Now that we are 20+ years down the line of air ambulance operations any charity that is happy to sit back and plod on with a normal 10 hour DAY/ VFR shift pattern should really be thinking about if they really are providing the best service they can.
The charities have all come along way since first shaking the tins years ago and are probably all now multi million pound businesses that are probably now in the position to start pushing forward with the advancement of air ambulance operations....
By adding a winch to any air ambulance will only serve one purpose, and that is to upgrade the service that they offer, o.k not all AA need one but there are quite a lot of hilly areas that make up the UK.
As for All weather Op's, SAR can not provide anything more than a AA can when the weather sets in apart from operating over the sea where there is nothing to bump into. If anyone can explain how IFR hill side rescues work then please crack on......
Regarding night HEMS, i'd suggest that a combination of lack of funds/ crews, the fact that most people are in bed at night coupled with the risk to crews out weighing the benefit to patient prevent such ops..... but as already mentioned night transfers are already in operation and once all the AA are on board to provide national coverage at night will advance things greatly.