Since 2009, the availability of 24/7 helicopter emergency medical services (HEMS) in the UK has improved, but significant regional differences persist, according to new research published in the Emergency Medicine Journal.
The study highlights that while more air ambulance teams now operate with doctors capable of delivering advanced critical care before patients reach hospital, not all regions have equal access to these services. The researchers note that "the provision of advanced potentially life saving interventions, such as blood transfusion and a minimally invasive procedure to staunch severe bleeding and stabilise blood pressure (resuscitative endovascular balloon occlusion of the aorta) remains variable."
Air ambulances are equipped to provide Level 3 interventions—advanced procedures that can only be delivered by prehospital teams including doctors. However, voluntary teams such as those associated with the British Association for Immediate Care (BASICS) offer varying levels of service depending on available expertise.
In 2009, there were 17 HEMS teams across England, Wales, and Northern Ireland; only 11 included a doctor and just one operated around the clock. By early 2024, an online survey distributed to all 21 UK HEMS organisations found that doctor-based teams had increased from 11 to 30, including two in Scotland. Consistent 24/7 doctor-based coverage rose from one team in 2009 to eleven in 2024.
Despite this progress, disparities remain. Some regions maintain full-time doctor-based coverage while others do not. Service hours also differ widely; some finish operations as early as evening while others extend into the early morning hours.
The ability to deliver advanced interventions is inconsistent. While most services offer blood transfusions (90%), only one provides resuscitative balloon occlusion of the aorta (5%). Additionally, ten other HEMS teams are available but lack doctors and thus cannot perform Level 3 interventions.
BASICS schemes exist in eleven regions but provide either Level 2 or Level 3 care on a voluntary basis. Funding continues to be a challenge: only one out of twenty-one HEMS organisations is fully government funded; twelve rely solely on charity funding and eight use a mix of charitable and government sources.
Researchers acknowledge limitations in their data collection—the survey reflects conditions as of March 2024 and does not account for all additional prehospital teams whose accessibility could not be confirmed.
"While it is encouraging to see this improvement in access [to HEMS], the ability to provide 24/7 access to Level 3 interventions, such as PHEA [prehospital emergency anaesthesia] remains variable across the country, with heavy reliance on the charitable sector. As in 2009, charitable funding remains the main source for HEMS in the UK," note the researchers.
