Cornwall Air Ambulance

Operations

The helicopters are based at a hangar at Newquay Cornwall Airport (EGHQ), near Newquay, which enables servicing and maintenance to be carried out overnight, which was impossible at the original open-air base at Treliske Hospital. The new base is also more centrally located, leading to quicker response times in many parts of the county. The helicopter can be airborne within two minutes of a 999 call and flies at 150 mph (240 km/h). It can cover the entire county in less than 20 minutes and reach the Isles of Scilly in 28 minutes. On average it takes 12 minutes from the time of the call to the scene of the incident.

Patients are taken to either Derriford Hospital, Plymouth or the Royal Cornwall Hospital (Treliske).

Aircrew

The Air Ambulance carries a crew of three: the pilot and two paramedics, or a paramedic and a doctor. To provide continuous cover, the service presently uses three pilots who are shared with Bond Air Services' Trinity House operation which, like the Air Ambulance, is based at RAF St Mawgan (Newquay airfield). The aircrew are selected from existing ambulance service personnel and specially trained for their work on the helicopter. There was originally a pool of twenty aircrew who worked on the Air Ambulance on a rotation basis. When they were not on helicopter duty, the crew would revert to their normal jobs on the road ambulances in the County. In 2006 the system was changed: now there are just 6 full-time aircrew to improve continuity.

Aircraft

The first helicopter was a Eurocopter BO 105D (reg. G-AZTI)which was replaced by a slightly larger BO 105 (reg. G-CDBS) which was used until 2001, when it was replaced with the more advanced Eurocopter EC 135T (G-KRNW). The EC 135 is used extensively as an air ambulance in many places around the world. It has four rotor blades to ensure a smooth flight, which can prove particularly beneficial for patients suffering head or spinal injuries. Twin turbine engines give it a cruising speed of 160 mph (260 km/h), and skid landing gear allows it to cope with all types of terrain. Its compact dimensions allow it to land in confined spaces, yet it has room to carry two stretcher patients. It contains all equipment found on any front-line ambulance plus other special items.

In late 2014 the Cornwall Air Ambulance changed their aircraft provider from Bond Helicopters to Specialist Aviation Services, through their sub company, Medical Aviation Services. With the change came a change in helicopter and the service now operates the MD902 Explorer, with its NOTAR design. As part of the contract the service now have 2 helicopters (reg. G-CNWL and G-CIOS - formerly G-LNAA and G-SASO respectively), one on operational readiness, the other on immediate standby in case of engineering requirements or un serviceability of the primary aircraft. Both MD902s were delivered as night capable for HEMS operations in darkness. As of 2015, the helicopter is available 12 hours of the day, a first for the air ambulance service in Cornwall. This means that during winter months the helicopters are available even during darker hours, thanks to the use of special night vision goggles mounted on the helmets.

Control decision

The control centre for the South Western Ambulance Service is located at Exeter and is manned 24 hours a day, every day throughout the year. It is here that the decisions are made regarding ambulance mobilisation for the four counties of Cornwall, Devon, Somerset and Dorset, in response to 999 calls. The Cornwall Controller decides whether the patient should go by land ambulance or be flown to hospital on the Air Ambulance.

Cost and financing

It was assessed that the cost of the Air Ambulance was seven times more than a land ambulance, but it could cover the same area as seventeen land vehicles. Operational costs for the Cornwall Air Ambulance are £80,000 a month as of 2007. This includes the lease of the aircraft, pilots, service engineers, spares, servicing and insurances, as well as a charge of some £350 per flying hour to cover fuel and other combustibles. The cost of the two paramedics is borne by the Strategic Health Authority, by whom they are employed.

The Cornwall Air Ambulance is a charitable organization solely maintained by donations as it receives no form of official funding. The resident population and visitors to Cornwall finance the Air Ambulance by donations, various fund-raising events, purchase of weekly Air Ambulance lottery tickets and legacies.

All donations received are administered by the First Air Ambulance Service Trust (FAAST), a registered charity established in November 1987 for this purpose.

Beginnings

The idea for Cornwall’s air ambulance originated during a major review of the Cornwall Ambulance Service and was one of the recommendations in the report published in April 1986. It was not, however, a new idea but all attempts to develop the concept had thus far failed until a unique window of opportunity arose in the summer of 1986. Helicopter air ambulances had been in use for about fifteen-years in various other countries but the centralised funding of the NHS had always rejected the concept. When Cornwall’s started operating on 1 April 1987 it was the first in the UK.

The Cornwall Ambulance Service was part of the Cornwall & Isles of Scilly District Health Authority’s Primary Care & Community Services unit under David Green, the recently appointed general manager. In the autumn of 1985 Green and a team of doctors and ambulance officers with external consultancy support from the Management Advisory Service to the NHS were reviewing ambulance service performance and how to implement a national ambulance service salary structure. Their report ‘Proposals for the future organisation of patient transport services in Cornwall’ became known as the MAS Report (April 1986). It recommended fundamental reorganisation of the ambulance service and various other options, including introduction of a helicopter air ambulance. In itself, use of helicopters was not new. Like other ambulance services, the Cornwall Ambulance Service used third-party helicopters for inter-hospital transfers. In the period 1983 – 1986 the Cornwall service spent just over £9,500 on such transfers: it was not a sufficiently high-demand task to justify a dedicated helicopter, a point not lost on BBC Radio Cornwall.

Green took the MAS report to the DHA meeting on 14 May 1986 for approval to proceed with the recommendations. The report attracted fierce public debate and on the day of the DHA meeting BBC Radio Cornwall interviewed Green and Len Holden, his Chief Ambulance Officer (in post since 1974 and now part of Green’s organisation), about the specific proposal for the introduction of a helicopter air ambulance. From 14 May 1986 the idea for the Cornwall air ambulance was on the public record and in the public domain. This resulted in a number of helicopter operators and freelance pilots contacting Green who, confiding only in Paul Hanage his Director of Finance whose advice and involvement was essential for the propriety of any plans, judged it too soon to proceed.

In the late summer of 1986 Geoff Newman, a freelance helicopter pilot and consultant, contacted Holden about the air ambulance project. This chance meeting between a pilot and the Chief Ambulance Officer for Cornwall was to prove fortuitous. Newman had been working on a parallel project in the Gloucester area when Holden suggested that his efforts should be directed towards the needs of Cornwall. Holden knew that his new Head of Primary care, David Green, an ex-RAF aviator of some standing, was supportive of the general concept of a Helicopter Emergency Medical Service. It was Newman's decision to approach Stephen Bond of Bond Helicopters Ltd that was to prove to be the catalyst for the successful deployment of the air ambulance the following year. Visiting Stephen Bond in the autumn of 1986 Newman suggested that the provision of a helicopter free of charge for a three-month trial period would allow the British public to see how such a service could improve emergency care. Stephen Bond's decision to agree to this proposal and the interesting exchanges with David Green during this critical phase are available in Newman's archives and clearly show how the project moved from concept to successful execution. (note - relevant correspondence can be published where required). Subsequently, Newman was retained by Bond Helicopters Limited (Bond), initially as their local project manager in which role he produced the first draft of the contract, and then as their pilot. During the autumn Green’s organisation and the Bond team continued discreet preparatory work to introduce the air ambulance as a joint venture between the DHA and Bond.

On 24 November 1986 Green took his confidential paper ‘Helicopter Emergency Medical Service for Cornwall’ (reference DRG/LC/12.11.86) to the DHA’s Corporate Management Group and then to the full DHA on 10 December 1986. Six days later the contract with Bond was signed and the helicopter started operations just under four months later on 1 April 1987. Before the end of that year Holden had retired and Newman had left the project but it would take another three years or so of hard work by an increasingly large and committed team of people to secure the future of Cornwall’s First Air Ambulance. The involvement of the Cornwall Air Ambulance charity was to prove to be the saviour of this new project for funding from Bond Helicopters was limited and the NHS were unable to provide the scale of finance required. It was always the case that 'he who paid the piper called the tune' and so the charity took an increasing role in the management of the service until we see today (sumer 2013) a move by the charity away from Bond Helicopters as the helicopter provider. Next year MAS at Gloucester/Staverton Airport will be providing two helicopters showing just how far the concept has developed in 26 years.