London's Air Ambulance, also known as
London HEMS (Helicopter Emergency Medical Service), is an
air ambulanceAn air ambulance is an aircraft used for emergency medical assistance in situations where either a traditional ambulance cannot reach the scene easily or quickly enough, or the patient needs to be transported over a distance or terrain that makes air transportation the most practical transport....
service that responds to seriously ill or injured casualties in and around
LondonLondon is the capital city of :England and the :United Kingdom, the largest metropolitan area in the United Kingdom, and the largest urban zone in the European Union by most measures. Located on the River Thames, London has been a major settlement for two millennia, its history going back to its...
,
EnglandEngland is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
.
The service was formed in 1989 by Dr. Alastair Wilson OBE, as a response to a report by the
Royal College of SurgeonsThe Royal College of Surgeons of England is an independent professional body and registered charity committed to promoting and advancing the highest standards of surgical care for patients, regulating surgery, including dentistry, in England and Wales...
that criticised pre-hospital trauma care. It is now headed by
Dr. Gareth DaviesGareth Davies is an NHS Accident & Emergency Consultant working at the Royal London Hospital, Whitechapel. He is best known for his role as lead doctor of the flight crew for the London Air Ambulance and has been seen many times on the popular BBC documentary television series Trauma and Trauma...
(also Chairman of the charity's trustees) and is based at the
Royal London HospitalThe Royal London Hospital was founded in September 1740 and was originally named The London Infirmary. The name changed to The London Hospital in 1748 and then to The Royal London Hospital on its 250th anniversary in 1990. The first patients were treated at a house in Featherstone Street,...
in
WhitechapelWhitechapel is a built-up inner city district in the London Borough of Tower Hamlets, London, England. It is located east of Charing Cross and roughly bounded by the Bishopsgate thoroughfare on the west, Fashion Street on the north, Brady Street and Cavell Street on the east and The Highway on the...
. The service was the first air ambulance in the
United KingdomThe United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
to carry a
doctorA physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
trained in
emergency medicineEmergency medicine is a medical specialty in which physicians care for patients with acute illnesses or injuries which require immediate medical attention. While not usually providing long-term or continuing care, emergency medicine physicians diagnose a variety of illnesses and undertake acute...
in addition to a
paramedicA paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...
at all times. Since the service was founded, trauma deaths in London and on the
M25 motorwayThe M25 motorway, or London Orbital, is a orbital motorway that almost encircles Greater London, England, in the United Kingdom. The motorway was first mooted early in the 20th century. A few sections, based on the now abandoned London Ringways plan, were constructed in the early 1970s and it ...
have fallen by more than 50%.
Operational area
The operational area of responsibility is London and the area within the M25, though it can fly further afield if requested to. The team can be airborne within two minutes of receiving a call. From its hospital base, the furthest section of the M25 and thus the usual limit of responsibility, is only 12 minutes flying time. The helicopter operates during daylight hours only because of the difficulties associated with landing on un-surveyed sites at night; during the dark hours it is replaced by rapid response cars.
Helicopter
The current helicopter used is a
McDonnell Douglas MD 902 Explorer|-See also:-References:* Jackson, Paul. Jane's All The World's Aircraft 2003–2004. Coulsdon, UK: Jane's Information Group, 2003. ISBN 0 7106 2537 5.-External links:* *...
,
registrationAn aircraft registration is a unique alphanumeric string that identifies a civil aircraft, in similar fashion to a licence plate on an automobile...
G-EHMS, which is notable as it does not use a tail-rotor. This was a useful feature, as the helicopter must routinely land in confined inner city areas. It replaced a SA 365N Dauphin, registered
G-HEMS, in October 2000.
Although the MD 902 Explorer is a quieter model aircraft than its predecessors, a number of noise complaints are still filed relating to HEMS.
The helicopter usually cruises at 175 to 180 mph, at an altitude of 1,500 ft. A regular fuel load, around 400 kg, allows for one hour's flying time.
Rapid response cars
At night or when the helicopter is offline the medical crew, including a paramedic and senior trauma doctor, still respond to emergencies, but travel in a specially-equipped rapid response car. The six cars,
Škoda OctaviaThe Škoda Octavia is a small family car produced by Czech automaker Škoda Auto since 1996, its name revived from a model originally produced between 1959 and 1971. The current Octavia is available in five-door liftback and station wagon....
s, occasionally operate during the day, carrying backup medical teams to major incidents, or responding to local incidents or those that occur while the helicopter team is already deployed.
Funding
The service costs £2.25 million a year to run, but is only partly funded by the
National Health ServiceThe National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
. London's Air Ambulance in a registered charity (number 801013) and the service is funded through charitable donations and corporate donors, most notably by the
Virgin GroupVirgin Group Limited is a British branded venture capital conglomerate organisation founded by business tycoon Richard Branson. The core business areas are travel, entertainment and lifestyle. Virgin Group's date of incorporation is listed as 1989 by Companies House, who class it as a holding...
, which donates around £170,000 per annum. A full list of corporate donors is available on the HEMS website. The charity also runs a weekly lottery to raise funds for the service, and holds a number of small and large scale fundraising events throughout the year.
Missions and major incidents
During 2009 London's Air Ambulance undertook a total of 1,741 missions, down slightly from 1,771 in 2008. The crews attended the following emergency incidents:
- 672 road traffic collisions
- 377 falls from height
- 349 stabbings
- 69 shootings
The Air Ambulance team have been involved in many major incidents over the past few years, including the train crashes at
Cannon StreetThe Cannon Street station rail crash was an accident on the British railway system which occurred on 8 January 1991 at Cannon Street station. The accident killed two people and injured 524 others...
,
SouthallThe Southall rail crash was an accident on the British railway system that occurred on 19 September 1997, on the Great Western Main Line at Southall, west London. Seven people were killed and 139 injured...
and
PaddingtonThe Ladbroke Grove Rail Crash was a rail accident which occurred on 5 October 1999 at Ladbroke Grove, London, England. Thirty-one people were killed and more than 520 injured...
; and the
7 July 2005 terrorist attacksThe 7 July 2005 London bombings were a series of co-ordinated suicide attacks in the United Kingdom, targeting civilians using London's public transport system during the morning rush hour....
, when the HEMS team carried out 26 missions using the helicopter and constant deployment of rapid response cars to deliver medical care and supplies to the scenes of the bombings. This was only possible because a meeting, attended by many current and former HEMS staff, was coincidentally scheduled for the same day. 208 people were treated at the Royal London Hospital on that day. HEMS holds a contract with the London Ambulance Service obliging them to provide medical oversight at declared major incidents.
Crew
The crew usually consists of one pilot, one co-pilot, one doctor and one paramedic. There is sometimes an observer, who is a doctor or paramedic in training.
Ground services
On arrival at the Royal London Hospital helipad, specialist ground crew receive the patient and a dedicated, express elevator carries the patient to the
accident and emergency departmentAn emergency department , also known as accident & emergency , emergency room , emergency ward , or casualty department is a medical treatment facility specialising in acute care of patients who present without prior appointment, either by their own means or by ambulance...
on the ground floor—where a
trauma teamA Trauma team is a group of healthcare workers who tend to seriously ill or injured patients who arrive at a hospital emergency department. The team is composed of a number of specific roles, with a typical team consisting of:...
with A&E doctors, general
surgeonIn medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...
s, specialist trauma surgeons, and
anesthesiologistAn anesthesiologist or anaesthetist is a physician trained in anesthesia and peri-operative medicine....
s assemble to assess and treat them.
Television appearances
In 2004 the service was featured heavily in the
BBCThe British Broadcasting Corporation is a British public service broadcaster. Its headquarters is at Broadcasting House in the City of Westminster, London. It is the largest broadcaster in the world, with about 23,000 staff...
television series
Trauma. In 2009 a standalone documentary about the Air Ambulance was made for the BBC by
North One TelevisionNorth One Television is a television production company based in London and Birmingham, England, and Sydney, Australia. It was originally known as Chrysalis Television and is now part of All3Media....
. It showcased the service in a number of emergencies and was called
Medic One: Life and death in London.
Administration
The HEMS Clinical Director is
Dr. Gareth DaviesGareth Davies is an NHS Accident & Emergency Consultant working at the Royal London Hospital, Whitechapel. He is best known for his role as lead doctor of the flight crew for the London Air Ambulance and has been seen many times on the popular BBC documentary television series Trauma and Trauma...
. Davies is also an Accident & Emergency and Pre-hospital Care Consultant working at the Royal London Hospital and regularly flies in the helicopter to the scenes of accidents.
Concerns were expressed in the media after the London Air Ambulance charity dismissed its Chief Executive in 2009. The Charity Commission promptly made recommendations on
governanceCorporate governance is a number of processes, customs, policies, laws, and institutions which have impact on the way a company is controlled...
to the
TrusteeTrustee is a legal term which, in its broadest sense, can refer to any person who holds property, authority, or a position of trust or responsibility for the benefit of another...
s, but did not express an opinion over the dismissal.
Physician Response Unit
Davies has been responsible for many innovations in pre-hospital care such as the Physician Response Unit (PRU), which brings the doctor to the patient in their home, preventing an unnecessary waste of ambulance resources. The PRU also operates from the Royal London Hospital in a rapid response car.
The PRU is staffed by a doctor and an
Emergency Care PractitionerAn Emergency Care Practitioner may come from either a paramedic, nursing or allied health professional background and most have additional academic qualifications, usually at university, with enhanced skills in medical assessment and extra clinical skills over and above those of a standard...
(ECP). Compared to just sending out an ECP in a car or an ambulance crewed by a paramedic and an
emergency medical technicianEmergency Medical Technician or Ambulance Technician are terms used in some countries to denote a healthcare provider of emergency medical services...
, a higher level of diagnostics and treatment can be initiated on-scene, giving the optimal outcome for the patient, and saving expensive procedures that could otherwise have been initiated.
Other emergency medical services
- London Ambulance Service
The London Ambulance Service NHS Trust is the largest "free at the point of contact" emergency ambulance service in the world. It responds to medical emergencies in Greater London, England, with the ambulances and other response vehicles and over 5,000 staff at its disposal.It is one of 12...
- Royal London Hospital
The Royal London Hospital was founded in September 1740 and was originally named The London Infirmary. The name changed to The London Hospital in 1748 and then to The Royal London Hospital on its 250th anniversary in 1990. The first patients were treated at a house in Featherstone Street,...
- Air ambulance
An air ambulance is an aircraft used for emergency medical assistance in situations where either a traditional ambulance cannot reach the scene easily or quickly enough, or the patient needs to be transported over a distance or terrain that makes air transportation the most practical transport....
- International SOS
International SOS provides integrated medical, clinical, and security services to organisations with international operations. Services include planning and preventative programs, in-country expertise, and emergency response. It has 9,000 employees, led by 1,100 full-time physicians and 200...
, Provider of air ambulance evacuation & repatriation services
Other emergency services
- HM Coastguard
- London Fire Brigade
The London Fire Brigade is the statutory fire and rescue service for London.Founded in 1865, it is the largest of the fire services in the United Kingdom and the fourth-largest in the world with nearly 7,000 staff, including 5,800 operational firefighters based in 112 fire...
- Metropolitan Police
Metropolitan Police is a generic title for the municipal police force for a major metropolitan area, and it may be part of the official title of the force...
External links