New heli for Essex Air Ambulance

[Heliport]

Essex Air Ambulance Service has taken delivery of its new Eurocopter EC135T2 helicopter, G-SSXX.

http://www.essexairambulance.co.uk/essex/images_stat/newairamb.jpg

The brand new Eurocopter 135 replaces G-ESAM, its 30 year old stretched BO105DBS

Essex Air Ambulance is a charity and not funded by either the NHS or Government. They say the total cost of keeping the fully operational is £60,000 per month - found from charitable donations from the public and local businesses.

[Hilico]

Charitably run - couldn't you say the same about all Air Ambulances in England and Wales?

I spoke to a nice lady in the Essex office; they launched it to the public in Colchester Castle Park on the afternoon of Friday 30th May. It was attended by two or three thousand people, the weather was lovely (well, sunny and warm) and "it couldn't have gone better".

[Thomas coupling]

The way to go!
Makes you wonder why most of the charitable air ambulances are still sticking to their old craft. False economy, methinks.

An excellent example of forward thinking....good luck to them.

[Heliport]

Charitably run - couldn't you say the same about all Air Ambulances in England and Wales?
Yes - as far as I know.

Odd isn't it?
Wonder if any of them get any of the Lottery handouts which seem to go to very odd places at times.

[HOGE]

Correct me if I'm wrong but isn't the London HEMS operation funded by Virgin and the NHS??

[Hilico]

Sorry, don't about the London operation. However, I was talking to someone in the business and they reckoned places like Devon and Cornwall and Norfolk had little trouble raising the operating costs from the public, but when it came to somewhere really affluent like the Home Counties...oh dear.

[What Limits]

1. The two Air Ambulances in Scotland are fully funded by the NHS
2. The others, in the main, are supported by charitable donations.
3. Some are supported up to 100% by Commercial Organisations.
4. Some people refuse to contribute because they feel that the NHS should fund them.
5. It takes up to 10 years to achieve a solid income stream, especially if you want a new generation helicopter.
6. Some Police Helicopters carry Paramedics as a joint operation. These are funded mainly by the Police Authority often with a contribution from charity to cover the Air Ambulance missions.
7. Generating income for Air Ambulances is difficult, most members of the public do not realise that they rely on charity.

Head above the parapet again!!

[PANews]

but when it came to somewhere really affluent like the Home Counties...oh dear.


To put that little statement in context, air ambulance services are all newish and the teams that raise the money have a learning curve to tread. It is better to learn with a 'cheap' airframe as it gives more time to learn without having to run themselves into the ground.

To speak simplistically, Thames Valley went bust because they served a large area but did not have the resources to raise the money throughout that area.

When they discarded the new aircraft it was easier to cope and they now expect to return to new in 2005 bcause they believe that they have overcome the learning curve sufficiently.

It had little to do with the type, any new airframe would have caused a similar situation, it was all about capability.

[What Limits]

So where do we get those 'Cheap' airframes from then?

Also just realised from the original post..... £60,000 a month??? They must be using the same acountants as Enron!

[Another KOS]

It's no accident (excuse the pun) that the most successful financial model for HEMS in Europe comes from the continent.

Germany, which probably has the most mature system, is mostly funded by ADAC - the equivalent in the UK of the RAC or AA. A relatively small amount from a large number of subscribers permits a systematic coverage with modern equipment.

This model allows trauma to be addressed at the scene of the accident (as with London HEMS) by providing funding for a doctor to be part of the crew (that is not to demean para-medics who do an excellent job). DRF and BGS have not been mentioned although they also contribute substantial equipment to the systematic coverage.

This has permitted German HEMS to re-equip over the last 10 years with the small (and clever) modern twins.

Germany is now looking for further benefits by data-streaming the casualty's vital signs (I'm not sure I have the term correct but you will know what they are) back to the trauma hospital. Why? To ensure that unneeded members of the trauma team can be stood down (a good example of lateral thinking). Data protection is an issue that still has to be solved.

This model has been exported to other European countries.

Another successful financial model comes from Switzerland where REGA is the recipient of funds collected as insurance contributions. Once again a small amount collected from a large number (for Switzerland) of subscribers. Excellent organisation, the finest equipment (e.g. has been using NVG for at least 30 years and provided substantial contribution to the generation of the JAA NVG guidance - TGL 34).

The US uses a different (but successful system) which will be explained by others with far more knowledge than I.

More information on HEMS in Europe from EHAC - who have a dedicated web site. Most States' HEMS organisations have membership of this umbrella group.

No vested interest in any of these organisations!

[Thomas coupling]

Another KOS: Excellent post, thanks for the breakdown of comparable systems elsewhere. Could you imagine how successful air ambulances in GB could be with this sort of infrastructure? [successful, meaning beneficial to the casualty].

[Hilico]

PANews - thanks, I wondered if there was a little more to it.

On the subject of NHS funding for HEMS, I am very much torn two ways. On the one hand, I can't help thinking how much basic primary care (eg smaller A&E departments open) sixty thou per calendar month would buy. On the other, there have been times in my experience when the HEMS was the only available ambulance of any description (landed in the car park of the pub next to my Mum's house); and when there's a medical emergency in the middle of nowhere (chap rowing down a river, keels over with MI), there is simply nothing else that will do; and HEMS can go straight to the appropriate specialist unit rather than having to go to the nearest place to get the patient stabilised, then transfer.

Wonder if I've answered my own question?

[Anton van Dellen]

NHS partly funds helis in Scotland and London.

AA stumped up funding over a 3 year period to pump-prime new helicopter services. Once this ran out, several million pounds was provided from central NHS funds to keep these helis running.:cool:

[MightyGem]

What Limits, £60000 a month is about right. That's £720000 a year.
The average Police unit operating 24 hours a day, runs on a budget of about £1000000 a year. Remember that takes everything into account: payments on the aircraft, maintenance, wages of the medics, pilotage and engineering contracts, right down to the last paperclip.

[Anton van Dellen]

Police costs per hour are significantly lower. Costs of paramedics on helis are borne by the NHS and not the charity. Major cost difference between the two operations appears to be that HEMS aircraft are predominantly leased versus police owning their aircraft. I wouldn't comment on police hours of operation, suffice to say that the police heli transports medical patients at night. :cool:

[Another KOS]

To avoid misunderstanding, it should be understood that police aviation in the UK is to a totally different modus operandi from those in the US (where they are operated as public use aircraft = state aircraft). Police helicopters in the UK are required to be twins and operate to a pseudo AOC, using a standard (suitably modified for each unit) operations manual.

My understanding is that when HEMS operations are conducted by the police, they are to the same standard as the dedicated HEMS operator. The lower cost of operations for police (if it is true) could be related to the synergy of operations and utilisation factors. The downside is that any 'shout' for the police must take precedence over a HEMS call.

There is no bar to HEMS being conducted at night by the HEMS operator - provided that the operating rules are observed.

[What Limits]

AFAIK the NHS do not fund the cost of paramedics on Air Ambulances except in Scotland. They may have stepped in last year to rescue several of the start-ups after the AA/CENTRICA reneged on their sponsorship deal.

Night HEMS - I hope that this subject has been done to death in previous threads. To recap, in UK, there is no such thing.

[whoateallthepies]

What Limits

Night Primary HEMS is done in Sussex by the joint Police /Ambulance operation. A HEMS approval added to their PAOC covers this.

It makes for interesting flying

Paramedics are paid for by the NHS on this unit, don't know about the rest.

[Another KOS]

What Limits:

Night HEMS - I hope that this subject has been done to death in previous threads. To recap, in UK, there is no such thing.You appear to imply that it cannot be done - what exactly prevents it?

[whoateallthepies]

It can be done and it is being done. The joint Police/Ambulance units use the police equipment to recce the landing site before making the approach using nightsun.

In future it is to be hoped that NVGs may be considered acceptable by the CAA for night HEMS operations. Night HEMS is part of the long term plans of at least one UK Air Ambulance.

[Obs cop]

With regards to police owning helicopters, I believe that may be incorrect.

Macalpine supply quite a few of the police helicopters, and certainly the force I work for used to own its helicopter but now leases from Macalpine as a package including the piots. The observers are paid police officers.

I think:ugh:

[john du'pruyting]

You think wrong obscop...as far as the midlands goes most (if not all, not sure about N Mids), police ASU/AOUs own their aircraft.
:)

[Anton van Dellen]

Police casevac does not operate under the same JAROPS restrictions as HEMS, hence the anomaly of police helis doing casevac at night and HEMS not.

Operating costs are not lower due to medical reasons. Medical equipment is sponsored and para salaries are paid by the NHS, not the charity. :cool:

And AA did not renege - was only ever a 3 year sponsorship, on a declining basis per year %-wise. :cool:

[Another KOS]

Anton:

I wouldn't be shouting that too loud if I were you - the PAOM was intended to constrain Police to the same (similar) rules as the HEMS operators.

Once again, there is no rule that prevents night HEMS.

[Thomas coupling]

Whoa guys...some anomolies here:

FACT:

The NHS pays for welsh (through the welsh assembly)and (I believe) english paramedic salaries on air ambulance units.

Air Ambulances will always be less cost efficient than their police counterparts because the police are more accountable to the public and they can and do tender for their aviation services. Most, if not all air ambulances, contract through one or two service providers who offer "packages" (pilots/fuel/accom/aircraft/servicing/spares, etc) this overall package is not necessarily best value, but the charities like it because it is hassle free.

Night HEMS is available to ANYONE (police / air ambulance). There are simply, certain guidelines to follow. The problem is that they can prove expensive (Twin pilot / IR / Full IF suite / suitable geographical territory to fly over, etc). As mentined before, Sussex do night HEMS (with dispensations). Air ambulances would do it too, if it were not for the cost implications.

Casevac is a police role and has nothing to do with HEMS. It is controlled by the ANO and not JAR. It was designed to extricate downed police officers from congested areas. This is why you can land at night in 'certain' areas at night that you can't do under normal police ops.
Casevac is always available to the force, and if this means picking up a civvy who is injured in a car crash (primacy of care), then so be it. Before we (personally)went full HEMS, we racked up about 30 night casevacs a year. We still use casevac to pick up patients at night.
HEMS approval was granted to 'certain' police forces because it was deemed a commercial operation under the then, new JAA regs and it required special dispensation (from acquiring another AOC). However, those who have this dispensation, comply in every respect with the JAA requirements for day HEMS.

A significant proportion of police helos are self owned by them...best value etc etc......

NVG is definitely the way to go with night police ops, be it HEMS and or otherwise.

[Another KOS]

Thomas:

Nice summary.

I believe the standard text for HEMS was incorporated in the PAOM due to issues of cross charging (making it a commercial activity).

I also believe that we might be seeing a change of views over the two pilot issue for night HEMS (in view of single pilot IFR panels, autopilots, well trained HEMS crew members etc.). Why break up a good team concept just for night operations - it works well in Switzerland with REGA as does NVG operations.

I put this on another thread but it's worth repeating here. The JAA issued the TGL on NVIS Operations on June 1st (TGL 34).

[slim_slag]

Somebody asked about the US.

My partner is a flight nurse for a company in AZ which does fixed wing as well as rotor. She is at a rotor base, but will do fixed wing if necessary. They use a nurse with advanced qualifications so don't need a doctor, in fact she trains doctors on how to look after critically ill patients. She also has a para-medic on board to help out, the medic can do most things, she is the boss. She thinks most physicians are idiots when it comes to "golden hour" critical care, and she is probably right :) She gets paid far less than other nurses, but she loves flying and it's an interesting job, and the employers know it.

As you might expect, it's all commercial. They fly single pilot single engine turbines (AEC 350 A Star I think) over built up areas with no problemo. All VFR, even at night over the desert. The pilots are trialing night vision goggles and love them. There are plenty of cheap French helicopters on the market right now (a bunch of police departments decided it was unpatriotic to buy French so stuck the taxpayers with more expensive American ones) and they are getting some of those. Don't know the type.

The cost of transport comes from the patient, I think they bill out at around $10k to attend, then a mileage when the patient is on board. I think they collect well under half. They will transport you even if they know you don't have insurance.

It's still very profitable and competitive - even dirty. I think Phoenix itself must have over fifteen helicopters, though there is a lot of desert to cover. They will fly down to the Mexican border to pick up patients if necessary. Quite often they do transfers which might not be totally medically necessary but they think of a reason as they pay well.

Interestingly enough, I know of a conflict between the commercial air ambulances and the police helicopters. The commercial air ambulance service decided there was sufficient business to set up a new base in a town. The police helicopter based there, and who was not previously interested in medivac work, suddenly didn't like this new kid on the block. As the cops get to hear about the accidents first, and are publically funded so can go where they like without much oversight, they have started attending accidents and not calling the commercial ambulance service. Stupid really, because if the commercial service doesn't get the business they may as well leave town. Although the police will pick up a nurse from the local ER when they go on a call, they are not as well trained as some of the full time flight nurses, and it will mean a worse medivac service for the local population.

OK, now a question. On Sunday afternoon I was sunning myself on Richmond Green with a picnic hamper and bucket of Pimms. The Virgin air ambulance turned up and flew around the general Richmond river area for around 10-15 minutes. All of a sudden it descended over the Green (which was full of people loafing around like me), sounded a siren, and landed on the grass! It shut down, sat there for around 15 minutes and an ambulance turned up. They transfered a patient and 10 or so minutes later the helicopter headed off north.

what I found interesting was no policemen turned up to set up a landing zone. There were a lot of people hanging around, and the helicopter only gave a few seconds siren warning that it was landing before plonking down. I think there was a potential for danger, why don't the cops turn up? It was flying around for a long time before it landed, I would have thought there was plenty of time to secure a LZ.

It was considerably bigger than US air ambulances and I had to smile as the pilot was wearing a helmet. I was also surprised at the length of time it took to get the patient on board. I wonder why they would have to pick up a patient like that, but that is a medical question, and I don't have any insight of course.

I remember around 15 years ago when they started this air ambulance in London, the senior physician at one of the top teaching hospitals was found unconscious in his garden in the suburbs. They sent a helicopter to pick him up and transported him to The London! Not sure the likes of you or I would have got that :)

[PANews]

Not sure why they were hanging around over the park, but to second guess things how about that they were waiting for the police or someone else to turn up?

The constabulary are always whinging that they have no persons to do anything these days and that even applies to the other emergency services. There was a time when they would break their necks to help out in such instances.

Lots of alternatives of course, waiting for the ambulance they met up with being one of them. In a perfect world the ambulance would have someone with the knowledge to clear the LZ but we all know its not a perfect world do we not!

Maybe someone knows....

[Bearintheair]

Just two comments:

On our joint Police / HEMS unit a medical task will almost always take precedence over a police task. The preservation of life is of course a police officers first priority.

We conduct Night HEMS under our PAOC with a HEMS approval. The rules written into the the PAOM HEMS Supplement for day and night HEMS are I believe a straight lift from JAROPS and don't differ from those for a HEMS operator working under a JAR AOC.

[whoateallthepies]

Slim_Slag

There's no favouritism (around here anyway). If someone is unconcious in their back garden (or anywhere) and require quick transport to hospital then this HEMS unit will take them. It doesn't matter who you are or where you are.

Why did you "have to smile" because the pilot was wearing a helmet?

[DBChopper]

Slim_slag

Possibly transporting a spinal injury? London's roads these days are more like the surface of the moon than a thoroughfare so it's the safest method. I once escorted an ambulance from SE London to NW London at no more than 5mph by road and it took three hours. I know which method I'd prefer...

And for yourself and PA news...

Any suggestion, veiled or otherwise, that the police knowingly just decided not to turn up to set up a LZ is frankly offensive. And, yes, we do have a very good working relationship with the other, similarly overstreteched emergency services and will pull out all the stops to assist whenever humanly possible.

[slim_slag]

DBChopper,

Thanks for the possible patient idea, makes sense. I'm not sure who suggested the police deliberately didn't turn up, it certainly wasn't me :) I was more interested in whether there were procedures which required a LZ to be set up. Obviously not.

pies,

Favouritism is rife in the medical trade, I've seen it, I've done it, I've benefited from it. A cardiologist mate of mine jumped an 18 month waiting list last week (though they are not supposed to exist). I don't agree with it but I'm not going to change it. It was at least 15 years ago and I can promise you that there is no way that helicopter got sent out back then unless there was a major mess. I guess I was smiling because I don't often see helicopters that large transport patients, no harm done, it's good to smile.

Actually pies, I tell a lie. We used sea kings to pick people up from the Lake District Fells when I was in the mountain rescue team back in the real old days. Big ******s they were, and they wore helmets in those too. I didn't smile much then as it was usually bloody miserably cold.

[PANews]

I'm not sure who suggested the police deliberately didn't turn up, it certainly wasn't me


It was nobody.... my comment was just that in recent years the police are, or claim to be, overstretched and there are few people with the authority around able to clear a landing ground ... hence the circling that was at the root of a prior comment. It was only a suggestion anyway.

[902Jon]

First, congratulations to Essex on their new EC135. I’m sure the benefits will be obvious very soon.
slim-slag
In response to your previous posting:
London HEMS is a service bringing senior trauma specialised Doctors with paramedics to the patient. As with all U.K air ambulances it is dispatched by the regional ambulance control (London Ambulance Service) and is therefore not in a competitive market. There will only be one helicopter sent to a job unless another one has been requested from or by another county service.
On the Sunday afternoon in question, the aircraft had been tasked to an incident on the Thames at Richmond. The captain elected to land in the park as there was no suitable area nearer to the incident. The patient was transferred from scene by ambulance to the helicopter and following treatment by the doctor, airlifted to a major trauma unit.
HEMS have an excellent working relationship with the Met Police. New Scotland Yard control room is informed every time the aircraft is dispatched and they in turn help us as much as possible. With the short sector times we have (6 minutes average) plus the police’s own pressures, they are not always able to attend before we land, even if they know where we are going.
In the U.K it is mandatory for all flight crews of air ambulance & police helis to wear flame retardant overalls and flying helmets. As for the size of the MD902, in the U.S many operations use SK76, SA365, and B412 which are much larger helicopters. We had a SA365 Dauphin prior to the MD902.
With respect to your partner, I am sure she is well qualified and experienced in her job. However, I am also sure she cannot give a general anaesthetic, perform life-saving surgery on scene or give drugs beyond a certain level. When your partner takes a critically injured patient to hospital, does she hand them over to a nurse or to a doctor led trauma team?
The education of the public and consequent fundraising from is an uphill struggle at the best of times. Uninformed comments like yours do nothing to help.