. The NHS has such massive problems which the politicians seem unable to understand. Their answer is to simply pour in more money which wont work. They are about to ban whole areas of medicine (knee arthroscopy, spinal blocks etc) so there isnt a snowballs's chance of them volunteering to take on additional services from the charitable sector.