In August 2017, Northern Ireland became the final region of the UK to launch an air ambulance with the potential to save up to 50 lives per year. David Whelan visits the Maze/Long Kesh site to find out more about the service’s operations.
Although only recently in operation, the promotion of an air ambulance for Northern Ireland has been the focus of a sustained campaign for well over a decade. Despite repeated attempts to establish a state-sponsored Helicopter Emergency Medical Service (HEMS), an increasingly stretched health budget meant that the service was never going to be a priority for those controlling the purse strings.
It fell instead to a group of campaigners to establish the Air Ambulance NI charity and push forward with plans to put Northern Ireland on a level-footing with the rest of the UK in terms of emergency response services.
Those campaigners were not without a blueprint, some regions of England have been running a charity-based air ambulance for almost 30 years and in fact, Scotland is the only region of the UK where an air ambulance service is funded by the NHS.
Speaking about the demand for a service in Northern Ireland, AANI Chair, Ian Crowe says: “We and many others recognised the need for the service here in Northern Ireland. Trauma is the biggest killer of under 40s in the UK and the additional support an air ambulance adds to our existing emergency infrastructure would save lives, which is now being proven. Our province is a rural one with large swaths of poor road access and infrastructure, meaning emergency air support is a critical addition.
“Thankfully, the work of the 21 existing charities across the UK gave us the encouragement, confidence and knowledge to press on with the project.”
Although Air Ambulance NI is a charity and requires donations as its main funding channel, the consultants and paramedics working on the service are provided by the Northern Ireland Ambulance Service (NIAS) at a cost to the public sector.
Trustee Ray Foran explains that the project almost didn’t get off the ground: “In late 2015 we submitted an application to then Chancellor George Osborne for £5 million worth of seed-funding, which was to be sourced from fines levied on banks for LIBOR market-rigging. That application was actually rejected, however, we refused to give up and following extensive consultation with Treasury officials, a second submission made up of £3.5 million plus an additional £1 million of matched funding was granted on 16 March 2016.”
The seed-funding would secure the first 22 months in operation, including the procurement of Babcock Mission Critical Services, who are contracted to provide both the primary and secondary helicopters, pilots and the maintenance of the aircrafts. This, coupled with a signing its Memorandum of Understanding allowed the charity to start accepting the donations that were being offered to support the service.
The operations of the service are such that one helicopter is constantly operational 365 days a year through daylight hours from their operational base at the Maze/Long Kesh. A secondary back up helicopter is located at St Angelo Airport, Enniskillen.
The Ambulance Service provides six paramedics, two of which will be on shift at one time. One as medical flight crew and another manning the air desk. A further four paramedics provide backup to the original team, which is all controlled by an operational lead.
The 15 doctors, all of whom are consultants, are rostered from the various health trusts but importantly, provide their services in addition to their usual working hours.
Crowe explains that ensuring the service would be as effective as possible from the earliest stage, while not taking away any resources from the existing health infrastructure, was an important element.
“The NIAS have been brilliant in facilitating the staff to man the air ambulance. Whether or not to be doctor-led was an important decision to be made and everyone involved needed to ensure that the resources were there to support the service. The 15 doctors who rotate shifts for the service do so in their own time. It’s additional work and so do not require time off within the trusts to facilitate Air Ambulance commitment.”
Some of the air ambulances across the UK remain paramedic-led and as Foran adds, the fact that the AANI has begun with a doctor-led service is a major achievement.
“For many of the charities across the UK, the switch to a doctor-led service was an evolution from where they originally started. Being able to have a consultant at the scene of an incident within a maximum of 25 minutes for anywhere in Northern Ireland is a major advantage to saving lives and delivering the best possible care.”
Although less than six months in operation, the AANI is facing different challenges around a core funding stream available to others in the rest of the UK. Crowe explains that in this area, the charity is at a disadvantage when compared to its counterparts. “Across the UK one of the bedrocks of air ambulance funding is membership lotteries. An example is the Air Ambulance in Wales, who raise £4 million a year through membership lotteries. However, in Northern Ireland, legislation which puts a cap on how much you can raise (maximum £80,000) means that this model wouldn’t be financially viable for the level we require.”
Instead the charity has devised a monthly membership club which launched on 1 December, which includes branded gifts and will be expanded to include store discounts and wider benefits. The Air Ambulance Club can be signed up for through www.airambulanceni.org
Crowe adds: “We will be assessing various funding channels. To date the public and businesses have been very generous and we hope that will continue to be the case. I believe that the more people recognise the benefits of the air ambulance, the more likelihood there is for them to get involved. We have sufficient funding for the first few years and our focus is now to create sustainable funding for year four and beyond.”
However, the charity’s ambitions go beyond attaining funding for year four. As Foran outlines: “A lot of what we have in terms of expansion will depend on the
statistics we gather on the conclusion of the first year. Things like night flying and a second vehicle will be based on the demand and may be explored over the coming years. Long-term we’d also like to establish a permanent base. Currently we’re leasing from the current site and to have our own dedicated base in five years’ time would be an ambition of ours.”
Air Ambulance NI will be seeking further support in the coming months following the recruitment of four area fundraising managers, engagement with the public and seeking corporate support will be one of their priorities. Crowe adds: “Our service is unique and we hope businesses consider the opportunity to support us to keep our medics in the air.”