Air ambulance plans for new centre of excellence base in Teesside

[Beafer]

The Great North Air Ambulance charity are asking for donations towards building their new base next to DTV Airport.
The new centre has been approved by the charities trustees and is waiting for planning permission.

The charity has been given £1m through the government Libor funding towards the centre.

Great North Air Ambulance submits plans for new £3.9m base on Teesside - Gazette Live (http://www.gazettelive.co.uk/news/teesside-news/great-north-air-ambulance-submits-12426880)

[[email protected]]

Would love to see the detailed justification for this major expansion - saving 'tens of thousands of pounds' by spending £3.9m (2.9 of which is charitable donations) seems a very poor return, especially if it might affect the 'financial stability' of the charity in the meantime.

Does an Air Ambulance provider really need a 'centre of medical excellence' to do research or is this an over ambitious CEO empire-building?

[Shackman]

More space needed for trollies?

[Hedski]

You have to love the self promotion of establishing or self declaring a 'centre of excellence'. There must be several of those already in UK HEMS. But the cheek to say it will increase life-saving. I'm sorry but absolute h@rsesh1t. Just another excuse for spending more money in order to gain more. Just like elsewhere spending an extortionate amount of funds raised on an almost useless and increasingly unfavoured and unsupported airframe just because that's what was raised by the public when similar can now be got for 1/10th of the price in the UK. Some of these charities require closer scrutiny. Ooops, think I said the quiet part loud again....

[oldart]

Does anybody know how much it cost's to operate out of MME each year? Why would they need space for three aircraft when two are going to be based elsewhere!

[Sky Sports]

Would love to see the detailed justification for this major expansion - saving 'tens of thousands of pounds' by spending £3.9m

Its the same reason as the current trend for larger helicopters and 2 pilot operation (and the subsequent increase in wages).
The charities are raising more money than the operations side can spend. They are limited to what they can bank, so there comes a point when a big expenditure is forced upon them by the charities commission, whether it is needed or not.

[[email protected]]

And that is despite paying some CEOs rock-star wages. Perhaps they could put their excesses in to support the NHS while it is 'in crisis'.

What would the donating public say if they realised that money was being spent just for the sake of it - very short-sighted planning.

[homonculus]

When the Daily Express agreed to fund HEMS at the London Hospital, the Departments of Health agreed to fund the relevant staff - not only the flight doctors, but radiologists, surgeons and anesthetists, to provide a trauma centre.

It is sad that 30 years later this rather sensible idea has been forgotten. Agreed, the words 'centre of excellence' are drivel, but if we have a serviceable HEMS it is about time we look further down the patient pathway in today's NHS - no point bringing in critically ill patients by air to put them on a trolley in the corridor....I suspect ministers wouldnt get the same publicity from putting the money where it could do some use, but the charities could be more beneficial by looking downstream rather than buying more bells and whistles

[PANews]

sky Sports

Right on the nose with your assessment

A runaway gravy train

[[email protected]]

But if the level of donations falls, they could be left with a large capital expenditure to pay for along with a more complex and expensive fleet to run - there could be trouble ahead.

More short-termism.

[PANews]

I think the point is that the majority of UK HEMS operations can mark time and go back to an earlier point in time and still provide an adequate service if donations were to fall away.

The ability to sell the purchased aircraft asset, sell or mortgage the property purchased and do away with the double crew and yet still provide what we now see as an existing good service in times of trouble is an attractive win-win money burner for charities currently well placed.

The downside of that strategy is that it is more efficient and tends to reduce overall costs which creates more [surplus] funds. This then faces [some] charities with a future where they will need to build things like 'Centres of Excellence' and the such that are money spinners.....

This does not apply to some of the weaker UK HEMS like Great Western as their reserves are currently low. Also in particular Northern Ireland - that is entirely dependent on Libor money until the charity gets its act together and raises funds. It might be difficult for them as they are hitting the road running with more than enough Libor funds in the Stormont bank to operate for a long time. Most charities started with nothing and were 'hungry' to succeed and raise funds .... how do you recreate hunger with £4M in the bank?

The mystery in this case is why GNAA did not take the new aircraft route. Their AS365 fleet works pretty well but it is old and inefficient.

If they cannot afford a new fleet .... they only have £4M in the bank ... why go for bricks and mortar when the core business is promoted as flying?

All of the charities are different and you can make an unscientific judgement on which of them have the more efficient fundraising strategies by what they fly, what they own and what they have left in the bank.

[oldart]

If newer doubled crewed aircraft were purchased, would they be able to fly during darkness?

[[email protected]]

an attractive win-win money burner for charities well I would certainly stop donating if I thought this was going on - perhaps the charities commission needs to look closer at what is going on.

Perhaps even the idea of pooling the charitable donations across the UK and divvying it up so everyone gets the same service - a National Ambulance service.........

[ShyTorque]

If newer doubled crewed aircraft were purchased, would they be able to fly during darkness?

As far as I'm aware there has never been a direct connection between single/double crew and night flying per se.

[Hedski]

Here's a crazy idea if they've too much money. Given HEMS pilots in UK are often single pilot IFR now how about paying the wages equivalent to the single pilot IFR sector, same goes for multi-crew. Then there wouldn't be such a struggle to survive so much for those actually doing a tough job. Specialist in Gloucester only pay IFR NVG captain's somewhere in the 50k's, Bond similar, Sloane just over 60k. And London maybe high 60k-70k at a push. It's utterly disgusting especially given the wages the charity senior staff often take home. So if there's so much floating about.... This is especially true for directly employed pilots who have had the senior consultants earning double or triple their wages whilst at times hitching free lifts in the aircraft but pilots not getting increases even in line with them percentage wise.

[tigerfish]

It can be cost effective though. My old Police Air Unit based on the old Filton Airfield, (now closed and sold for development) were given their marching orders by the new developers, as were the Great Western Air Ambulance unit, mentioned by PA News above. They were both forced to look for a new site, but quickly realised that they both operated EC135's, both required similar maintenance and administrative support etc and all the other add on's that units need, so agreed to form a combined unit. Still entirely separate from each other but combining premises and everything else apart from operational matters.
Now that seems a good way of giving a good bank for the buck to me!

Tigerfish

[CharlieDontSurff]

Don't see the point in this personally. Hospitals do the operating, heli's get the casualty there. What will this centre add that isn't already at their existing base? Dyson blade hand dryers?

[[email protected]]

Because for every HEMS pilot in the UK, there are 50 other pilots who would do their job for less money. And most HEMS pilots are ex-mil and hence, have an ex-mil pension and didn't pay a penny for their training (ie zero training debts). But they are generally very well trained, got to be pilots because they passed a stringent selection and testing process, have served their country in some pretty unpleasant places and usually don't have anything like the amount of pension you think they do.

[Nigerian Expat Outlaw]

crab,

Well said. :ok:

NEO

[oldart]

It can be cost effective though. My old Police Air Unit based on the old Filton Airfield, (now closed and sold for development) were given their marching orders by the new developers, as were the Great Western Air Ambulance unit, mentioned by PA News above. They were both forced to look for a new site, but quickly realised that they both operated EC135's, both required similar maintenance and administrative support etc and all the other add on's that units need, so agreed to form a combined unit. Still entirely separate from each other but combining premises and everything else apart from operational matters.
Now that seems a good way of giving a good bank for the buck to me!

Tigerfish
Good idea, would not work for the GNAA, Cleveland police are losing their aircraft

[SilsoeSid]

Good idea, would not work for the GNAA, Cleveland police are losing their aircraft

Considering that the proposed new GNAA centre would be 50m across the road from the Cleveland & Durham Police Tactical Training Centre, and only 2 miles down the road from their current location at the airport (good for crew travel times remaining the same), something might have worked out.

However with only a single figure number of weeks to go before NPAS Tees_Valley closes, despite Teeside being central to the region and only c10mins flying time to Newcastle, it's all too late.

Having said that, the linked report in the 'op' mentions the GNAA base at Newcastle International Airport will continue to be “integral” to its future plans.

[PANews]

I would certainly stop donating if I thought this was going on

That I think is the problem. That we should not speak of....

If you look at all the major charities, the household names, they run into having 'too much' occasionally but you simply cannot say "enough .... stop fundraising for six months please..." it just does not work like that.

No names no pack drill.

[Aucky]

Its the same reason as the current trend for larger helicopters and 2 pilot operation (and the subsequent increase in wages).
The charities are raising more money than the operations side can spend. They are limited to what they can bank, so there comes a point when a big expenditure is forced upon them by the charities commission, whether it is needed or not.

Perhaps they could put their excesses in to support the NHS while it is 'in crisis'. What would the donating public say if they realised that money was being spent just for the sake of it - very short-sighted planning.

you simply cannot say "enough .... stop fundraising for six months please..." it just does not work like that

Exactly right - look at the RLNI. They raised £184M in 2014, £183M in 2015 and claim '442 lives saved' yet are not being deemed as anything other than a professional and invaluable resource, rightly so! Braver folk than I. The rate at which they buy new gear for their volunteers and bases is astonishing, because they absolutely CANNOT stop fundraising. By very rough comparison I'd guess that in total all HEMS charities across the UK combined probably raise £100M, and attend something in the order of 15-20,000 people with potentially life-changing consequences.

I hate to think what one Eurofighter costs the tax payers, involuntarily, or how many lives it truly makes a positive difference to each year.

Can we not agree that this is a positive thing for our industry?

Multi-pilot money well spent? Yes, if the charities want to do 24hr ad-hoc landings on NVG I'd argue it is in peoples interest to have a second pilot up front. With that comes a requirement to facilitate longer legs with reduced fuel options at night - larger aircraft. Is 24hr worth it? Well the proven answer is yes, to industry it employs more pilots, to patients it makes a difference to the long-term outcome of more lives when they need help, and to those donating it dilutes the fixed costs of overheads too. For a 24hr charity in the south (info all publicly available), spending went up from circa 5M to 6M a year (20%), and the number of treated patients went up by 30-33% improving the efficiency of charity spending per patient.

I sense sour grapes among some, but this small part of the industry is seemingly financially secure (for now), offering growth in employment, offering low-time co-pilots a route into twin-land with valuable hems experience, investing in latest technology aircraft, NVG experience etc - whats to complain about. And the population cost per head equates to around £1.50/year (but no-one is forced to pay). Seriously...

Would you still be grumbling if your son/daughter/sister/wife was in an accident, and had a better long-term prognosis after being treated by a HEMS team, at zero cost to you or the tax payer? And a very small cost to those who are choosing to donate. Does it occur to you that the significant donations generated through legacies are likely from those who have witnessed first hand the value they bring?

I have no comment on the specific value of the centre of excellence in Teeside, but feel compelled to stand up to those who seemingly devalue the sector as a whole.

[[email protected]]

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.

Everyone expects the RNLI to go out in all sorts of horrendous conditions (and they do) so all that fundraising does provide a true emergency service 24/7 - I suspect the public belief is that their donations go to provide the same level of service from an air ambulance which certainly can't do what a SAR aircraft can.

I'm not expecting AA to operate to SAR limits but I bet that's what a lot of the public think they do.

Air ambos are excellent for the heli industry but throwing public donations at a limited capability is wasting money that should be spent elsewhere - other bits of the NHS for example.

[MightyGem]

if the charities want to do 24hr ad-hoc landings on NVG I'd argue it is in peoples interest to have a second pilot up front
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.

[oldart]

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?

[CharlieDontSurff]

I welcome co-pilots on air ambo's. Give those without an extensive military background (of which fewer and fewer are available) to gather the skills required to be in command.

Never a bad thing to have a pilot sat next to you as back-up.

[[email protected]]

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.

[Aucky]

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.

[[email protected]]

Aucky - a very defensive post - I wasn't for a moment advocating a SAR vs HEMS debate - it is very much horses for courses.

To be clear, I haven't done SAR for a couple of years now so any info I have regarding capability would either be out of date or anecdotal.

However, for many years, SAR helicopters spent the majority of their time conducting inland rescues/medtransfers/medrescues etc - including landing in the middle of congested areas and on roads/motorways.

I'm not sure what limits the CG SAR helos operate to nowadays but I suspect not that different to milSAR who could quite legally hovertaxi in cloud/fog/rain/snow, day or night to get to the casualty - you can't tell me that is what any AA in UK can do.

Your comment about who needs the RNLI when you have SAR is at odds with the one about horses for courses and shows rather a lack of understanding about SAR.

Out of interest, whilst talking about night capability, are you allowed to operate on NVD down to a field site that hasn't been recced (except by the aircraft circling it?)

And are you saying you have never had to wait to get your casualty to A&E just because you have a doctor on board?

[[email protected]]

Perhaps we should buy bigger aircraft, 139s? with airborne radar so the CAA will let us fly about low-level IMC 24/7 forgot to add - don't know where you got that idea from - that capability is only for over-water use.

[air pig]

Looking at the picture of the presumed new build, why such an elegant looking building surely such a building could be just a plain office block in design.

[Peter-RB]

How much vaguely of course does the CEO get in remuneration(wages) and or Plus Bonuses.

I have a pal who owns a transport company running 1500 tractors and as twice many trailers daily his Transport manager makes £65k pa, his Co-ordinator makes £48 k. both plus a car,... they are really pleased with that sort of money. so what does a CEO of the Helimed thingy earn..... ?

[MightyGem]

Do you not have a competent police observer trained to help you in such situations,
Trained in the use of NVGs, yes, and cleared for the front seat, but not confined to it.

reading rates of climb/descent, rad alt heights, air speed vs ground speed, spotting incipient VRS,
They don't do that, unless things have changed since I left. I did consider teaching them to do that when doing their NVG training(being used to it in the Army), but decided it wasn't practical without a set of flying instruments infront of them.

Out of interest, whilst talking about night capability, are you allowed to operate on NVD down to a field site that hasn't been recced
From an Air Ambo pilot last week, they have to switch to white light for the landing.

[[email protected]]

When they say landing, do they mean long finals, short finals, in the hover or actual touchdown? Is there a height below which they can't use NVD?

[gsa]

How much vaguely of course does the CEO get in remuneration(wages) and or Plus Bonuses.

I have a pal who owns a transport company running 1500 tractors and as twice many trailers daily his Transport manager makes £65k pa, his Co-ordinator makes £48 k. both plus a car,... they are really pleased with that sort of money. so what does a CEO of the Helimed thingy earn..... ?

I wouldn't go there, that can of worms was opened a couple of years ago over GNAA and it died down after the paper trail went different directions if i remember rightly.

[[email protected]]

I don't think they are required to provide detailed enough financial statements for public perusal to show individual salaries - they are all rolled into one bill - saves awkward questions no doubt.

I don't think it is unusual for those CEOs to earn significantly more than Peter RB's mate though.

[ShyTorque]

Maybe some of the "excess" funds would be better spent towards providing more hospital beds, of which there seems to be a worsening shortage.

(Yes, I know it's a charity and folk actually donated for Air Ambulances)

[[email protected]]

I'm with you Shy - given that the Air Ambulance community is essentially propping up the NHS by providing a service that one could reasonably expect to be provided by the NHS in a first world country, it isn't too far a jump to suggest excess funds be used to prop up other areas where the NHS is struggling.

[jimf671]

Anyone over-flying a mountain area or harbour that sees someone below spitting feathers, that's a mountain rescue or independent lifeboat (https://en.wikipedia.org/wiki/Independent_lifeboats_in_Britain_and_Ireland) treasurer who has had to listen to somebody talking about charity air ambulance finance! :ugh: :ugh: :ugh:

While air ambulance charities swallow up huge amounts from the giving public's total donations and spend it on air operations and nice offices, in the world of 24/7 rescue, MRT and independent lifeboats in some areas struggle to raise enough money to meet legal operating requirements, house their specialist kit without it going rotten, or even survive at all. :ooh:

The cost of running some of these teams/crews is a few tens of thousands of pounds a year. Often the cost of new boats or vehicles or buildings is just a dream well beyond the realm of the normal funding base and only exceptional donations from other charities or government grants can save them. :sad:

For example, the whole of Scottish Mountain Rescue (http://www.scottishmountainrescue.org/) runs on just over one million pounds per year. Think about how far that goes in air operations. :ugh:

MREW (https://www.mountain.rescue.org.uk/)
MRI (http://www.mountainrescue.ie/)

[minigundiplomat]

Nobody has mentioned the ADAC model in Germany (or ANWB in the Netherlands) under which HEMS is provided as a function of car/life insurance as a small levy on the policy.


The problem for the UK is the tax, EU levies, policy increase due to fraud and everything else that's loaded into already an already expensive policy.


I don't have any issues with a centre of excellence for HEMS as such; my ask would be that it acts in support of standardisation across the sector and supports common rules, operating procedures and methodology.

[jimf671]

... "plus I never go in the sea or up the mountain so why should I pay?"

The brutal reality is that it's not the experts, and not even just those deliberately going there, that die in remote and mountainous terrain (or at sea). It's not the air ambulance that'll bag the bits of body from an air crash so the family will have something to bury.

[[email protected]]

Yes, body recovery (or bits thereof) is a task normally reserved for SAR, MRT or RNLI - often with all the same risks involved as with a live casualty.

[MightyGem]

When they say landing, do they mean long finals, short finals, in the hover or actual touchdown? Is there a height below which they can't use NVD?
Around 200', I think. Jayteeto told me. I'm surprised he hasn't popped in here yet.

[Aucky]

Perhaps operator specific, but there is no requirement across the board to come off NVG at any stage in the approach, and you can use them to the ground.

The only time that you might be required to come off-goggles is at a hospital where you're not exempt from the requirement to fly PC1. But then it's a lit pad so no need.

[[email protected]]

I can understand different AOCs for different operators having slightly different limits but what are the CAA/EASA regs about NVD approaches to the ground?

[jayteeto]

Dave, some things you get involved in and some you don't.
Has anyone considered that a centre of excellence can sell courses and make a profit? They can also allow crews to train for scenarios more realistically.

There are two ways to approach the above comments.

First: our conditions are crap and yours are lovely. You shouldn't have good conditions. (Army mentality)

Second: our conditions are crap and yours are lovely. Well done, we need to bring ours up to your standard. (Airforce)

[[email protected]]

And having seen both side of the coin extensively, there are situations when one approach is better than the other but its never always the same one that is better.