First, thank you for your help.
Mode of operation of HEMS in France:
Contract: Tenders between 3 to 5 years between the hospital and helicopter companies.
Type of flight: VFR day and night in OPS 3. Somes hospitals are day (8h00 to 22h00) with 3 pilots and others H 24 with 5 pilots.
Helicopters: A 109, EC 135, AS 355 N, and few AS 365 and MD 902 (Belgium Operator: NHV).
Crew: 1 pilot (CPL H) employed by the helicopter company. 1 doctor and 1 nurse employed by the hospital.
Our delay: No advance on the EASA NPA regarding HEMS Crew Member, and the use of NVG. Problems with weather forecast and low altitude weather forecast.
One question about IFR: How is used the IFR ? If IFR condition do you take off or refuse the flight (In my question you are IFR rating)? Does it exist IFR emergency, meaning you take off with VFR condition and if deteriorating weather you continu the flight IFR.
Are there any hospitals certified IFR or you are landing at airports certified.
Do you have problem with low altitude weather forecast ? This will be a problem regarding IFR !