To amplify the above, here is a cut and paste from my post in 2002 -
Zaplead
Your post brings up a what I perceive to be one of UK HEMS bigger problems. If you ask ten UK EMS pilots how and when they are allowed to apply the available exemptions you will get at least five different views, possibly ten.
One of the confusions is created by the pre-JAR terminology of a Primary Mission. This term, to the best of my knowledge, is not recognised under JAR but as you suggest enabled the following situations-
1. Call to a collapse in a city street, 2 P.M. outside pub - we could apply every exemption under the sun, land in the street cause loads of disruption etc. etc. despite being 80% sure that this was a person who had five too many drinks in the pub. That said, there is 20% chance that this is a life threatening collapse so we could do it. (Yes, I know a wise man will land in the large factory site 800m up the road and get the medics to hitch a lift, but I'm talking about what the rules say I can do!)
2. Call from road ambulance crew to assist them with a patient in a city street who has been hit by falling scaffolding pole. Patient has massive head and chest injuries an airway problem and possible spinal injuries - he needs to be in a trauma unit now! During the ten minutes that we will take to travel to the scene, the road crew will package the patient and transport him to a large factory site 800m up the road suitable for our landing. -"I am very sorry road crew, but by loading your patient onto the vehicle and conveying him up the road you have turned this into a secondary mission - I am now unable to land at an unsurveyed landing site in a congested area to pick him up. Please feel free to turn round and drive four miles through the traffic jam to a pre-surveyed secondary site"
Thankfully, JAR does away with Primary, Secondary and Tertiary (inter-hospital) missions and splits it into HEMS and Air Ambulance where HEMS is a response to a location at which a person is in urgent need of medical treatment etc. (I do not have the full definition in front of me so please don't savage me for not quoting it) and Air Ambulance is a routine movement of a patient, usually pre-planned, carried out to normal AOC criteria. The term "Life Threatening" is not used within the definitions although it does still appear in CAA exemptions.
I feel very strongly that because EMS pilots are, by the very nature of the operations, isolated from each other we are diverging in our understanding and interpretation of the rules (with all of us convinced that we have the correct perception of them).
I would be a very happy man to see a conference organised involving EMS line pilots, Aircrew Paramedics etc from around the U.K. to discuss the future but I suspect we all work too many hours to attend.
Cheers
TeeS
Hope that makes sense.
TeeS