I agree that a centralised control a la ARCC would be very beneficial and might stop ambulance control leaving SAR helicopters at the bottom of their callout lists. A multi casualty RTA often needs a big helicopter with the ability to carry more than one stretcher but the local Air Ambulance will always get called first (unless it's dark or the weather is sh*t) because the ambulance authority has to justify it's existence. Once the Air Ambulance has either not been able to get there or has it's one casualty, then and only then do they think of using military SAR helos. The poor old patient's golden hour is meanwhile ticking away.. .This sounds like a rant and maybe it is but the air ambulance is not a panacea for meeting government response time targets and I do resent the press attributing jobs done by SAR helos (medevacs, ECMO, multiple casualty transfers etc) to the local air ambulances just to keep their profile high. This is not intended to denigrate waht the air ambulance guys and girls do but letting the NHS foot the bill for air ambulances whilst the military SAR force teeters on the brink of civilianisation/collapse is at best an inequality.. .Rant over!