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April 3, 2013 3:07 pm
London is alone among its rich world peers in relying on one helicopter for airborne medical services, putting emergency treatment in the capital at risk, the head of the city’s air ambulance service has warned.
Graham Hodgkin, a former Deutsche Bank executive who took over in December last year as chief executive of London’s Air Ambulance, said cities such as New York, Paris and Sydney each had at least four helicopters running equivalent services.
The London service is run as a charity. Now, Mr Hodgkin, who spent more than a decade at Deutsche Bank largely in commercial banking, is aiming to make use of his City network to put funding on a more sustainable footing.
A second helicopter is a key objective – the one aircraft spends up to six weeks a year being serviced – leaving the air ambulance flightless for long periods. At these times, as well as at night or when the weather is bad, the teams run a car-based service. But response times inevitably suffer.
“London is a city that can have up to 11m people in it at any time. Instinctively it feels vulnerable to have only one aircraft to do what we do,” Mr Hodgkin told the Financial Times.
For this reason, he is researching the charity programmes of every big City institution and talking to the Square Mile’s guilds and livery companies.
He sees the ideal relationship as being with a wealth manager or private bank: “Access to their corporate and high net worth clients would create a different dimension in terms of funding sustainability,” he said.
Date of birth: July 1966
Mar 2011 to date: Signpost Advisors Limited
Sep 2000 to Dec 2010: Deutsche Bank AG, London
Oct 2008 to Dec 2010: Managing Director, Head of Corporate Banking Coverage
Corporate Finance, Global Banking, UK & Ireland.
July 1994 to Sep 2000: The Sumitomo Bank, Ltd, London
Assistant general manager, Head of London branch operations
Jan 1988 to Jul 1994: Bankers Trust Company, London
Apr 1986 to Jan 1988: Prudential Bache Trade Finance Ltd. London
Aug 1984 to Apr 1986: Brown Shipley & Company Ltd, Haywards Heath
London’s air ambulance is no ordinary ambulance service. It brings highly skilled physicians to the scene of an emergency, where they can perform complex surgical procedures and make use of anaesthetics and ultrasound tools normally reserved for accident and emergency departments.
Last year, for instance, the service carried out 40 open-heart operations at the site of accidents.
Gareth Davies, medical director and chair of the trustees, said: “We bring the hospital to the patient’s side, whether that’s their bedroom, underneath some scaffolding or beside a road or railway track.”
The service is based at the Royal London hospital in Whitechapel in east London, covering a zone that extends roughly to the M25 ring road around the capital.
It has unique privileges in London’s airspace, with priority over other air traffic when on call. Its pilots have the right to land anywhere, including this week on Waterloo Bridge in rush hour.
Since it was founded in 1989, the service has won an international reputation as a pioneer in emergency medicine, drawing highly qualified doctors from around the globe on secondment.
“We attract some of the best doctors in the world,” Dr Davies says. “People in London don’t quite realise this when they’re being treated.”
But the work places an intense psychological pressure on its practitioners. Of 4,000 emergency 999 ambulance calls made every day in London, just six or seven of the most critical will be passed up to the service. These are life-and-death incidents where time is of the essence and mortality rates are high by definition.
“There is a brutality to the work we do. It is austere in many ways due to the severity of injury,” says Dr Davies, adding that secondments are limited typically to six months and doctors are regularly rotated back on to accident and emergency wards to relieve the pressure. “It’s important to keep your feet on level ground,” he adds.
The NHS and local authorities pay for the service’s six doctors and paramedics – accounting for about 25 per cent of the £4m annual costs – but the helicopter and other operational costs are funded through a mix of charitable donations, a self-run lottery, a grant from St Bartholomew’s Hospital Trust and corporate sponsorship such as a five-year deal with Aberdeen Asset Management.
For now, Dr Davies can only look with envy at the resources in other big cities. “That’s one of our big challenges: to deliver the resilience that they have.”
It was Alana’s first day at a new primary school when she slipped and fell off a railing. Initially, she appeared unhurt, with just a slightly bruised head. But when, shortly afterwards, she collapsed into unconsciousness, teachers immediately called 999.
Dr Gareth Davies, medical director of London’s Air Ambulance, arrived on the scene within minutes, diagnosing a skull fracture that was bleeding into the five-year-old’s brain. The resulting pressure was rapidly shutting down vital functions. “She had minutes to live,” he said.
Using highly skilled techniques to bring her heart rate down, he was able to control the pressure and stabilise the girl in the school gym before rushing her to intensive care.
“It’s important to get to the patient quickly but for some patients it’s pivotal to get back [to hospital] quickly. There is absolutely no doubt that in most places in the world she would no longer be here,” he said.
Dr Davies, the driving force behind the service, has dealt with every major emergency to hit London in the past 20 years, from the 7/7 and Bishopsgate bombings to the Potters Bar rail crash. But some of the most difficult situations arise when, as occasionally happens, traumatised members of the public displace their anxiety and anger on to the team.
“If they have a loved one who has gone down, the only currency they have is to threaten you to get it right. The team have to be able to take that and not necessarily with any protection,” he says. “A stab vest is sometimes the only thing between you and them.”
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