Key Issues


AAA Policy

Desired Outcome



Flight Time Limitations are being debated by EASA and the CAA, with the potential of a set number of working hours being placed on HEMS Crew Members.

To allow Air Operator Certificate (AOC) holders to manage HEMS Crew Members via the Chief Pilot and Aircraft Commanding Officer. This will be achieved by setting and monitoring working hours, reducing fatigue. This will safeguard the operation of the aircraft, allowing for winter pressures, illness and periods of inactivity.

EASA to allow state oversight of AOC operations.

·  European Aviation Safety Agency (EASA)

·  Civil Aviation Authority (CAA)

·  British Helicopter Association (BHA)

·  European Helicopter Association (EHA)

·   AACE


In 2016, it is planned that the replacement for the ambulance services (Emergency Services) radio network will be launched. This will replace the current Airwave system that allows air to ground and ground to ground communications between the Ambulance Services and Air Ambulances.

The rollout of the new 3G/4G platform is welcomed as it will enhance the current voice only platform with the ability to transmit data. The rollout must be smooth and allow for continued communication, with the installation of the new equipment ideally taking place during the annual maintenance of the aircraft. Owner/Operators and Contracted Customers of the aircraft should be able to choose where the new equipment is fitted, with the cost of the installation being met by the Home Office.

The smooth transition from Airwave to the new 3G/4G platform.

·  Home Office

·  Department for Health


·  Ambulance Services

·  National Police Aviation Service (NPAS)



Access to Helicopter Landing Facilities at Specialist Treatment Centres is inconsistent across the UK. Additionally the introduction of night air operations realises the need for approved night landing sites.

The AAA supports the need for increased NHS Trust infrastructure funding allowing the development and improvement of sites. This will result in easier access by HEMS flights to specialist treatment centres and for the impact of darkness and low light to be reduced by the introduction of approved lit landing sites.

To see increased collaboration between NHS Trusts that receive or transfer patients via air ambulance; engagement with air ambulance charities, AOC holders, CAA and ambulance services, to provide a complete patient and safety focused facility. The facility should allow for the speedy, safe and dignified transfer of a patient from an air ambulance to the treating clinicians.

·  Department of Health

·  Civil Aviation Authority

·  NHS England, Scotland and Wales

·  AAA members





To define the role of media personnel who participate in HEMS missions; facilitating the promotion of the air ambulance charities that fund air ambulance activities in the UK.

The AAA seeks clarity of the aviation law surrounding media personnel who perform a valuable, safe, but infrequent activity in support of producing media content for the promotion of air ambulance activities, while being recorded as medical personnel.

To ensure the safe operation of the air ambulance allowing the recording of media material to promote the activities of the air ambulance sector in the UK.

·  Department for Transport

·  CAA


·  BHA

·  EHA


The Culture, Media and Sports Select Committee are taking evidence in consideration of increasing legislation on society lotteries, increasing set up costs and reducing the percentage of revenues generated being given to good causes.

Lottery income is a critical component of air ambulance charity income. Flexibility should be provided for in the legislation, ensuring new lotteries or changes to existing lotteries can easily be implemented, without allowing operations to reduce the income of good causes. 

The AAA wishes the Cabinet Office to look at examples of high performing lotteries in the air ambulance charity sector and ensure the high incomes received with low operational costs are not undermined.

·  Cabinet Office

·  Charity Commission

·  Gambling Commission

·  Lottery Fundraising Council

·  Fundraising Standards Board


To maintain Ambulance Services as the primary coordinator of pre-hospital care.

The AAA believes that Ambulance Services should coordinate all forms of pre-hospital emergency care services within their respective region; including the provision of specialist services such as part of major trauma care networks.

Ensuring the UK’s Statutory Ambulance Services prioritises, coordinates and tasks Air Ambulances to the patients that most need the service; be that emergency services or transfer services. Through this unified approach, prompt patient treatment, care pathways and major incidents are best placed to be managed.

·  Department for Transport


·  MCA

·  Department of Health

·  Communities and Local Government

·  General Public

·  NHS


The introduction of European Standards should be encouraged to ensure best clinical and operational practice in the operation of air ambulances.

The AAA will engage through its partner British Standards Institute (BSI) to participate in the European Committee for Standardisation (CEN) ensuring the UK model of operation is represented and understood.

To ensure a balanced and appropriate standard is set for both the size of the airframe and the minimum equipment levels required to practically improve patient care within the geography, economic and environmental constraints of the UK.

·  Business Innovation and Skills (BIS)

·  BSI

·  CEN


The inconsistent use of terms and confusing position statements around HEMS, paediatric HEMS and inter-hospital transfer is confusing and potentially misleading to legislature, industry operators and the public.

The AAA seeks to encourage more open and transparent communication across the sector through the development of a generally accepted taxonomy, thus reducing confusion and ensuring that the best possible service is provided to patients and the communities.

To eliminate inaccuracies and confusion around air ambulances in the UK.

·  All Government Depts. (local and national)

·  All Third Party Aligned Organisations

·  General Public


Some major national super market chains decline access to their stores for the purpose of canvassing of air ambulance charity lotteries which are one of the main charitable income streams. 

Whilst accepting the supermarkets’ right to take this action, the AAA seeks to persuade supermarkets to change this policy. 

To seek equitable access for charity lotteries in super markets.

·  WM Morrisons PLC and Sainsbury PLC

·  Main Stream Press and Media

·  Lottery Fundraising Council


Confusion between the purposes of helicopter emergency medical services and search and rescue services is undermining the regulatory frameworks (aviation and clinical) at a National and European level.

The AAA places the treatment of the patient at the centre of the service being delivered.  A greater understanding of the differences between search, rescue and medical services is needed. The AAA supports greater collaboration through better tasking and standard setting bodies that enhances patient care.

To see all regulators and service providers sharing information through peer reviews and agreeing standards that meet patient needs at European and state level.


·  CAA

·  CQC


·  Maritime and Coast Guard Agency (MCA)

·  Department of Health

·  Department for Transport



The Deregulation Act 2015 has made the use of Rapid Response Vehicles owned by a Charity with certain types of reflective markings illegal. 

The AAA wishes the Department of Transport to consult and amend the legislation, ensuring no enforcement action of emergency medical service drivers takes place.

To promptly amend the legislation allowing for legitimate charity vehicles tasked by statutory ambulance services to work within the Road Traffic Regulations Act 1984.

·  Department for Transport

·  Department of Health


·  Cabinet Office


A number of air ambulances within England currently receive little or no funding/support from public funds.

The AAA asks that the Department of Health and Commissioners support local air ambulances and ambulance services through the necessary support/provision of both financial and clinical help at a local level.

Ensuring close collaboration between ambulance services and the commissionaires delivering exceptional patient treatment in collaboration with air ambulance charities.

·  Department of Health

·  NHS Hospital Trusts and Foundations

·  Ambulance Service Commissioners