Wales Air Ambulance
 

The Wales Air Ambulance has set a target of a separate helicopter to be based in North Wales as a dedicated service. With the North Wales Police currently providing this service with a paramedic on board this helicopter would this be a step forward or backward???

North Wales is only one of three areas which offer a join Police and Air Ambulance service and I was wondering about the benefits and problems that this can cause.

The following is the story borrowed from icWales

With the way it is presented I would have thought it would be better to concentrate on gaining the funds to continue to provide the Swansea aircraft for 7 days a week and leave the North Wales area with the Police........

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Air ambulance looks for help in raising enough cash to run two helicopters Jul 22 2002

Joanne Atkinson, The Western Mail


THE Wales Air Ambulance service has set a new target - to fund two helicopters to save lives across Wales.

But unless a business sponsor is found to replace the Automobile Association, who pulled out earlier this year, the service could be grounded altogether.

The vital service, which currently runs one helicopter out of Swansea Airport, received a £70,000 one-off payment in February to fund the paramedics' salaries, but relies on public donations to keep flying.

The first fund-raising target of £600,000 was met recently to allow the air ambulance to increase their flying days from five to seven days a week from July 1, and the next aim of the service is to fund a second helicopter in North Wales.

Welsh Ambulance Service NHS Trust spokesperson Alison Watkins said, "It costs £750,000 a year to run an air ambulance, so we have set a new target of £1.5m to enable us to set up a North Wales base in Rhuddlan in addition to our Swansea operation.

"At present a paramedic is present on the North Wales police helicopter, but an air ambulance would offer a dedicated service in that area."

But she stressed that the air ambulance service needed extra help to keep flying at all.

"The targets are high, and we are desperately looking for new business sponsors," she said.

"We are hopeful that the public will keep supporting us to allow us to maintain the seven-day level of service, especially over the summer months."

The cash from the National Assembly will fund the crews' salaries until April 2003. In Scotland, £5m a year is provided by the Scottish government to fund its five air ambulances, but in England the services are funded via public donations.

"The air ambulance has completed 560 missions since its launch on March 1, 2001," said Ms Watkins.

"The air ambulance is crucial in getting to patients quickly in the first "golden hour" after injury, especially during the summer months when the roads are so busy."

The joint Police / Amb set-up do a cracking job but a dedicated HEMS aircraft would undoubtedly be a step forward for a number of reasons:

No conflict between HEMS / Police tasking

Dedicated A/C fit

2 Paramedics....etc.....

However, I do agree that getting the South up to 7 days would be a better priority. Just an off the cuff answer though. Maybe they have a reason for moving North.

Often wondered about the tasking conflict when I worked in Sussex....

Have there been any occasions that any one knows off and what the decision was ie. Police or Ambulance which 'won'?

May be wrong but tend to think the joint option actually has some benefits. Especially the night operations....

As for two paramedics working together... one is bad enough! :D

Give old Thomas Coupling a medibag, he'll do the job, stop him chasing all those innocent bikers!;)

Don't worry,

TC et al are kept busy already taking those bikers to hospital - they form a vary substantial proportion of an air ambulance's business.

Don't forget however that there are 2 RAF SAR bases that will cover these areas as well. One at Chivenor who also cover South Wales and one at Valley who cover North and Mid-Wales.

Surely setting up an Air Ambulance in North Wales would add to the problems that have only been smoothed out by decent liaison between the SAR Flt and the Police as to who goes to an incident.

I know from personal experience that the Police have been called to an incident which clearly called for a winch and the ability to operate outside of CAA rules, and as they went they told ther controllers to call for the RAF and their controllers don't until the Police helo says that there is nothing that they can do and then the SAR Cab gets called some 30-45min after the initial scramble.

If the system gets organised like it is in Scotland then the system will work, but if it gets organised like it is in England and Wales it will generate more bad feeling and annoyance on the parts of all operators.

When does the harmonisation committee report?

OOPS - Please keep in mind that a HEMS helicopter is not a SAR Helicopter. If someone rings 999 and asks for an ambulance then the control will assess the location and incident and possibly respond a HEMS unit. If the incident is aviation related then our control automatically informs the RCC of the response so that we can co-ordinate. I can not perceive of any method that would enable us to decide whether a climbing incident will require a full SAR response without us getting there first.
We have a good working relationship with the RCC and have never been afraid of requesting SAR support when required - don't forget there is life after being a SAR pilot and a fair few of them end up flying on HEMS units.
Regards.
TeeS

Changing to combined SAR/EMS operations would make a lot of sense. The system works well in Australia and most are corporate funded (AA type motoring organisations and banks etc) with partial health department funding.

Helicopters are medium size, IFR, winch equipped with paramedic crew and respond to SAR, EMS, Police, Fire and aeromedical tasks on a 24 hour basis.

obvious question time
 

Sorry for being Mr.Thicky here - but why do HEMS rely on 'charity' to keep flying?

Why don't they claim the call-out from the various insurance companies?

If you're injured in a car accident, I'm sure the hospital now bill the insurance company for the workups/procedures done on you.

Why don't the air ambulance services do the same?

I'm sure the insurance companies would rather pay a few thousand quid for a helicopter ride, than a few hundred thousand quid on a life policy....

Just going back to the original question, haven't South Wales already gone 7 days?

some weeks ago I posted a thread on 'military' with regards to the civ use of mil assets. Some interesting views came up.

I have an unofficial project (more of a scrapbook of interst for myself) as to how we could justify a joint services chopper here on the IOM. It would have to be something of the Dauphin Genre, capable of transferring cases to UK hospitals, and that is where primacy would lie. Followng that, tasking would be available for Customs (100 miles of coastline to patrol as well at territorial waters) Fisheries Protection (as above) and of course police work. Ideally I would also like to see it SAR capable. We justify six lifeboats which gives you some idea. Valley can be there reasonably sharpish, as can Irish SAR, but every little helps.

Crewing would be interesting. I would see the need for dedicated specialists, rather than trained up paramedics and police officers.

In todays congested Britain, helo's are the way forward for efficient deployment of emergency assets. We just cant seem to see it, neve mind afford it. Compare Greater Manchester Police (1 a/c) to the LAPD (15 a/c). Both are geographically similar areas.


One day......................one day!

Aren't paramedics and police officers dedicated specialists just using a different mode of deployment?

Who trains helicopter paramedics? I accept that most SAR winchmen are paramedic trained but is that the same thing?

PW

After I typed it, I did wonder if I had been clear enough!

What I envisaged was an omnicompitent crewperson, capable of carrying out the winch/paramedic/air observer role, rather than having to RTB and collect the relevant specialist dependant on mission. Ultimately, ex mil SAR staff have to be the obvious choice.

As far as I am aware, helo medics are simply qualified Paramedics who have done a helo course.

There has long been an argument that police air observers need to be police officers. The reason for this being that they need to know how the ground operatives mind is working. However, the same argument applies to civilian police communications operators. Onc they are up to speed, the majority of them are more than capable of running a pursuit, firearms incident or whatever. Even as someone who hoped to do the air observer thing sometime in my career (before transferring to Fraggle Rock) I still think it could be done by 'civ' crew.

As you probably gathered from my last post, I think we are rather small minded about air support in the British Isles. It is ultimately done on the cheap (please take that in context) and within very tight parameters. For example, look at the number of counties with coastline, that have no realistic maritime ability within their a/c. I remember an incident at Blackpool around 92/93, prior to Lancs purchasing their Squirrel, when a youth fell into the sea. Merseyside pitched up with their machine to scan the scene with nitesun and FLIR. No winch, or rescue ability. Bigger machine with different equipment and who knows?

Be interesting to see the views of ASU's up and down the UK. This isn't a dig at anyone's role or professionalism, just a creative view that will doubtless provoke some discussion.

STANDTO

Looked at logically, I am sure that you are right that there is a better way of deploying helicopters for public emergency services purposes. However, there are two points that occur to me about this:

One of the major problems is that the political vested interests and empires involved don’t want to see beyond the ends of their respective noses. So, with the exceptions of one or two far-sighted organisations like N Wales Police, until there is a major national political initiative you will never get the various purse-string holders to agree and combine their money.

The other thing is that your “bigger, better more of” approach to helicopters would cost a lot more and there are lots of moans already about the cost of these helicopters. There seems little prospect of moving away from relying on the support of charities (for air ambulance) and the goodwill of the military for SAR. Despite the grants provided by the Home Office, some Police Forces still do not have air support at all.

An example of a strange agreement is Hampshire where there isn't a Police or Air Ambulance helicopter. Police cover is a fixed wing aircraft.

But at Lee on Solent there is a SAR aircraft which under an agreement has a paramedic crew provided for medical emergencies at sea by Hampshire Ambulance Service NHS Trust.

Anyone know if the NHS employees are always on board or only for certain emergencies???

There is a more sensible way of achieving SAR, EMS and Police rotary cover in UK..... IMHO. This would of course mean that all factions put aside their own interests and agree on a new way forward. This would therefore be totally unrealistic.

However........ Imagine if UK military SAR was redeployed as CSAR and SH. (I cannot believe that the UK SH force is not overstretched at the moment). Tenders for civilian operators called for to operate medium helicopters for combined SAR/EMS roles at say 10 bases around UK. These aircraft funded jointly by Government, corporate sponsors and community fundraisers and tasked by Coastguard and Ambulance.

A medium helicopter could operate offshore up to 150 miles. Any longer range SAR tasks could be tasked to CSAR heavy machines. Medium helicopters could easily be tasked to operate EMS and land easily in most places that a light twin presently lands.

In my experience, both UK SAR and EMS helicopters are lightly tasked - combining the two would make economic sense and create a more interesting work environment for crews. This would also help change the current situation where unequipped helicopters arrive at scene unable to safely effect a rescue and provide adequate medical assistance. In my experience most rescue tasks have some medical component.

Police helicopters have a defined role and should not be diverted to SAR or EMS tasks where, beyond acting as a command and control platform, their contribution would be limited.

UK SAR, Police and EMS operations are very highly regarded overseas for their level professionalism, experience and innovation. However, I believe that the tasking of these assets is sadly lacking.

Back after a glorious week in the lake district. Apparently experienced some of the few dry days (they experience) whilst there! Strongly recommend a visit...

Interesting thread for me ...obviously!
Happened to read/see that excerpt on a HEMS helo moving to N Wales. Didn't know it was possibly going to be based at Rhuddlan, though. That would make it about........
right where we work:eek: Food for thought, have to move the golf course now:D

Who knows the magical mystical workings of these charitable organisations, I mean, take a look at what is going on in Yorks with theirs:eek: Perhaps S Wales will strike lucky financially. Not only will they have to double their takings, but they will have to replace their ageing bolkow with 2 modern machines too. We shall have to see.
I only know of one other HEMS operator who is successful enough to operate 2 a/c...(correct me if I'm wrong) but it's west mids. An efficient operation with a proven track record. Also, and possibly most important, some very generous members of the public too!

My main concern for any operation that provides such an emotive service to the public is that it will be a long term affair and not a one year wonder.

Paramedics who fly with us are first and foremost...trained medical specialists. SAR crewmen with 'paramedic' experience are not primary responders, there is a massive difference in skill level! One of our paramedics is also a trained (police) observer, capable of carrying out this dual role when required. [But only wears one set of green flying overalls:cool:]

With over 9000 sq miles of force area, 360 miles of shore line and innumerable lakes and rivers, we carry out a variety of tasks in the HEMS role. Last year saw 130 HEMS jobs, some of them twin stretcher roles. Suicides/plane crashes/RTC's/fallen climbers/missing persons/drownings, are a few of what we are involved with. We liaise very closely with 22 sqdn at Valley, often sharing work [our FLIR their NVG]. If it smells of a winch ...it's theirs, no question. There is no competing only healthy co-operation.
It would be a sad day when we have to stand down to let a dedicated HEMS chopper do its job :( :( But we need to remember that the other 92% of our tasking is police work and that's the real reason why we are here.
[There is no conflict between the two; if one is life threatening then thats the priority].
PS: thanks for the kind words about our Unit, the crew (and I'm sure the management) are most appreciative...

...break a leg...:)

Unless it's changed the SAR heli at Lee on Solent never carried NHS personnel.

I spent a day with them several years ago and the winchmen had trained to the NHS paramedic standard, at a local NHS hospital and in their own time if I recall correctly. I m not sure what has happened since paramedics have become state registered though as many people outside the NHS have had difficulties in getting their registration approved.

Sussex Ambulance had an arrangement where some staff were 'trained' so that they could be flown offshore should the need arise. eg multi-casualty incident on board ship. I think like many similar ideas when managers moved it all went out the window.

I also approached Bristows for winch job but was basically told no chance unless you are ex-mil.

Also with the current pressures on the NHS ambulance services, especially Hampshire who like many are having trouble meeting the required standard I doubt that they would be able to consistantly supply a paramedic on demand to arrive within the scramble time, (about 5 mins from call in daytime from what I recall).

HEMS Funding and Training
 

Dept of Health do partially fund HEMS - £2.4 million in the next financial year after negotiations by (Gen) Sir Christopher Airey, Chairman of the National Air Ambulance Association.

The Scottish Exec fund Scottish Amb Svc HEMS (and fixed wing).

London Health Authorities contribute to funding of the HEMS based at the Royal London.

Due to recent interpretations of charity funding regulations, ambulance trusts now have to pay for the paramedic salaries on the heli, rather than the charity.

County, based in the Midlands, in fact runs 3 helis - Helimed 03 (RAF Cosford), Helimed 06 (Strensham) and Helimed 09 (Derby). No cover at night.

Paramedic aircrew training - obviously already need to be paramedics. For County, they also need to be Pre-Hospital Trauma Life Support (Royal College of Surgeons, England) trained, and do a two week air-crew course, covering CRM, navigation, etc.

Helimed Essex (think is 07) used to run with one para and one tech - not sure if they still do or have moved to two paras.

Anton :cool:

Anton

Small correction - The a/c at Derby is not at Derby. Sorry, its something that gets my goat re the media too. Its based at East Midlands Airport which is in Leicestershire, but has a Derbyshire postal address. Work that one out.

Anyway, I cant talk as I work in Leicestershire, but it has a Northamptonshire postal address.

I'll go and lie down again now. Cheers.