SLMFS - providing there are no obstacles to affect the safety of the aircraft, descending whilst winching out would get the patient to the ground quicker and have the small added benefit of reducing the downwash slightly - the primary aim would be to get the stretcher down within reach of the ground party asap.
Thanks Crab, understanding the intention is to get to the ground sooner makes sense. The only counter argument could be that remaining higher means there will be more cable out and the stretcher will be less effected by the down wash. I understand your point though. See the point below for John but normally when I winch its at the lowest safe height for the operation. This doesn't really leave any significant room to descend over land but judging from the video it looks like they had plenty.
John Eacott thanks for your reply also. I agree with your points about excessive winch height. Watching the video my first thought was why are they so high? I do try to not judge though as camera angles can change the perspective or the crew may have had a good reason for winching high that we are not aware of. Generally speaking I have noticed on many videos that the winch can be very high. I prefer to be lower where the references make hovering easier, the winch time is minimised as well as the exposure for the operation. Some may argue to winch higher for OEI options but while that needs to be considered but I do not think this can be done in isolation.
Winching also needs to be done with intelligent reasoning. I once had a disagreement with a new Crewman that wanted to move during ship winch from the very large bridge wings of a massive container ship back and left over the water. When I explained that due to the size, stability and clear zones of the vessel we could remain over the wing where the winch height was about 15ft rather than move back and left over a 150ft drop to the ocean. His answer was that the operations manual stated that was the procedure. It took quite a bit of reasoning that while normally that would be the best option in this case it wasn't so we were not going to do it and be slave to a procedure. He did come around in the end when we agreed that a 15ft drop to a steel deck was bad but a 150ft drop to the ocean would surely be fatal. The aircraft safety was the first priority and the aircraft was not jeopardised to achieve this, it ended up been a very simple and easy winch.