It's so clear when you know how!!!
Casevac is a POLICE ROLE. It should be treated under the same auspices as a pursuit or a misper etc. In that the rules and regs are fully embedded in the PAOM I.
It was/is designed purely to swoop and scoop a downed police officer and transfer to a medical facility - endex.
It Is a means of responding to a life threatening tasking WITHOUT PLANNING FOR IT.
ALL police helicopters have this capability built in (or should I say all police crews?).
CASEVAC is day and night capable.
CASEVAC must NOT allow for commercial financial gain. That is to say that the police cannot charge an external agency for the occasion. To do this would require an AOC.
CASEVAC should be used only after ALL OTHER MEANS OF RAPID TRANSPORT
HAVE BEEN EXHAUSTED. This is because there are commercial companies out there trying to earn a buck doing this for a living and they dont want public money stealing the show.
A HEMS flight requires intent. Intent to commit an emergency medical response. Be it operational and/or financial.
You either intend to man your a/c with a full time paramedic, or
Plan to pick one up en route, or
collect one at scene, or
charge the ambulance authority for your services.
Your intent signals your desire to operate outside the PAOC. Thus the need for an approval. This is not guaranteed. The CAA have to vet your operation and it is themselves who will decide whether you deserve a HEMS Approval (police).
When operating under HEMS you operate under JAR OPs 3.005(d)Annex.
There are no insurance complications.
There are restrictions - the main being no night HEMS unless you either operate twin pilot OR, the terrain you operate over allows the CAA to grant you approval for night ops with a suitably qualified HEMS crew member. In the UK I believe only Wilts have this exemption?
Certainly keeps the pilots honed
