UK Air Ambulance night flights
Avoid imitations
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Surely, in most cases, once the patient is picked up, the need for NVGs has gone?
Pitts: This is what I was hinting at earlier. Each "Air Ambulance" set up is a self perpetuating business empire where, under the auspices of "Charity" you set up a small business and appeal to the public to pay for it! Meanwhile you cream off a decent salary, perhaps even find a place for family associates (nearly said members then) and or 'friends'.
There is very little demand for night AA's but watch what happens...........
There is very little demand for night AA's but watch what happens...........
TC - yes I hear you, but what I don't get is no doubt a bunch of people are ripping it out of these charities already? So with if there is little demand for night operations (and they already gettig paid for the operations they do provide) is the push from Bond merely a way to be the leader in this type of operation and win other regions? Otherwise they just set up a faster cash burn don't they, and I always thought these operations were cash constrained?
Night HEMS in the UK, a very good concept, but if they are operating to civil constraints not military, will that limit landing options, in relation to ground level obstructions, will training be provided to ground crews in that, the area they have to land on will be safe after a site appreciation and who makes it, also in the event of an incident, I can see the NHS backing away at the speed of light.
As has been stated by a previous poster is this a worthwhile operation? At night there is less of an obstruction by traffic, but the level of injury is frequently in relations RTA's is higher and the ability to transfer to a Trauma centre does increase the incidence of survival of the victim.
Inter hospital transfer is another situation in particular to intensive care patients, the vast majority take place by road due to the size of the UK under the terms of the UK Intensive Care Society (ICS) guidelines but air transfers are very rare and usually undertaken due to distance involved when it really should be by fixed wing transfer as rotary transfers may require numerous fuel stops, may not be able to carry a full transfer team and their equipment. For Hospitals in the UK air transfers also have a problem in the terms of transfer team training as this is not specified in the ICS document, which states only 'those undertaking these transfers should have specific specialist training' not how it should be accessed or who provides it. Air Ambulance training is different to primary AA HEMS operations in the terms of patient care.
Back to the main subject, will this be an increase in patient survival against cost effectiveness ??
Finally, please excuse a non pilot stepping into this debate as I am fixed wing flight and ICU nurse.
As has been stated by a previous poster is this a worthwhile operation? At night there is less of an obstruction by traffic, but the level of injury is frequently in relations RTA's is higher and the ability to transfer to a Trauma centre does increase the incidence of survival of the victim.
Inter hospital transfer is another situation in particular to intensive care patients, the vast majority take place by road due to the size of the UK under the terms of the UK Intensive Care Society (ICS) guidelines but air transfers are very rare and usually undertaken due to distance involved when it really should be by fixed wing transfer as rotary transfers may require numerous fuel stops, may not be able to carry a full transfer team and their equipment. For Hospitals in the UK air transfers also have a problem in the terms of transfer team training as this is not specified in the ICS document, which states only 'those undertaking these transfers should have specific specialist training' not how it should be accessed or who provides it. Air Ambulance training is different to primary AA HEMS operations in the terms of patient care.
Back to the main subject, will this be an increase in patient survival against cost effectiveness ??
Finally, please excuse a non pilot stepping into this debate as I am fixed wing flight and ICU nurse.
Last edited by air pig; 27th May 2013 at 12:55.
Air Pig, quite a lot of inter-hospital transfers, both day and night, are conducted by SAR helicopters and these are paid for by the NHS.
Something the size of a Sea King or S92 can carry transfer teams and equipment over surprisingly long distances and has the added advantage of landing at or very near to the hospital rather than an airport.
I think one advantage of AA night operations will be not turning into a pumpkin at nightfall which limits their availability, especially in the winter months.
Jayteeto
I don't think anyone has suggested anything to the contrary
Something the size of a Sea King or S92 can carry transfer teams and equipment over surprisingly long distances and has the added advantage of landing at or very near to the hospital rather than an airport.
I think one advantage of AA night operations will be not turning into a pumpkin at nightfall which limits their availability, especially in the winter months.
Jayteeto
Bond are a professionally run company who i am very proud to work for
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To my absolute amazement the north east air ambulance based at Durham tees landed at an rtc outside a pub over the weekend. The pub was literally a minutes drive from an accident and emergency equipped hospital (north tees) and elected to fly to the already overcrowded James cook. Absolute waste of time, fuel and aircraft flying hours.
Should they fly at night - don't see why not. The police helicopter has on numerous occasions took critical patients to hospital during night hours and there's never been an issue. The pilots are more than capable to perform this.
Dan
Should they fly at night - don't see why not. The police helicopter has on numerous occasions took critical patients to hospital during night hours and there's never been an issue. The pilots are more than capable to perform this.
Dan
I don't really know. I know if you have a car crash and need hospital treatment their is a reclaim against the insurance of the parties involved usually; I wondered if that was a similar case if AA were involved?
Then wondered the mechanics of how who is responsible for calling them out in the first place.
Edited to add:- from Kent's website:- "The air ambulance is deployed by a specialist paramedic working on the HEMS desk at the control centre of SECAmb, who screens all 999 emergency calls coming into the ambulance service to establish if the air ambulance would be of benefit to the patient."
So does that mean if called to a motor accident there is a reclaim and a revenue stream?
Then wondered the mechanics of how who is responsible for calling them out in the first place.
Edited to add:- from Kent's website:- "The air ambulance is deployed by a specialist paramedic working on the HEMS desk at the control centre of SECAmb, who screens all 999 emergency calls coming into the ambulance service to establish if the air ambulance would be of benefit to the patient."
So does that mean if called to a motor accident there is a reclaim and a revenue stream?
Last edited by Pittsextra; 27th May 2013 at 14:56.
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The funding is through the charity donations of the public. There is no claim back or insurance claim made by the charity. If the job is an inter-hospital transfer (ie an Air ambulance rather than a HEMS job) then the charity may bill the hospital from their patient transfer budget as is also the case with most transfers flown by SAR (military or CG) aircraft.
Pitts,
All English and Welsh HEMS are local/regional charities (fund raisers, tins round pubs). Some AA's are local charities but often additionally sponsored by hospital trusts/companies (guys hospital / virgin (not any more)).
Scottish HEMS are Scottish government run.
N Ireland is AAC, I believe.
When some units have 2 brand new helos parked outside - you realise something else is going on inside the charity other than simply providing the community with HEMS etc. And of course the shining light of unusual practices is the Childrens Air Ambulance....
HEMS units running a turnkey operations with 1 x EC135P2++ hangarage, rent, salaries, fuel, insurance, back up, spares etc come in at around £1.2 million/annum. 2 choopers about 1.8mil. That is a lot of tin shaking going on
I wish there was a nationwide charitable audit office scrutinising their books/operations because as sure as eggs is eggs, all these choppers/units cannot be the most effective way to provide national HEMS/AA cover, can it???
All English and Welsh HEMS are local/regional charities (fund raisers, tins round pubs). Some AA's are local charities but often additionally sponsored by hospital trusts/companies (guys hospital / virgin (not any more)).
Scottish HEMS are Scottish government run.
N Ireland is AAC, I believe.
When some units have 2 brand new helos parked outside - you realise something else is going on inside the charity other than simply providing the community with HEMS etc. And of course the shining light of unusual practices is the Childrens Air Ambulance....
HEMS units running a turnkey operations with 1 x EC135P2++ hangarage, rent, salaries, fuel, insurance, back up, spares etc come in at around £1.2 million/annum. 2 choopers about 1.8mil. That is a lot of tin shaking going on
I wish there was a nationwide charitable audit office scrutinising their books/operations because as sure as eggs is eggs, all these choppers/units cannot be the most effective way to provide national HEMS/AA cover, can it???
Last edited by Thomas coupling; 27th May 2013 at 16:32.
Interesting there was some work done here:-
The Association of Air Ambulances in the UK
But it only dates to 2007 so is out of date..
What happens at Childrens AA that is so different from the others?
It kind of seems if this is anything to go by:-
BBC News - Air Ambulance Service: Unease over new charity service
As if commercial protectionism is the primary motive to object to this?
After all my idea of a charity is bang for buck, so if you have £4m in the pot then I guess the idea is to provide the service where you have most use? So therefore daytime operation - costing I'd say less than night time? - would be better to have 2 x a 12hr daytime service than 1 x 24hr service? or am i missing something?
The Association of Air Ambulances in the UK
But it only dates to 2007 so is out of date..
What happens at Childrens AA that is so different from the others?
It kind of seems if this is anything to go by:-
BBC News - Air Ambulance Service: Unease over new charity service
As if commercial protectionism is the primary motive to object to this?
After all my idea of a charity is bang for buck, so if you have £4m in the pot then I guess the idea is to provide the service where you have most use? So therefore daytime operation - costing I'd say less than night time? - would be better to have 2 x a 12hr daytime service than 1 x 24hr service? or am i missing something?
Whilst trying to avoid repetition yes £5 million a year is far far too much for a couple of counties. To put it into perspective it would pay for major surgery for 1000 cases of bowel cancer or 3000 heart attacks or 5000 hernias. A year. In just a couple of counties. To save possibly a couple of lives. The economics let alone the reduction in mortality and morbidity just don't stack up. Sorry. This is crazy.
What is also worrying me is that the cost of operating a helicopter is increasing - I have seen costs like for like more than double in 20 years. The cost of individual operations or treating one person with one pathology has overall gone down (please let's not argue about whether we need to spend more on an ageing population - this is about cost per patient). So we can expect over time the 1000 to become 2000 etc.
The public may indeed be generous but they are not fools. Push it too far and you may see the law of diminishing returns
What is also worrying me is that the cost of operating a helicopter is increasing - I have seen costs like for like more than double in 20 years. The cost of individual operations or treating one person with one pathology has overall gone down (please let's not argue about whether we need to spend more on an ageing population - this is about cost per patient). So we can expect over time the 1000 to become 2000 etc.
The public may indeed be generous but they are not fools. Push it too far and you may see the law of diminishing returns
SAR yes take the point around the variable costs attached to using it - but in this context using it is a good thing? i.e. the air ambulance is doing air ambulancing!
After all wasn't that the main thrust of the argument against this Childrens AA - its not doing much...?
After all wasn't that the main thrust of the argument against this Childrens AA - its not doing much...?
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You might be able to do a gazillion operations for five million pounds........ But what five million pounds is that? It doesn't exist unless the public donate it. No air ambulance and it wouldn't be there. People fund raise and donate to what suits them.... Free choice. If they thought they were donating to bail out the nhs, they would not do it. On that one, the nhs could teach the charities to masters standard on how to waste public money. Charities are amateurs at waste compared to government departments
Sure JTO but thats not answering the question is it...
Surely someone has sat down and run the numbers to see what strategy provides the best value? Otherwise its more PR than real use - i.e. a chance to gain a headline and a new message to take out to the willing donors....
Surely someone has sat down and run the numbers to see what strategy provides the best value? Otherwise its more PR than real use - i.e. a chance to gain a headline and a new message to take out to the willing donors....
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Ching ching! Sarwannabee gets it and gets it good.
The question of best strategy for value for money. Wrong mind set, thinking like a manager.
What the public get is a service that is a luxury. Is it best value? Probably not, but they fill the tins for a service in THEIR LOCAL AREA that they will not have to depend on this week's management directives to see if it is available. Look at the npas scenario, some areas have terrible service now it's national. If they didn't like what was happening they wouldn't donate. If it costs 5 grand a patient, they don't care as long as the patient in need gets treated.
I don't personally fancy night hems, but will do it if asked. I will try to be careful and look after my crew and patients. The charity executives are offering a platinum service because they might just save one person, just one person, even at high cost. Our charity chief started this all up on a good old dream. Save one or hundreds, it didn't matter, one was enough, more was a bonus.
Pie in the sky? Maybe, but I donate every week because I like the way she thinks!
The question of best strategy for value for money. Wrong mind set, thinking like a manager.
What the public get is a service that is a luxury. Is it best value? Probably not, but they fill the tins for a service in THEIR LOCAL AREA that they will not have to depend on this week's management directives to see if it is available. Look at the npas scenario, some areas have terrible service now it's national. If they didn't like what was happening they wouldn't donate. If it costs 5 grand a patient, they don't care as long as the patient in need gets treated.
I don't personally fancy night hems, but will do it if asked. I will try to be careful and look after my crew and patients. The charity executives are offering a platinum service because they might just save one person, just one person, even at high cost. Our charity chief started this all up on a good old dream. Save one or hundreds, it didn't matter, one was enough, more was a bonus.
Pie in the sky? Maybe, but I donate every week because I like the way she thinks!