• The H135 and H145 helicopters play a critical medical transport role in the United Kingdom, being we

“When we first bought the H135 in 2008, we asked ourselves how we could best meet the needs of the patient,” says Nigel Hare, operations director at Devon Air Ambulance, a helicopter emergency medical service (HEMS) and air ambulance operator serving England’s south western county of Devon.

“When responding to patients who are in life-threatening situations, it is essential that every aspect of our service provides the very best chance for the patient to survive. Every minute matters, so we need a reliable aircraft that is quick to deploy and has a fast cruise speed so that we can reach the patient and transfer them to hospital quickly, while also being smooth and stable in flight to prevent the patient’s condition from deteriorating,” says Hare. “The additional requirement of having an aircraft with sufficient endurance to enable us to respond to the next patient resulted in us choosing the H135.”

Further north in county Yorkshire is the headquarters of Yorkshire Air Ambulance, likewise a HEMS and air ambulance operator, which recently received its second twin-engine H145 on July 13 at the Farnborough International Air Show.

“The H145 performs well with near 360-degree visibility for a HEMS pilot who needs to get into tight, small sites near where casualties need to be evacuated,” says Yorkshire Air Ambulance chief pilot Andrew Lister.

Although located at opposite ends of England, the large counties of Devon and Yorkshire share much geography in common: hills, moors, forests, coasts and beach. Small villages dot the countryside, some so geographically remote that, when a medical emergency occurs or a patient needs to reach medical care, prompt access to transportation is of the essence.

Helicopters play a critical medical transport role in these two counties in both emergency and non-emergency – also known as air ambulance – situations. Air ambulance is a form of public transport in which patients, often fairly sick, are transported from one hospital or location to another. Helicopter emergency medical service (HEMS) refers to missions where life is at risk.

The vital role of the helicopter in medical situations scales to the entire United Kingdom, where a fleet of 37 helicopters provide the primary pre-hospital medical transport service according to the UK Association of Air Ambulances (AAA), the organisation representing 20 UK air ambulance organisations.

Many helicopter operators perform both of these services, including all 19 of the AAA’s members. Among them is the East Anglian Air Ambulance, based in Cambridge, which was the first air ambulance service to save lives with the H145 in the UK in 2015.

Three operators, two helicopters

Devon Air Ambulance, Yorkshire Air Ambulance and East Anglian Air Ambulance have fleets comprised entirely of Airbus helicopters – two H135s for Devon, two H145s for Yorkshire, and two H145’s for East Anglian. These air ambulance charities are far from alone, as worldwide the H135 and H145 account for over 40 percent of the HEMS market.

Yorkshire Air Ambulance chief pilot Lister says their new H145s are modern and easy to fly with a small footprint: “Flying is a dream. The Helionix software to me, as a new end user, is intuitive and does what you want it to do. Very quickly I found myself engaging the higher levels of the autopilot.”

Steve Rush, a Devon Air Ambulance pilot with 24 years of flying experience, describes a similar experience with the H135: “The H135 feels like it was built around the pilot. When you sit in it and put your hands down to where they naturally want to be to fly, that’s where the controls are and the aircraft is wrapped around your comfortably. It’s a swift process to get aircraft started and online. We can get airborne in a time frame not limited by the aircraft.”.

Both aircraft are likewise well equipped to meet the unique needs of a medical-based mission performed in challenging landscapes.

“Devon’s various landscapes provide different challenges. The H135 is well equipped for landing in confined areas thanks to its small footprint, or land in marshes or sandy beaches with the bear paws. The cockpit visibility from where the pilot sits is very good,” says Rush.

“The H145 is a larger aircraft with better endurance and a longer range than we’re used to, which helps us cover  Yorkshire’s 5 million acres, but the overall footprint is small enough for reaching patients in tight areas,” adds Lister.

Speaking in 2015, East Anglian Air Ambulance medical consultant, Dr. Jeremy Mauger, commented, “The H145 has more space, better equipment, and is smoother than I had imagined.” He adds, “The loading with the new stretcher worked superbly and we were able to make a significant difference in the care of that patient.”  

Charity services for the local communities

Devon Air Ambulance, Yorkshire Air Ambulance and East Anglian Air Ambulance share another thing in common besides flying Airbus helicopters: much of their air ambulance services are charity based.

Devon Air Ambulance for example started as a local community charity to raise funds to provide a medical resource that could respond more quickly in certain cases than a land ambulance could. They flew their first mission in 1992.

Yorkshire Air Ambulance similarly owes many of its operations to public donations. “Our H145s are essentially owned by the public from contributions donated to the air ambulance cause,” says Lister.

The pre-hospital air ambulance sector in the UK is operated predominantly by 20 air ambulance charities working closely with ambulance services who task the aircraft. Only the Scottish Ambulance Service provides a state-funded fleet of aircraft.

Clive Dickin, national director of the AAA comments:

“Some countries look on in disbelief that the UK has a charity-funded HEMS fleet, thinking that it is unsustainable or unprofessional. Nothing could be further from the truth. The sector is very well supported and during the 2014/2015 fiscal year raised over £146M which is an amazing feat. Since 1987 when the first charity was established, there has been a constant drive to improve the service through patient focus, which now sees an ever-improving and enhanced fleet of aircraft with increasing and expanding clinical capability. This would not be possible without the continuous and ongoing generous support of the charities' supporters.”

The AAA recently worked with the UK Treasury to acquire more funds to support air ambulances, something that has allowed many operators to extend or renew operations and aircraft.

This financial independence is a source of pride for many operators. “We are not reliant on other organisations,” says Hare of Devon Air Ambulance. “If we know there is a particular type of treatment we need to provide or equipment to carry, we can do that if that’s what the patient needs.”

As always for these helicopter users, the patient comes first.