But in reality, the weather limits they are obliged to operate to means that, day or night, they are often not able to give that additional service the public might expect in all weathers.
True to some extent, but the point is - the number of patients attended by said charity, HAS risen from 1500 to 2000 a year thanks to the addition of 24HR ops. 24/7 they are, the aircraft perhaps not due to wx, within the limits set by EASA. When the aircraft can't attend due to weather an RRV will be in place to deliver the team as a back up instead so the charities are doing their best to provide a 24hr solution, and attending around 33% more patients as a result, for only 20% more spent. Thus improving efficiency of spending to those who donate.
I'm not expecting AA to operate to SAR limits but I bet that's what a lot of the public think they do
If we're honest the public you meet on scene think it's all paid for by the NHS, and are horrified when they fid out it's not. Perhaps we should buy bigger aircraft, 139s? with airborne radar so the CAA will let us fly about low-level IMC 24/7 with extra crew man, charity money well spent? The current solutions seem appropriate for the UK.
which certainly can't do what a SAR aircraft can
I doubt you'll ever believe anything different, or that it's horses for courses. Who needs the RNLI when you have SAR? Surely thats your bread and butter? But it's not about what the AIRCRAFT can do. It's about what the TEAM deliver. SAR don't carry doctors as their standard crew, do you? RSI? Thoracotomies? get tasked inland to the centre of towns at night, land on the M25 and other central motorways at night? I've no doubt that you do your offshore and mountain rescue to the highest professional standard, i'd hope so given the cost to the government and taxpayer, but you don't attend the emergencies we're called to, and wouldn't fit your S92/139 in a great deal of the places we land - or your downwash would destroy the surrounding houses and be a hazard to third parties.
I've waited plenty of times in a SAR helo for an ambulance to transport the patient to A&E from the helipad but it very much depends how far the pad is from A&E - some are so close you just need a trolley.
Some hospitals we use have both an 'A&E pad' directly outside for HEMS sized aircraft, and a larger 'SAR pad' or secondary site for SAR which is an ambulance transfer away - designed to not obliterate the A&E and persons/ambulances outside when the heavy aircraft land.
Not really. We did/do it with one pilot in Police aircraft. The air ambos also have to switch to white light for the landing.
Do you not have a competent police observer trained to help you in such situations, usually who's been doing the job a while - who's sole role is front left? Some HEMS bases are operated single pilot with NVG, with a paramedic trained as the TCM in the front. Asking the paramedic to become a TCM one minute reading rates of climb/descent, rad alt heights, air speed vs ground speed, spotting incipient VRS, operate Trakka beams whilst helping the captain assess the suitability of a site, program gps/radios etc, whilst also having the medical job in hand in the back of their mind is not ideal CRM, and probably not the safest way of tackling it. In my experience the paramedics (who used to sit in the front) who work at units that have gone 2 pilot are very glad to be able to concentrate on their own medical task, when they hear two pilots working together up front at night with the increased workload and cockpit communication during critical phases of flight. Not to mention that medically, it means both medical professionals are able to remain together as a team in the back, attending the patient on the way to hospital - better for the patient, which is equally important.
Also, not many of the police units i'm aware of are regularly landing at night off airfield, 400-500 night landings a year? Wiltshire perhaps? Yes it's possible, and has been done with a good safety record, of course, but they're trying to promote the safest way to move ahead, when considering a number of units will likely be flying NVG in coming years, and I don't personally believe it's the safest way, having done both.
Not sure if I missed this, do hems teams have to wait to deliver patients at a hospital A and E, the same as paramedics?
I think the question you asked is slightly different to the one crab answered, and the answer is often no. Because of the medical assessment made by the doctors in the team you get the option of going direct to CT scan at some hospitals, or direct to Resus.