"Hospital Flight"

[Xing30West]

I have a technical question for you controllers, especially any outside the United States. I fly air ambulance flight all over the world. In the United States I can specifically find in the 14 CFR's where the term "Lifeguard" should be used as a radio call sign. However, I am not able to locate where if at all the term "Hospital Flight" should be used as a call sign. I can find "Hospital Flight" in the ICAO as a definition but not a call sign. Can anyone help me with this? My interpretation is that it should be used in the remarks on the flight plan but not used on the radio. I have never had a controller refer to me as "Hospital Flight NXXXRH."

Furthermore, in Canada, because I am an "N" regerstered aircraft, I use the call sign "Lifeguard" not "Medevac." Would you all agree with that?

[Scuzi]

I can't speak for anywhere else but in the UK, the "Hospital Flight" you put into the remarks field on the flight plan will show up on the controller's flight progress strip therefore negating any need to use a specific callsign.

[vespasia]

I can't speak for anywhere else but in the UK, the "Hospital Flight" you put into the remarks field on the flight plan will show up on the controller's flight progress strip therefore negating any need to use a specific callsign

But be aware that will not give you any priority over other traffic. If your flight is one where priority is required e.g. time critical organ donor flights, critically ill patient you need to file as a Cat A flight.

[Hyperborean]

Also in the UK some of the dedicated flights have their own callsign which identifies them as such. The Scottish Ambulance Service use Helimed for the helos for example.

[Spitoon]

...you need to file as a Cat A flight.

The tricky thing is, you can't file as cat A. The UK AIP gives the following information about declaring the status of flights in field 18 of an FPL.

The following standard abbreviations should be used:
-STS/EMER for flights in a state of emergency;
-STS/HOSP for medical flights specifically declared by the medical authorities;
-STS/SAR for flights engaged in Search and Rescue missions;
-STS/HUM for flights operating for humanitarian reasons;
-STS/HEAD for flights with 'Head of State' status;
-STS/STATE for flights other than 'Head of State' specifically required by State authorities;
-STS/PROTECTED for use in flight plans which should only be available to those who 'need to know'. Normally flights that are security sensitive;
-STS/ATFMEXEMPTAPPROVED for use only when approval has been obtained from the appropriate State authority for exemption from flow regulation.

The instructions to controllers in the UK says that cat A priority is given to aircraft in emergency (e.g. engine fault, fuel shortage, seriously ill
passenger), aircraft which have declared a 'Police Emergency', ambulance/medical aircraft when the safety of life is involved. These classifications are not directly related to FPL STS.

Despite vespasia's comment, in reality unless advised that it is not necessary I think I've always seen NOSP and MEDIVAC flights given priority to one extent or another.

[vespasia]

Fair point spitoon, but I see no reason why a STS/HOSP Cat A should not be filed for those categories I mentioned (critically ill patient/time critical organ donor flight). While I will try to find out if a "hospital flight" deserves priority, it's not appropriate to give such priority to a flight, for example, returning a pax with a broken ankle from their skiing holiday.

[Spitoon]

I'm not sure how STS/HOSP Cat A on a FPL would be handled. The STS items are recognised by CFMU and, as far as I am aware, the cat A, B, C etc is not universally used or recognised.

The point I was making was that my experience is that flights with this sort of status get some priority unless the pilot advises it's not needed. It's not the same priority that an organ flight would get but if it's important enough to put a note on the flight plan, even if it's just a matter of comfort for the broken leg owner, the flight tends to get some form of priority. But you're right, officially, unless it's cat A, B or C it doesn't get any special handling.

Whilst I have found that operators are generally quite straight about this, I did have experience of one specialised operator that abused the system and the goodwill of a good number of controllers to the extent that the crews 'boasted' about it in the bar. Company now long gone.

[Xing30West]

So using the term "Hospital Flight" on the radio instead of "Lifeguard" like we do in the United States is not an accepted practice internationally? The aircraft's normal call sign should be used because the controller is aware that you are a hospital flight. It is a definition for the remarks section of the flightplan and that is all.

Would ya'll agree with that?

[vespasia]

Would ya'll agree with that?

Agreed - but if you feel that the controller may not be aware for any reason, let them know. At my unit the remarks section of the FDE (electronic strip) isn't always obvious.

[Hyperborean]

If you file Hosp in the STS line of the flight plan you can amplify the need for priority by adding a comment in the RMK line ie RMK/hospital flight request priority a due to patients condition.This will flag up at destination but I would still advise making the point by r/t on each handover. Any hospital flight should attract some priority. If I recall correctly under the definition of '"other flights of a humanitarian nature."

[Jerricho]

So using the term "Hospital Flight" on the radio instead of "Lifeguard" like we do in the United States is not an accepted practice internationally?

When you guys head up our way (Canada), it's not unusual to hear "Lifeguard" prefixed to the type or the "Medevac" suffix. Depending upon what's been filed in Field 18 (STS/HOSP or RMK/MEDEVAC) may dictate if we actually know the priority of your flight. ATC Units that use electronic strips (predominantly Terminal Units) may not have any display of what's in the flight plan regarding this.

[QWERTY9]

The filing of STS/Hosp in itself will NOT give any priority whatsoever as far as ATC systems and CFMU are concerned. Only approved (or self approved-depending on operator) flights will be given priority by the system as long as they are STS/ATFMEXEMPTAPPROVED. If a flight is non-approved then approval HAS to be sought from the relevant authority to operate that flight as such.

The filing of HOSP has been abused by operators for many years, hence the tightening of controls around such flights.

Three types of flight ONLY are given automatic priority status by ATC systems with exemptions in the UK.

EMER
SAR
STATE

All others sould seek approval !

That's the theory, in practice it can be quite different

[andrepilota]

very short,simple,easy tip.

call in with your normal callsign,and right after the callsign just say "..and we are hospital flight"...

Me,as an ATCO,i'll try and give u as much priority as possible,unless u say that u don't need it...

ciao

[radarman]

Filing STS/HOSP may give a nice warm feeling to crew or operator, but it really gives ATC no idea at all about the urgency of the flight or any special handling required. A number of operators will automatically file HOSP for both the outbound (empty) as well as the inbound (with patient) leg. The empty flight may thus get special treatment it does not deserve, and the aircraft waits an hour on the apron for the patient to arrive from hospital. On the other hand the empty leg may need expeditious handling if the patient is already at the airport and medically stabilised for the flight. There is no way ATC can discern the subtleties of the situation from STS/HOSP, so a quick hint from the pilot on the R/T is probably the best way to let ATC know of special handling required.

[This is a crisis]

STS/HOSP gives absolutely no priority at all - it does not even exempt you from flow control. Most of the time to gain exemption from flow you have to fill in a form signed by a medical authority!

We have an operator who puts STS/HOSP on all it's flight plans, whether they are just positioning to pick up a patient or what. In my mind there is no such thing as a pilot declaring himself a CAT A flight. The flight categories are ATC cateogories that we allocate to an aircraft based on the information the pilot gives us, e.g. a pilot declares a MAYDAY - ATC afford him category A status.

IMHO the only way for a hospital flight to gain priority is to declare an emergency owing to the condition of the patient, in much the same way as any other flight with a sick passenger would declare a PAN. ATC would then afford the flight category A status. In fact, when i first started MATS 1 used to say just that!

Having said that, there are some pre-approved callsigns that give automatic priority - HEMS flights spring to mind.

[Wojtus]

No special prefixes in Poland, and no special rules for STS/HOSP flights treatment. For example, we have regular flights which carry isotopes for cancer treatment - also with a STS/HOSP.

HEMS in Poland is using "Ratownik ##" (will be Rescuer ## in english) callsigns, and there are automatically regarded as STS/SAR. But only one public institution is providing HEMS and only they are authorised to use this callsign.

Anyway, if you need priorioty - ask for it.

[aluminium persuader]

If you used "Hospital Flight c/s" on initial contact with me and told me you required some sort of priority I would endeavour to meet it.

ap

[minti the mini]

What is meant by priority required?

I notice people are interested in getting priority for hospital flights. The only time a patient would need priority is when they are being moved from their local hospital to a state of the art facility where specialist treatment is required urgently. This may be the case from a small island hospital for example.

However, in my experience most 'air ambulances' are for moving holiday makers back home again. In this case, the patient would not be moved unless they were stable and hance would not need priority and we would never ask for priority for this type of transfer.

Having said that, it's important that the flights do not get flow regulated. Although a patient may be stable, they might still be critically ill. The ambulances at both ends need to be there at the right time. Imagine a patient who is ventillated having to wait on an aircraft for 2hrs waiting for a slot. The aircraft would need to be started to provide power for the medical equipment. It's also an extra 10-15 litres of O2 per minute required. The same applies to a skiing patient with 'just a broken hip'. Remember passengers can wait in a terminal. A immobilised patient can't. Making them wait inside a cold aircraft for an hour or 2 waiting for a slot is not acceptable.

[Coast]

in canada your call sign usually shows up as LN****** and everyone i work with will use the prefix "lifeguard"
as in "lifeguard november *****"

i did work a usa military fight the other day call sign E****, telephony was "evac ****" and the remarks in the flight plan were hospital flight and medevac

[Dumbledor]

I have operated a fair amount of hospital flights on bizjets. It is right that you don't get slot delays for either the pick up and patient delivery flights as long as the flight plan shows that it is a hospital flight.

As has been mentioned earlier, you can't have an ambulance hanging around for hours at an airport waiting for the inbound a/c, nor at the other end either. The ambulances and crews have other jobs to do. The patient, as someone said before has been prepared for travel with drugs etc. A few may or may not make it home... literally. In one case recently a whole family was hit by a car while waiting for a bus in Spain. The mother was killed, the son was the patient, who had lost a leg and the relative with him was his Dad. The argument that the most the patients are stabalised, so there is no rush is flawed. The oxygen and drugs etc on board is finite and cannot be topped up in the air. The patients have quite often gone through a terrible trauma or they are on a 1-way trip home. They are always very very pleased to get home. Sorry for the rant.

If you carry more than one patient and they are going to different destinations then there will be at least 3 'hospital flight' sectors which are free from flow control. Sometimes ATC quiz us about our status on the 3rd sector to check that we have a patient on board. They think we are pulling a fast one!

There could be an argument for keeping the hospital flight status on the final positioning leg as well, so as to get medical crew home ready for the next job. Sometimes the flight crew duty days are very long and you can add 4hrs (with conditions) onto the standard day under FTL's.

D