Every week, Express FM runs a live show dedicated to news about the Coronavirus in Portsmouth, as Robbie James interviews a range of local people, including politicians, experts, residents and businesses. On 22nd April, Robbie spoke to Alex Lochrane, Chief Executive of Hampshire and Isle of Wight Air Ambulance about the work they are doing with the RAF. Transcribing by Peta Sampson.
RJ: Hampshire and Isle of Wight Air Ambulance are amongst the first Air Ambulance Services to collaborate with the Royal Air Force (RAF) to carry critically ill patients from more remote areas to major trauma centres with increased intensive care capacity. This is a prime example, isn’t it, of the MOD and the community working together?
AL: Well, I would say under normal circumstances, Robbie, but these are anything but normal circumstances. Your listeners will have heard that loads but these are very, very difficult times. It’s a tough time to be in a charity but it’s a tough time also to be on the frontline in healthcare.
Our team spend all their time on the frontline in healthcare, pre-hospital emergency medicine is right at the front end of bringing the hospital emergency department to the patient. Being able to do it alongside some fantastically capable aviators in the Royal Air Force is just another opportunity to show how much we, as two organisations are able to combine forces really, really effectively, and bring the best critical care capability to patients when they need it most.
So, Hampshire and Isle of Wight Air Ambulance, explain to us how you normally operate and how the RAF are now helping you and helping out?
Normally, we would operate a helicopter called an H135, which is a brilliant little aircraft that is really well adapted because it can land in some tight spaces to air ambulance operations. The difficulty under these circumstances is that we can’t safely carry a suspected or a positive Covid patient because we can’t isolate that patient from the rest of the crew, and equally, the rest of the crew can’t wear the PPE, the protective equipment that you’ve seen so much about on the telly, so effectively –
– Sorry, why is that, that they can’t wear it?
It’s because in order to wear the equipment that they need to wear to safely fly the aircraft – so, a flight helmet, safety visor, microphones and all that kind of stuff – they could not wear the PPE over the top of that. Obviously they can’t fly the aircraft without wearing that equipment for flight safety, so you get to a situation where sadly, one patient coming in the back of the aircraft might actually end up creating another three, which is absolutely what we must try and avoid.
So, working with the Royal Air Force, in the back of an enormous Chinook aircraft, allows us to carry a critically ill patient, sometimes even possibly a ventilated patient – that’s a patient that has been put to sleep and there are machines breathing for them – but our team can be right next to them, and they can wear the full protective equipment in the back of the aircraft. In the same way that they’re attending the patient, the RAF aircrew can be far enough away, at the front of the aircraft, for them to be safe from the patient without having to wear the protective equipment.
So it’s essentially just a case of a bigger aircraft and literally, just a practical distance thing?
Exactly – bigger aircraft, more space, [and] more challenge. [There’s] more challenge because our crew can’t wear the normal flying equipment that they would wear, [such as] having earphones where they would listen to what is going on in the aircraft. [That means] they’ve got the noise of a great big aircraft going on, [while] they are having to watch the patient’s vital signs to give care to the patient. It’s a big challenge for our team but they are absolutely up for it.
Is it requiring more people per flight or more resources?
No, because of our fantastic partnership with the University Hospital of Southampton [means that] on these RAF missions, we carry one of our critical care doctors who is a normal member of our team; one of our specialist critical care paramedics, who is a normal member of our team; and in addition, an intensive care technician from Southampton Hospital. Those guys and girls are very skilled at using the equipment that we are using with the patient in the back of the aircraft.
So, that’s only three people that make it run smoothly, much fewer than I expected it to be. How is it working logistically in terms of who is influencing how this is structured? Is it from the RAF, is it from you guys, is it councils or government?
The government has very much pushed it forward through the NHS and Department for Health. They’ve asked the RAF to put three helicopters on standby to conduct transfers, if necessary, from either the Channel Islands or the Isle of Wight. They are ready, at two hours notice, to move and the Channel Islands or the Isle of Wight send a message to say they’ve got a critically ill patient who needs transferring now, they’ll come to our airbase at Thruxton with the aircraft.
We have a standby crew, in addition to our normal helicopter crew. They’ll come to the airbase, join the Chinook and then go and pick the patient up. In earnest, we did it for the first time on Tuesday 7th April, it was before we had managed to do any formal training with the RAF but that’s the nature of these things. There was a patient with a very serious head injury in Jersey and the RAF were ready to go. They picked us up and two of our fabulous team, Dr Simon Hughes, who is ex-Royal Air Force himself, and specialist paramedic, John Gamblin, who is an ex-Navy medic, flew two hours to Jersey. [They] picked up this very badly injured patient, brought them back to Southampton, and they went straight into surgery at Southampton. So far they are making a good recovery, so thank the Lord for that.
It sounds to me like something that would take months and years to prepare for but you’ve obviously done it in such quick time here. Have you been prepared to work with the RAF if it ever had to happen before?
Under normal civil contingency procedures – [these] are dormant plans kept by all ambulance services, the NHS, [and] overseen by the government [which] are sitting in the wings in case there is a major air crash or terrorist attack – the team needs to be incredibly flexible and adaptable, which they are. They are supremely professional and dedicated.
[So now] they’ve taken out the plans and the training that they’ve done with our partner, South Central Ambulance Service in the past, and said, ‘Okay, how are they going to work this time?’ Then the military have come in, under contingency procedures called ‘Military aid to Civil authority’, looked at the problem and said, ‘Okay, let’s try and find a solution to this’.
It does sound like it’s something they’ve prepared before, but they haven’t. No one was ready for Coronavirus, six months ago we wouldn’t even have known what the word meant, but now it’s the only word we speak. So, they’ve taken plans, adapted them and used their flexibility and professionalism, but absolutely, always at the centre of all our procedures is the patient.
I’m sure there will be a lot of people in the community that will want to support this and get involved with this, if they can. How can people support this because this is going to be an ongoing effort?
I think it will be, for a while, and it’s great that you’ve asked about support because as an independent charity, we fully fund the service – not the RAF, but all our medics and our paramedics, we fully fund them.
We rely on the generosity of the people in Hampshire and the Isle of Wight to keep us funded. If folk go to our website, on our News page are lots of updates about what we’re doing. There is the occasional video message from me, if anybody can bear that! But also [there are] ways that they can support us and there’s loads going on on social media.
We have a Facebook quiz every Tuesday night, that’s being run by one of our paramedics, usually when they’ve just come off shift! They’ve been really popular and very successful but there are lots of hints and tips on our social media and on our website, so I’d just ask folk if they want to follow us and they are able to support, go to the website, get updated. Every little bit helps for us.
Well, this absolutely is a fantastic cause and please pass on our gratitude to everyone doing such a fantastic job back at Hampshire and Isle of Wight Air Ambulance and of course, the brilliant RAF as well. You’re doing a sterling job and we appreciate you chatting to us about it.
It’s a pleasure Robbie, and thanks to all your listeners. We will be there for them if they need us, we are their Air Ambulance.
This article was transcribed from Express FM’s weekly Coronavirus Special podcast, 22nd April 2020, and has been edited for clarity and length.
Listen to the full interview over at Express FM’s website, and subscribe to the weekly Coronavirus Special podcast, or listen live every Wednesday, 6pm-7pm. To find out more about Express FM, head over to the website, and follow them on Facebook, Twitter and Instagram. And of course, listen live every day on your radio at 93.7FM or via the website.
Find out more about Hampshire & IOW Air Ambulance over at their website and follow them on Facebook and Twitter.
Image by Hampshire & Isle of Wight Air Ambulance taken from their Facebook page