Helicopter Emergency Medical Services (HEMS) is one of the most recognisable and applauded operations within the rotorcraft industry. Tasked with delivering specialist medical care to the seriously injured, the missions completed by HEMS operators can be the difference between life and death for many. And, with the need for a wide range of diverse capabilities to respond to medical emergencies, a focus on innovation is critical to understand the growing requirements of the sector, improve procedures and the resources available to them. With HEMS firmly on the agenda at this year’s will Vertical Flight Expo & Conference (VFE), we investigate the growth of the HEMS sector, and the innovations helping our flying doctors save lives.
As with many EMS innovations, the concept of the air ambulance originated in the military where it became common practice to evacuate the wounded by helicopter during the Second World War. However, with limited capabilities, the ability to treat passengers came much later with the 1970s through to late 80s proving a pivotal time for the development of HEMS operations.
In the UK, the first dedicated HEMS helicopter was commissioned in Cornwall in 1987. The same service today flies around 700 missions each year, and as of 2012, had exceeded 26,000 missions in total.
In the UK, there are currently 22 HEMS services in operation, including the Essex and Herts Air Ambulance helicopters and rapid response vehicles which have attended 24,311 incidents since 1998. While the Great Western Air Ambulance received 971 call-outs, equating to 162 a month, or more than five a day in the first six months of 2019 alone.
In response to this remarkable demand for HEMS aircrafts, air operations officer, John Wood, said: “We have seen a steady increase in the number of patients we have been able to help over the years and it’s only through the help and support of our local communities that we are able to respond to this increase in demand for our service.”
To put the frequency of support in context, in the UK an Air Ambulance helicopter takes off every 10 minutes to respond to an emergency.  However, despite HEMS being among one of the growing sectors within the civil sector, there are several hurdles threatening to limit the abilities of the crew and aircraft alike.
For HEMS operators, communication, time and manpower are key to mission success. While consolidation, funding, enhancing safety and an adequate supply of pilots and aircraft maintenance technicians (AMTs) are among the modern-day challenges facing the industry.
Over the past few years, consolidation in the number of HEMS programmes has been seen nationwide, with estimates that two-thirds of air ambulances in the US are owned by just three for-profit providers. The trend for consolidation has largely been attributed to longer distances between hospitals and private equity investments.
While for-profit operators are increasing their investment and expanding fleet sizes to cater to this burgeoning market, funding for not-for-profit operators continues to be an ongoing barrier for greater uptake. Here, charitable donations are key to many of the world’s HEMS services airborne. In the UK, it is estimated that regional services need £3 million a year to stay air-worthy, fuelled and manned. This sum is currently reached through public donations alone with no day-to-day funding from National Lottery or Government available.
And, the current outlook for skilled pilots is raising concerns about the ability to meet demand, with fewer pilots being inducted into training programmes or being hired by operators. This leaves a critical gap between demand and the ability to fulfil missions in the future. Based on interviews and surveys completed by 250 helicopter companies in 2018, the University of North Dakota predicted a shortfall of 7,649 helicopter pilots and 40,613 mechanics (across all aviation sectors) in the US until 2036.
This was reiterated by Tim Fauchon, Chief Executive of the British Helicopter Association – official show partner for Vertical Flight Expo 2019 – who said that “a lack of new entrants into the aviation industry” was a key concern in 2019. To combat this, Vertical Flight Expo and the BHA have partnered to launch its first careers day at the show in November, offering advice to school leavers and aviation personnel, with dedicated sessions highlighting the opportunities presented by the Armed Forces resettlement programme.
While widespread challenges – such as the skills shortage – impacting the wider aviation industry, challenges in communication are also presenting additional barriers within the HEMS sector. Becky Steele, General Manager of the Association of Air Ambulances – an official VFE partner – explained: “In 2016, it was planned that the replacement for all the emergency services radio networks would be launched to replace the current Airwave system that allows air to ground and ground to ground communications between services. To date, the project has been delayed with the transition of services estimated to be completed in late 2022.”
With new solutions emerging, improving communications between on the ground teams with those in the air, is ripe for innovation, with leading suppliers such as Axnes AS, Flight Cell International and LD Switzerland all confirmed to appear at this year’s exhibition to demonstrate new communication systems that both the pilot and wider crew’s ability to receive up-to-date information on the go.
Excellence on the scene
In addition to overcoming communication and mechanical challenges, Vertical Flight Expo exhibitions will also demonstrate the new technologies helping crews to carry out important life-saving missions. This includes the STILA board, from Northwall srl. The composite long board is designed to immobilise a trauma patient, allowing HEMS operators to easily load the trauma patient while minimising any further stress.
While Global Aviation Industries GmbH will present its Emergency Medical System complete with medical equipment carrier, oxygen station, medical cabinet, stretcher and more.
Long proven in the aviation sector, helicopters are ideal for transporting critical trauma patients because they can effectively decrease the time between an accident and arrival at a medical facility. Despite the challenges and adversities faced, the continued advances, further research and innovation spearheaded by the industry will help to continue this valued service of medical care.