Team Spotlight: Hayley Rainey
Role: Volunteer Recruitment and Development Manager
“There are many essential tasks at London’s Air Ambulance that the charity wouldn’t be able to deliver without its volunteers,” says Hayley Rainey, Volunteer Recruitment and Development Manager, reflecting on the up to date impact as well as looking ahead, on what the future of volunteering at London’s Air Ambulance looks like. With eight years’ experience in the third sector, ranging from a homelessness charity to the Enterprise Programme at The Prince’s Trust, Hayley talks about the mutually beneficial relationship that is at the heart of volunteering at London’s Air Ambulance.
London’s Air Ambulance has always relied on its dedicated volunteers. From drivers who devote a day per week each to collect our red donation pots throughout the community, to receptionists who have become the first point of contact with the charity.
“We highly value our volunteers and are always looking for ways to help them maximise their potential as well as making the most of their time to make the charity more sustainable. Importance of volunteer work grows even more as the charity expands and seeks new fundraising opportunities,” says Hayley.
Hayley’s responsibility is not just to find and recruit volunteers, but also to support them throughout their time with London’s Air Ambulance. Based on individual interests and availability, she identifies the right position within the charity for those supporters who have decided to donate one of the most precious resources – their time.
“Whether they have been initially attracted to the medical or aviation aspects of the service, whether they found the time to support us in between their university assignments, have dedicated their precious weekends to the cause, or have decided to give back to their community after reaching retirement, we want their experience with our charity to be more than a filling of a gap in their CV or newly acquired time.”
Hayley joined the charity in July 2013 after working in fundraising and programme delivery at The Prince’s Trust and homelessness charity, Crisis, where she led on a grants programme.
“Like many others, I was unaware that London’s Air Ambulance is a charity and was completely blown away by the stories that I read and the passion that everyone associated with the charity had for the work that they do. I was lucky to start here and feel privileged to work alongside such dedicated staff and volunteers.”
London’s Air Ambulance has a cross section of volunteers and welcomes all levels of experience. Reflecting on how volunteering might mean different things for different people, Hayley says:
“We always look at what the candidates are interested in and how best they can support us. It has to work for both sides. We have recently recruited a lady who had just completed a Masters in Database Management. We needed someone to help us with the new database system so it was a perfect relationship, allowing her to get hands-on experience in her area of expertise, while the charity benefitted from her skill set. Some roles are less profiled and enable the volunteers to embrace a broad spectrum of skills. One of our loyal volunteers, who covered a variety of admin tasks required in the office for the last two years, has recently moved to full time employment as a receptionist at Whipps Cross Hospital.”
“When our supporters decide to move on, whether it is to full time employment or due to other commitments, we want them to walk away with a deep understanding of our work and ethos. We hope they will become long life ambassadors of the charity. If they tell their friends, families and employers about us, that in itself makes a massive difference to London’s Air Ambulance, as a key issue continues to be lack of awareness about our charitable status.”
You might be between jobs and hoping to get some admin experience or maybe you just want do something worthwhile in your spare time. If you are interested, please, contact Hayley on
Team Spotlight: John Power
Role: Senior Helipad Fire Officer
John’s passion for flying and all things aviation has been career defining. He understands the service inside out. As a student in White Hart Lane School in Wood Green, he spent an immense amount of time looking out of the classroom window at passing aircraft.
His professional aviation history and active personal interest – he holds a hot air balloon, private pilot’s licence and a fixed wing private pilot’s licence – has enabled him to understand the service inside out. His aviation insight helps him deliver outstanding service – whether it comes to the clear and concise use of the communications system or a very good understanding of weather systems.
In the early days of London’s Air Ambulance, John provided invaluable support to the charity’s leadership and, having been with the service this length of time, he possesses a holistic understanding of its operations and can spot things others could overlook. His unique knowledge system sharpens his perception and enables him to identify incidents before they develop. On numerous occasions he has notified our aircrew and others to potential hazards.
Calm and collected, he embodies the qualities needed for efficient Crew Resource Management, the set of values and practices that, by requirement of Civil Aviation Authority, guide the air ambulance operations. His ability to pre-empt a need is an outstanding quality in prevention of fire and safety management.
John and his team have played a critical role in the co-ordination and mobilisation of medical teams and supplies during many major incidents that have occurred in London and the South East, including the 7th July terrorist attacks in 2005.
John also acts as a charity ambassador within the team. When ex-patients or potential charity supporters come to visit the helipad, his remarkable insight into the history as well as the daily operations of the charity immediately engages them.
Team Spotlight: Graham Chalk
Role: Lead Paramedic/Clinical Liaison Officer
"You can train someone how to do a surgical procedure or anaesthetic. You can't train them how to decide on dispatch of the only advanced trauma team for London on the basis of a 999 phone call. It is an art form, rather than science. Real experts will be able to make decisions with very little information. We need decision makers," says Graham Chalk, who has been in charge of the paramedic selection process and training at London's Air Ambulance for the last ten years.
Graham Chalk first joined London's Air Ambulance as an advanced trauma paramedic on secondment in 1997 and returned as a lead paramedic in 2004, acting as a main point of contact between London's Air Ambulance and London Ambulance Service (LAS). Graham personally selects, trains and mentors all paramedics seconded to London's Air Ambulance from LAS.
Split 50:50 between treating seriously injured people alongside a senior doctor and deciding on dispatch from LAS control room in Waterloo, the nine months spent with London's Air Ambulance are likely to be the most challenging period in a career of any paramedic.
"The hardest part of a paramedic job takes place in the control room. Sitting there, scanning up to 5,000 999 calls LAS receives every day for approximately seven cases of serious trauma is a huge challenge," says Graham.
Having one team on call for the 10 million people in London, the charity has to ensure its dispatch process is as accurate as possible. Responsibility for dispatch rests on the shoulders of a single London's Air Ambulance paramedic. While some dispatch decisions are relatively straightforward - the team automatically tends to falls under trains or incidents involving amputations above the wrist or ankle, others can be extremely complex. People with serious head injuries or penetrative wounds to the chest might come across as stable, but can deteriorate within minutes. The decisions made in the control room make the difference between life and death.
"In the early days, London's Air Ambulance quickly realised that having a clinical person assessing the influx of 999 calls and drilling out more information about the patient from a caller will result in better quality dispatch, more accuracy and less cancellations."
"When you are a paramedic or doctor on the road, you can assess the patients. You can see them, hear them, smell them, feel them and you can work out what is wrong from that. In the control room, your only access to the patient is via a 999 caller who is not educated in medicine."
Graham's answer to the question on how to train a person to identify a critically injured patient from a desk in the control room makes it obvious why a minimum of five years' experience at LAS is a basic requirement for any paramedic applying for a position at London's Air Ambulance.
"Selecting the right people is crucial. Really experienced paramedics will be able to make decisions with very little information. When it comes to the dispatch, all you can do is guide them. It is a great art. How do you teach someone to paint the Mona Lisa? You can't do that. All you can do is to help someone learn how to paint so that they can produce their masterpiece. We have to select the paramedics who are confident and competent enough to make the dispatch decisions."
As a lead paramedic, Graham monitors and scrutinizes the dispatch decisions, constantly optimizing the system.
"It's very difficult to write lists of instructions and algorithms for dispatch of London's Air Ambulance. The process is multifactor. Our dispatch system was built on a very solid foundation from my predecessors. We have consistently tried to evolve it. The core is having a team of people who really want to do it well. Their decisions are closely supervised and audited. Whilst you might want tangible, concrete guidelines, what actually makes the big difference is lots of little, subtle things that, combined together, change the way we dispatch. But it's about selecting the right people in the first place."
Graham has made the paramedic recruitment process at London's Air Ambulance fit for this purpose. The robust and accurate assessment of potential candidates stretches over three months and escalates on the last day with collective input from other London's Air Ambulance staff.
"Usually around forty people, including our doctors, paramedics, medical students and LAS training and educational officers come down to help me pick the top candidates for the next two years. The assessment is carefully designed around decision making, people skills and managing under stressful situations to identify the right people for the job. It's a great testament to the system we evolved that the top 15 paramedics we selected on the last assessment day out of the 30 shortlisted candidates all passed the subsequent interview process. I am very proud of the process and the guys who helped me develop it. I think our paramedics are better for that. We get some of the best people from London."
The staff that assist the recruitment process do so for free, in their own time. Many of them are part of the emeritus scheme developed by Graham to keep the doctors and paramedics involved with London's Air Ambulance after their secondment comes to an end.
"The emeritus scheme is one of the system innovations I am most proud of. It can be challenging for a paramedic to get back to the normality of working for LAS after their nine months with us. We developed the scheme to keep people who are interested in pre-hospital clinical care in our advanced trauma system. If you ask the paramedics at the end of their secondment, they very often tell you that leaving is hard. They want to stay."
Team Spotlight: Mark Davies
Role: Director of Development
“London’s Air Ambulance is saving and improving lives every day - your donations play a vital role in maintaining and expanding our world-leading service,” says Mark Davies, Director of Development at London’s Air Ambulance. " Delivering a 24 hour service for 10 million people 365 days a year comes at a cost. But you can’t put a price on saving a human life,” says Mark
As Director of Development, Mark is responsible for securing support and sustainable income for London’s Air Ambulance. He oversees all fundraising activities, from community and corporate partnerships to trusts and events. Funds generated by our development team directly support the core service.
“The stories of our patients demonstrate the impact that London’s Air Ambulance has on people that live, work and travel within the M25. What strikes me about London’s Air Ambulance is that it truly serves London. Serious trauma is the most common cause of death for people aged under 45 and unfortunately it could happen to anybody.’’
Mark joined London’s Air Ambulance in June 2013 and brings with him a wealth of third sector experience, and a proven track record in fundraising within the medical, health and education sectors. “There are thousands of charities in London which means we have thousands of competitors for the same funding. But the service that our supporters enable us to deliver is unique. No other charity in London does what we do. We are the only provider of advanced pre-hospital medicine in the capital.”
Reflecting on the context of his previous position as Assistant Director at Centre of the Cell, the first science and health education centre in the world to be located within biomedical research laboratories, Mark says: “I am very proud of helping to create Centre of the Cell – it is having a significant impact on improving the life chances of young people from disadvantaged backgrounds. When developing the Centre, we were often asked: Why are you any different? How are you going to make a difference, given that there are many other charities with similar goals? London’s Air Ambulance is unique and has been at the forefront of advanced trauma care for 24 years.’’
“I believe a lot of organisations could learn from our clinical governance systems and the way London’s Air Ambulance operates. Our Standard Operating Procedures are world class and we are recognised throughout the world for clinical excellence. We keep pushing the boundaries in pre-hospital emergency medicine and patient care and our donors recognise that. We have recently been awarded a grant by the City Bridge Trust to appoint a Patient Liaison Nurse to enhance our research and patient care capacities..”
“I joined London’s Air Ambulance because I passionately believe in the charity’s cause, its ability to grow and disseminate what it does internationally. Since joining, I have been overwhelmed by what an incredible organisation London’s Air Ambulance is. A lot more can be achieved if we manage to dispel some of the misconceptions around the fact that we are a charity and need to raise significant funds. We are reliant on donations and we want the public to know that we need and greatly value their support. The continued support of our donors makes a huge impact and is greatly appreciated.”
Team Spotlight: Janet Brady
Role: Medical Secretary
Janet Brady, who has been the first point of contact with our charity for generations of medics, now retires. Students worldwide apply for medical electives at London’s Air Ambulance and professionals seek to observe our team’s work, with waiting lists ever expanding. During the last sixteen years, Janet has made this happen for thousands of applicants. Students she once advised on what to wear for their shifts and how to get home at night in London, now hold medical posts across the globe.
Janet started working at The Royal London Hospital in 1987. Ten years later, she became Medical Secretary to Dr Gareth Davies, Medical Director at London’s Air Ambulance. Janet’s role has changed dramatically as Gareth’s career evolved from Consultant in Emergency Medicine and Lead Clinician at London’s Air Ambulance to the highest medical post in the charity. In 2004, Janet became the secretary to Dr Anne Weaver and Professor David Lockey as well.
From the first email to the final assessment form, Janet has led students through their electives in Emergency Medicine & Pre-hospital Care and has helped doctors, paramedics and other professionals secure observer shifts with London’s Air Ambulance. Over the years, she has maintained the standards of application procedures, ensuring quality of applicants and equal opportunities for everyone.
Janet insisted on CVs as well as accompanying letters to ensure only those who were committed were successful in being granted a medical elective. She scheduled timetables for students admitted to the programme and helped them throughout their experience at London’s Air Ambulance. Over the years, Janet has seen many of them return to London’s Air Ambulance as registrars.
With the waiting list for observer shifts ever expanding, Janet’s structural approach gave everyone an equal chance to get on the shortlist. Despite delivering a 24 hour operation, the service can’t fully satisfy the demand. Before Janet took over, there wasn’t a formal structure in place, doctors and paramedics might have just invited their colleagues along. Applicants from across the globe can now be reassured that their chances of securing a place are better than ever, albeit they might have to wait a while!
Janet’s role continued to develop as London’s Air Ambulance’s reputation for clinical excellence spread worldwide. When students returned from their elective, they talked about the experience with the service to their classmates and colleagues. The number of applicants grew exponentially every year thanks to Janet who coordinates the programme delivered by London’s Air Ambulance, The Royal London Hospital and Queen Mary’s Medical School.
She smiles when she describes how London’s Air Ambulance and the A&E Department of The Royal London Hospital were one of the first in the hospital to use intranet and email. It didn’t quite work in the early days because they initially didn’t have anyone to email to. Others still wrote letters or picked up the phone.
I have loved working for such a good cause and I have really enjoyed working with everyone at the helipad and in the charity,” said Janet, reflecting on her time at London’s Air Ambulance. The staff said goodbye to Janet on Thursday 9th April and presented her with a gift and flowers.
Monthly Team Spotlight: Christine Margetts
Role: Community Fundraising Manager
The Charity’s first step towards community fundraising was a stall, selling polo shirts and helicopter pin badges in the hospital’s foyer in 1997. Christine Margetts, our Community Fundraising Manager and founder of that stall, talks about the Charity’s early fundraising efforts – from having her stall blown off by the landing aircraft, through to securing the first Rapid Response Car, all the way to our most successful community event ever, last year’s abseil that raised £94k.
Christine initially worked as a secretary for Dr Gareth Davies, London’s Air Ambulance Medical Director . In the mid 90s, she started looking for ways to generate additional income that would help cover the costs of the service, at the time supported by one major donor - Virgin Group.
‘Someone at the helipad organised branded umbrellas, baseball caps and other merchandise and I started selling it. I officially took on the job of Fundraiser and became the Charity’s first employee later on,’ said Christine.
In 2006, the Charity office had a team of four full time employees. The aim was to develop a more sustainable funding structure, with multiple corporate partners and a network of supporters across the local community. Changes in funding of the Rapid Response Cars illustrated the growing sovereignty of the fundraising team.
‘The first car replacing the helicopter at night was an Audi Quattro, paid for by Virgin. The Charity later approached a supplier of police vehicles, Volvo, who lent us the vehicles. We depended on Virgin's merely for the cost of insurance. The next Rapid Response Car, Subaru, was donated to the service with fully covered costs.’
The Charity’s fundraising structure has become increasingly complex over the years. Christine now holds the position of Community Fundraising Manager, working alongside Corporate Fundraising, Events, Finance and Communication Departments. She talks about the Charity’s early days with a smile.
'In the late 90s, I used to take a London’s Air Ambulance stall to the local markets and festivals at the weekends. We once brought the helicopter to West Wickham Summer Festival to help generate awareness about the charity. The aircraft blew the stalls at the market when landing and I had to throw myself at the merchandise to prevent losing everything.'
On another occasion at the Biggin Hill Air Show in West London, Christine was carried away by a random air turbulence when trying to save the charity’s gazebo.
'I was hanging to the gazebo like Marry Popins, while the ‘mini tornado’ dragged it twenty feet away. Stalls on either side of ours remained untouched, while our gazebo ended up completely damaged.'
The early fundraising efforts might seem like a distant past compared to current community fundraising events such as the Abseil 2012, with 200 people abseiling down 585ft off the Broadgate Tower. Yet the stall is still in the foyer of The Royal London Hospital, selling merchandise including London’s Air Ambulance polo shirts, metal models helicopters and iPhone covers.
Monthly Team Spotlight: Dan Barnwall
Dan Barnwall offers an insight into the main differences of working within the London Ambulance Service (LAS) and London’s Air Ambulance, as well as nuances of everyday life of a paramedic at both organisations. Dan joined LAS in 2001 and has worked as a paramedic for the past eight years. He started with London’s Air Ambulance in October 2012.
"You see more patients with life-threatening injuries in your nine months with London’s Air Ambulance than you probably will in your entire career at LAS. If you have been a paramedic for a while, it’s an exciting professional challenge," says Dan.
Dan reflects on the fact that London’s Air Ambulance caters for a niche group of patients that are very seriously injured and are likely to die unless advanced medical care is provided immediately.
"Every time the klaxon sounds at the helipad, you know you are going to someone that needs your help urgently. It’s a different mindset to LAS, where you can be tasked with a full spectrum of things that people call 999 for. Ranging from heart attacks, strokes and medical conditions to people who are just having social issues at home and they don’t necessarily need emergency care but don’t know who else to call.
"During the three years that I spent as a regular LAS paramedic in Bexley borough, I only saw a handful of patients that were traumatically injured. As a duty officer in Greenwich, I was working a lot more with London’s Air Ambulance and seeing more patients that were stabbed, shot or had significant traffic accidents. I dealt with one or two seriously injured patients a month. At London’s Air Ambulance, we go to an average of four severely injured patients per twelve hour shift.
"Your skill set is extended accordingly at London’s Air Ambulance. You learn advanced medical procedures, use more equipment and more drugs. What I perceive as one of the most dramatic advances at London’s Air Ambulance is the ability to set up pre-hospital blood transfusion and start to give the patient blood prior to their arrival to the hospital.’
London’s Air Ambulance paramedics work alongside senior doctors to deliver the treatment. Guided by the principle of governance, the team has to work as quickly and efficiently as possible.
"While the doctor is doing a proper assessment, the paramedic will be doing things that need to happen at the same time – getting a set of observations, preparing equipment and packaging of the patient. The governance system at London’s Air Ambulance is incredibly tight."
"A big thing for London’s Air Ambulance paramedics is to help perform simple chest surgery on the scene of the incident -an incision into someone’s chest is made to re-inflate a collapsed lung. It is a surgical procedure with a scalpel, exactly the same treatment the patient would get in the hospital. If required, this can lead to open heart surgery and other advanced procedures we assist the doctor with. Procedures London’s Air Ambulance can perform at the scene of the incident are profoundly different to what LAS paramedics can do. This skill set can really make a difference between life and death."
"Someone that’s dying from a traumatic injury might not have ten, fifteen or twenty minutes to be transported to the hospital. With a patient that’s dying in front of you, as an LAS paramedic you exhaust your options quite quickly and if it’s fruitless, it’s a horrible feeling. You have been sent to help the patient, but your armoury to be able to deal with them is quite limited. It is a relief when London’s Air Ambulance team arrives at the scene."
Monthly Team Spotlight: Dr Anne Weaver
Role: Lead Clinician & Trustee
As Lead Clinician, Anne is responsible for the day-to-day running of the service – she makes sure that the doctors and paramedics are trained, supported and maintain their skills. “When working at London’s Air Ambulance, you are the only doctor on the scene of serious injury and making the right decisions rests on your shoulders. That’s why the training is so thorough,” says Anne.
“The doctors we recruit are always senior and they spend the first month of their six-month placement working alongside one of the existing doctors, who will be training and de-briefing them after every mission. As Lead Clinician, I run twice-weekly case review sessions with the whole team where we challenge and learn from each other.”
When they are on duty, team members can call Anne day or night for guidance or to discuss the best course of action for a patient. “The service has a good reputation internationally and I need to ensure we not only maintain our high standards but also stay ahead of the game using cutting-edge technology and techniques. It’s a challenging role and there are never enough hours in the day.”
One day that is still clearly imprinted in Anne’s memory is 7th July 2005, the day that suicide bombers attacked four locations on London’s tube and bus networks.
“It was so surreal,” Anne says. “I was in a meeting with 16 past and present air ambulance doctors, something we do once a month. The chief pilot must somehow have been aware of something awry and said that we should all get our flight suits on. It seemed ridiculous at the time for 16 of us to get ready when normally only one doctor is on duty, but minutes later a major incident was declared.”
The helicopter and cars ferried the medical teams to the four London locations – Aldgate, King’s Cross, Edgware Road and Tavistock Square. Anne, as Lead Clinician, was responsible for organising the effort.
“I remember standing in the operations room on the helipad, looking over London and feeling sick and guilty that I was sending my friends and colleagues out into dangerous situations.
“I thought I was going to get a call to say that a doctor or paramedic had been killed if another device detonated. I knew that if I hadn’t done the organisation at the start, we wouldn’t have had people in the right places. But it was a relief to then go to King’s Cross myself and do what I felt I was meant to do in this situation: be a doctor.”
“Later that day, the chief executive gathered 400 staff from the hospital and air ambulance together to de-brief. It was an amazing feeling of camaraderie. Everyone had pulled together and we felt very emotional about the events. We knew we had provided a good service for patients that day.”
Anne juggles her air ambulance responsibilities with being a Consultant (Senior Doctor) in Emergency Medicine and Pre-hospital Care, at the Barts and the London NHS Trust.
The original version of this article by was published in Alumni Exchangew4, the alumni magazine of the University of Nottingham, UK.
Monthly Team Spotlight: Paul Smith
Role: Helipad & Driver Standards Manager
At night, when it is too dangerous for the helicopter to land in London, our medical team switch the MD902 Explorer for a Skoda Octavia and drive on blue lights to the scene of critical injuries. Paul Smith, Helipad & Driving Standards Manager, oversees the Rapid Response Car operations at London’s Air Ambulance - from training the paramedics in driving under emergency conditions and enhancing the doctors’ navigation skills, to ensuring all vehicles and the helipad are in service.
Paul holds the RoSPA Gold Grade, the highest riding award available to the public, and has being granted grade six by the Driving Standard Agency, the top evaluation for the Approved Driving Instructors. He has worked for the charity for the last 17 years, initially starting off as an aviation fire-fighter.
London’s Air Ambulance has its own internal driving licence and all paramedics undergo five days of training with Paul to get fully prepared for driving our rapid response cars. When asked whether anyone has ever been prevented from joining London’s Air Ambulance on the grounds of their driving skills, Paul admits that there have been a number of people in the past who had to have their driver training extended as they did not meet the level that he had required.
Our doctors navigate the paramedic to the scene of incident from the passenger seat. Paul trains them in map reading, phraseology of giving out directions and the operations of the sat nav. Preparing the doctors, who often come to work for London’s Air Ambulance from outside London or abroad, to promptly find their way around the Capital in emergency situations is an on-going process. “Doctors spend two nights training with me. In their training month, they will be shadowed by other doctors, who will also be giving them guidance on the sat nav training,” says Paul.
In addition to his work as Driving Standards Manager, Paul’s role as the Helipad Manager means he works closely with the Chief Pilot and the Senior Fire Officer. Commenting on his experience with the charity, Paul says: “I have worked at London’s Air Ambulance for almost two decades and it has been a great experience. I have learnt a huge amount and I have worked with some fantastic people.”
Paul currently manages six Skoda Octavias. The fleet also serves as a back-up when the helicopter is offline due to dangerous weather conditions or maintenance and its role further increases in the winter with arrival of early dusk.
Monthly Team Spotlight: Dr Julian Thompson
Role: Executive Director
A day in life of a doctor at London's Air Ambulance
Dr Julian Thompson, Executive Director, describes his London’s Air Ambulance experience - the responsibility of being the single doctor and paramedic team tasked with providing advanced life saving trauma care for 10 million people: “When the claxon sounds on the helipad, the terrible significance is that someone, somewhere in London has been seriously injured and is fighting for their life. After a few months in the job, the noise elicits an instant Pavlovian response. Adrenaline surges, the heart quickens, the mouth dries in the knowledge that in a few minutes we will be immersed in a time critical and life threatening situation.”
Julian worked as a doctor at London’s Air Ambulance in 2010 and returned as an Executive Director in November 2011 to lead an enhancement of the capacity and funding of the service in partnership with senior figures in the City of London. Julian qualified as a doctor from Oxford University in 2001 and his interest in Pre Hospital Care has been developed through his experiences of working with the British Army in Afghanistan and leading mountaineering and exploratory expeditions across the world. Today, Julian offers an exclusive insight into a day in life of London’s Air Ambulance doctors and paramedics.
“The night team comes to the end of their twelve hour vigil for the city at 7am and the day team come on duty with a sense of anticipation. The nervous wait for the first mission is filled with meticulous equipment, car and helicopter checks and the research and training activity that has allowed the charity’s expertise to have such a wide impact on trauma care beyond London.
Once the claxon announces an incident, the medical team and pilots run to the aircraft and two minutes later we are airborne and on our way. The helicopter can cover ground at 175mph so the flight across London is brief before we are circling overhead and the pilots bring the aircraft in to land with extreme precision.
Within moments of landing we are in the thick of incidents such as road traffic accidents, industrial incidents or stabbings. Whilst the critically injured victim is central to the mission, the additional challenges of such situations are intense, unpredictable and would never occur in a more conventional medical setting – fast moving traffic, electrified underground rails, falling masonry, ongoing violence to name a few.
Training and experience can eventually normalise even the most extraordinary of situations. Immediate assessment of the injured person and calm communication and collaboration with the other emergency services at the scene soon creates a unified plan for us all to work towards. Time is critical when people are severely injured and so difficult decisions and essential advanced procedures are performed there and then at the scene of the incident. Open heart surgery in the dark on a balcony in a housing estate with a crowd of bystanders is challenging however much experience you have.
During the mission, the emotional significance of the incident is secondary to the immediate tasks of preventing death and disability, and making the right decisions. Afterwards there are moments that haunt or resonate in unusual ways – an injured child of a similar age to your own, a suddenly bereaved wife – but the shared experience of the close knit team provides an often unspoken understanding of these issues.
After treating each patient at the scene of the incident we accompany them to the nearest specialist hospital, handover care to the waiting trauma team and declare ourselves ‘green’ for the next mission. Each mission may only involve thirty minutes of intensive care at the moment of the patient’s greatest need.
However most patients are so severely injured that they are unaware of our involvement and it is usually the last time we will ever meet them. Occasionally, patients who we have cared for contact us to say thank you. Meeting someone whose life you have helped save has great poignance and gives even more meaning to the daily efforts of this incredible service.”
Monthly Team Spotlight: Dr Gareth Davies
Role: Chair & Medical Director
A Short History of Dr Gareth Davies and his Career in Pre-Hospital Emergency Medicine
Dr Gareth Davies began his interest in pre-hospital medical care as a child, observing the helicopter emergency medical service provided for motorcycle crashes at the TT races near his home in the Isle of Man. A young Gareth felt that such care should be available to the public, and with almost 20 years of work with London's Air Ambulance, he is now a pioneer and leader in the recently recognised speciality of pre-hospital emergency medicine.
Gareth remembers the single moment when he recognised the need for a helicopter-based emergency medical service. A motorcyclist in one of the TT races he was watching had crashed into a bridge and was critically injured. He watched the helicopter land near the crash site and the doctor immediately begin delivering medical care. Gareth noted that, "the irony was the general public wouldn't get that service, it was only the riders at the race. So it seemed to me pretty obvious that is what the general public deserved if they crashed a bike or fell off a roof so when I was a kid that pretty much did it for me." Gareth knew that one day he wanted to be able to provide such a service to injured people everywhere, inside or outside of the motor sports world.
Gareth eventually began medical school, but there was no specialisation in pre-hospital medical care. In fact, at the time the whole sector of pre-hospital medical practice didn't exist on a recognised professional basis in NHS, so Gareth put his goals on the backburner while knowing he would be further involved with it one day. On one trip back to the Isle of Man as a junior doctor, Gareth found a pamphlet in the library for HEMS, the Helicopter Emergency Medical Service in London that is now London's Air Ambulance. It described a new type of service that had just started in London with the Daily Express and the Government. Gareth photocopied the pamphlet (a piece of paper he still has) and kept it with him, knowing that this is exactly what he wanted to do.
After his years as a junior doctor, Gareth began his application process for a registrar position with London's Air Ambulance. While looking for support and advice from senior medical colleagues, Dr. Davies received negative feedback and was told that the London’s Air Ambulance post would be a career ending decision. Determined to continue in the line of work that had peaked his interest for so long, Dr. Davies pushed on to get support. He remembers: "When I chose to apply for the job as a registrar in 1993, only one consultant in the North would support me. They all said I was committing career suicide by coming down. So I came down for six months and then got stuck! I've been here ever since." Since Dr. Davies joined London's Air Ambulance, pre-hospital emergency medicine has grown and become increasingly accepted by the establishment. Last year the General Medical Council announced pre-hospital emergency medicine as a legally recognised sub-specialty of medicine. "That's nearly a 20 year journey to go from being anti-establishment to a recognised specialty," Dr. Davies commented with a smile.
Now playing a key role in rapid response to traumatic incidents, London's Air Ambulance has been involved in all of the major incidents within the M25 since its establishment. Dr. Davies remarked: "We are usually on our way to a major incident before it’s been declared as a major incident. Our most significant performance was during the July 7th bombings, when we sent out nearly 30 doctors and paramedics to the various bomb sites. The service delivered a fantastic response to the events and was recognised at the recent inquiry in May for its contribution to people's lives and quality of life after their injuries. So this is part of what we do, and we train very hard for it. Not just terrorist bombings but things like chemical and biological attacks." Dr. Davies also commented on the tight resources available to the charity, noting how fortunate it was that on 7/7 there was a meeting where there were 30 doctors and paramedics in one room, which would not normally be the case. In usual instances, the service wouldn't be able to put out more than two or three teams in the first response.
Dr. Davies recognised that, "The NHS is undoubtedly a remarkable feature of our society, but it does cost a lot and there are many, many calls upon it; totally understandable and worthy causes, from breast cancer to cystic fibrosis, down to being trapped in a car, dying. The NHS can't support everything, and that's why we are also dependent on the charitable sector and people donating, whether they are individuals, or companies, and also the Government doing its bit as well." The importance of donations to the Charity increases the ability of London's Air Ambulance to build upon the current teams, research and capabilities of the service.
Commenting on his short and long term goals for London’s Air Ambulance, Dr. Davies said that, "the service has achieved its primary aim, which is to train as many doctors in pre-hospital medical care as possible." More short term goals include increasing capacity for on-call medical teams and achieving financial support to run a second aircraft. Dr. Davies' longer term goal is all about developing an academy to train more pre-hospital medical care professionals and spur on more research into improving their cutting-edge medical practices for their patients. Dr. Davies looks forward to developing, "equipment, techniques and processes for patients that currently have a 100% mortality rate, so that maybe in ten years time, they will be living, continuing life and having families, which we have seen with some of our innovations. In a group that had no hope, absolutely zero hope of survival, we now can expect a 20% survival rate and for them to carry on normal lives. The academy will hopefully allow that to continue as we move into the next decade and beyond."
When asked if he still has time for his hobby, Dr. Davies recognised that with four children he is unable to carry out motor sport, but he contributes as one of the Chief Medical Officers for the TT races that originally sparked his passion for his job. He said, "It is very rewarding to support these guys to go out racing and do what they do. I occasionally get back on a bike, although I won't be racing myself ... but it allows me to bring my work into something that originally inspired me to go into this field of medicine. I just love it!"
[Left] Dr Gareth Davies with ex-patient Alana at our recent Parliamentary Event [Right] Dr Gareth Davies with ex-patient Alana on her first visit to the helipad after her accident. Read more about Alana's story here.