AAUK - Airway Magazine - Winter 2024

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Contact Details

Email: info@airambulancesuk.org

It’s wonderful to see the pictures of all the Award winners from our Air Ambulance Awards of Excellence a few weeks ago. It’s always one of the year’s highlights and this year was no exception. I loved hearing all the stories of the winning individuals and teams and I send out my very best wishes to all who entered and were shortlisted, and a huge congratulations to our winners. Read more and see photos of the winners from page 8.

Earlier in the day, we had the AAUK Conference and Exhibition too. Once again, we were blessed with a series of outstanding speakers who brought all the latest information and innovation from the front line of operations, fundraising and clinical areas.

There was so much information that everyone could take away with them, share with their teams and maybe incorporate into their own practice. If there’s one thing that the air ambulance sector is, it’s innovative. Air ambulance charities are flexible, agile and always willing to try a new approach if the ultimate goal is to save more lives and create better outcomes for patients. Read a little more about some of the presentations on page 11.

Editor - Nick Campion

E: info@airambulancesuk.org

T: 07958 695778

REGISTERED OFFICE ADDRESS

On the subject of innovation, have a look at page 7, where one of our Conference speakers Marjan Shoeke from Vertical Aerospace, tells us about how eVTOLs - electric vertical take-off and landing aircraft - have the potential to shake up the pre-hospital emergency medicine landscape. It’s a fascinating idea and of course in its very early days – but the sector has been crying out for the development of alternatives to fossil fuel helicopters and maybe this could be part of the solution.

Association of Air Ambulances (Charity) Ltd., Operating as Air Ambulances UK. International House, 126 Colmore Row, Birmingham, B3 3AP.

On pages 12-13, we have two more Patient Stories - the remarkable tales that remind us just why air ambulance charities exist and the genuinely life-saving work they do. These stories are a stark reminder of just how critical every second is when someone has suffered a terrible accident or medical emergency.

Association of Air Ambulances (Charity) Ltd, operating as Air Ambulances UK, is Incorporated and Registered in England and Wales: Registered Company Number 9391251 and Registered Charity Number 1161153. Registered in Scotland SC051021.

Association of Air Ambulances Ltd is a subsidiary of the Association of Air Ambulances (Charity) Ltd and is Incorporated and Registered in England and Wales: Registered Company Number 08341197.

Disclaimer

Whilst

There’s a huge amount going on at AAUK itself, as you can see from our news pages (pages 4-6). One of those pieces of news is that I am writing to you now with just a few days left of my time at AAUK. In January, I will begin a new job as Chief Executive Officer at the Royal Life Saving Society UK. I have enjoyed my four years at AAUK enormously - it has been a privilege to work in this wonderful sector and to lead an outstanding team. I’d like to wish you all a very Merry Christmas and continued success in your lifesaving work.

@airambulances youtube.com/ @airambulancesuk/

BBC LIFELINE APPEAL HITS £43,977

Air Ambulances UK and the UK’s air ambulance charities were featured in a special BBC Lifeline appeal, presented by long-time supporter Rav Wilding, on 15 September, and as a result have raised an incredible £43,977.

The Appeal focused on three stories: Riley, who got a coin lodged in his throat, obstructing his breathing and threatening his life, and helped by Scotland’s Charity Air Ambulance; Jane, who suffered a cardiac arrest and whose heart was restarted by Devon Air Ambulance; and David, who survived a devastating car crash thanks to Warwickshire & Northamptonshire Air Ambulance.

The appeal was presented by Rav Wilding. He commented: “I’m thrilled to support Air Ambulances UK in this vital appeal. I’ve had the privilege of seeing the lifesaving work of air ambulance crews up close during my time on Helicopter Heroes, and their level of care never ceases to amaze me.”

The appeal not only raised £33,977 in donations from members of the public but also benefitted from £10,000 donated by Ageas – an incredible gesture in addition to much other fundraising by a valued Air Ambulances UK corporate partner.

AAUK has announced that Derek Redmond, one of Britain’s most iconic athletes has agreed to become an Ambassador for the organisation. Derek’s remarkable career and inspirational journey make him a powerful advocate for raising awareness and supporting the vital work of air ambulance charities across the United Kingdom.

Derek, a World and European relay champion, is renowned for breaking the British 400m record and being a key member of the relay squad that secured gold at the 1991 World Championships in Tokyo. His dedication and determination were on full display at the 1992 Olympics in Barcelona, where he finished the 400m semi-final despite tearing his hamstring, creating one of the most inspirational moments in Olympic history.

In his role as AAUK Ambassador, Derek will engage in campaigns and initiatives aimed at highlighting the indispensable role of air ambulance charities. His involvement will focus on raising public awareness and championing the incredible work carried out by air ambulance teams.

One year: £250,000

Simmy Akhtar, CEO of AAUK, said: “We are privileged to have Derek Redmond as an Ambassador for AAUK. His resilience, determination, and inspirational journey align with our vision. Derek’s involvement will undoubtedly strengthen our efforts to support air ambulance charities, save lives, and improve patient outcomes.”

Aside from his success as a runner, he also excelled as a basketball player, and moved into performance management and highperformance coaching. He has worked as Director of Development for UK Athletics, has authored the bestselling book Sport Is A Business and Business Is A Sport, and is now hired as a high-performance speaker.

Iconic athlete becomes AAUK ambassador

In his new role, Derek supported AAUK at the British Touring Car Championship at Donington Park, which was sponsored by AAUK partner, Kwik-Fit.

It has been revealed that in its first year as a corporate partner, Kwik Fit raised an incredible £250,000 for AAUK, to be distributed among the 21 air ambulance charities.

A packed year of activities saw a remarkably enthusiastic workforce throw themselves into various different events and challenges, while centrally and at board level the commitment was equally strong. Kwik Fit have supported AAUK in a number of corporate activities, national events and fundraising, including sponsorship of The Annual Awards of Excellence. This fantastic strategic partnership will continue in 2025.

CEO moves on

AAUK’s CEO since March 2021, Simmy Akhtar, will leave the charity at the end of the year to take on the role of Chief Executive Officer at the Royal Life Saving Society UK. Reflecting on her time at AAUK, Simmy said:

“Leading Air Ambulances UK has been a privilege and I have been fortunate to have worked with a talented and dedicated team who are all committed to saving lives. I am immensely proud of our achievements together and know the team will continue to deliver ever-growing value for its members. I am excited to be joining the Royal Life Saving Society UK and look forward to continuing to work in a role that makes a meaningful impact.”

LIGHT FANTASTIC

September saw another spectacular Air Ambulance Week, where air ambulance charities lit up landmark buildings as part of a national effort to raise awareness of the work done by air ambulance charities. With this year’s message of ‘Today’s Supporter, Tomorrow’s Lifesaver’, Air Ambulance Week really sought to make the connection between supporters’ generous donations and the reality that those donations could help save a life.

Air ambulance charities around the country also shared the incredible stories of those whose lives have been impacted by the dedicated teams of critical care medics.

AAUK’s overall campaign reach for Air Ambulance Week exceeded 89.7 million, with coverage including a Royal Mail postage frank on all stamped mail, print adverts in The Sun and Talksport Radio coverage. The Week was supported by The Royal Family on social media, as well as AAUK associate members and corporate partners, and a number of MPs.

Pictured left to right: Glen Picknell, Communications & Marketing Manager, AAUK & Derek Redmond

Coronation medals PRESENTED

To mark The King & Queen’s Coronation, a special commemorative medal has been awarded to all those who participated in the Coronation, as well as serving frontline members of the emergency services, prison services and the Armed Forces as a token of the nation’s thanks.

Racing Fans Raise £21,000

AAUK’s involvement with the British Touring Car Championship (BTCC) this season raised an impressive £21,095.88, which will directly support air ambulance charities across the UK.

Partnering with Kwik Fit, who sponsor the BTCC, gave AAUK the chance to connect with BTCC fans and raise awareness of the vital role air ambulance charities play. AAUK was also helped by another corporate supporter, Briggs Equipment Limited, whose sponsored driver, Árón Taylor-Smith, became the 2024 Independent Champion. Árón was incredibly supportive to AAUK throughout the year – and even had a special race suit for Air Ambulance Week, displaying the AAUK logo; this will be auctioned off to raise even more vital funds. AAUK was also very grateful to Smart Tab Products Limited for their support in the Porsche Carrera Cup, where AAUK was prominently represented throughout the season.

CPA and Flannery are latest supporters

In addition, the Construction Plant-hire Association (CPA) have agreed to support AAUK with a donation of £5,000.

Flannery Plant Hire have agreed to support AAUK as their chosen charity of the year in 2025. The partnership will begin in January 2025 and will aim to raise £100,000 in the year.

APPGAA relaunches

The dissolution of Parliament in May temporarily disbanded all All-Party Parliamentary Groups (APPGs), including the APPG for Air Ambulances (APPGAA). Following the State Opening of Parliament in July, AAUK has been working to secure the re-establishment of the APPGAA, which advocates on behalf of air ambulance charities and the communities they serve.

The new APPGAA’s inaugural meeting was due to be on 19 November 2024, but will now be held on 3 March 2025. The APPGAA will resume its advocacy efforts on four key issues:

1. Access to & Safeguarding of Hospital Helipads & Community Landing Sites

2. Addressing the Increased Demand and Rising Costs

3. Ensuring Safe Access to Patient Data

4. Opposing a Statutory Levy on Lotteries

AAUK looks forward to building on the momentum generated earlier this year, and working closely with the newly reformed APPGAA.

HERE comes

THE ELECTRIC ERA

eVTOLs - electric vertical take-off and landing aircraft - have the potential to shake up the pre-hospital emergency medicine landscape. Their proponents say they will bring speed, flexibility, and sustainability to medical air services. We asked Marjan Shoeke, Market Development Manager at Vertical Aerospace, to tell us more. He writes:

eVTOLS are being developed as a cleaner, quieter and more affordable alternative to journeys typically carried out by traditional helicopters. For emergency scenarios, where time is of the essence, eVTOLs provide a key advantage: they can be airborne nearly instantly. Unlike helicopters, which require a period to warm up the engine, eVTOLs are ready to launch within seconds. The time saved could be crucial in a critical medical mission.

Vertical’s VX4 aircraft is one such aircraft. It also has the appropriate door and cabin sizing to accommodate patients, medical crews and equipment - and has potential for 180 degree patient access. This flexibility allows it to be used in a range of medical applications, from rapid patient transport to organ transfer.

Today’s battery technology supports short to mid-range flights, which are ideal for urban medical missions, but advancements in battery capabilities, which will allow eVTOLs to take on more complex tasks, continue at pace. It is true that eVTOLs cannot yet replicate everything that helicopters can do but the speed of progress means it won’t be long. The cost efficiencies of eVTOLs are compelling. With significantly lower operational and maintenance costs compared to helicopters, eVTOLs open up possibilities for missions that were previously unaffordable, such as non-critical patient transfers.

With reduced technical complexity, the aircraft have higher availability throughout the year. eVTOLs’ quieter operations reduce noise pollution and cabin noise too.

Sustainability is another core benefit. eVTOLs like the VX4 operate with zero emissions, presenting an environmentally-friendly alternative to fossil-fuel-reliant helicopters.

Infrastructure is also advancing in tandem with the technology. Hangar space and airfield requirements are very similar to helicopter operations, meaning helipads can double up as vertiports, if the right amount of power can be supplied to a base. EMS operators are usually located close to larger cities, enabling potential dual use of facilities. In parallel we are seeing the construction of vertiports specifically designed for eVTOLs, enhancing the number of sites EMS can use.

Safety remains a non-negotiable, of course. The VX4 is engineered to comply with the highest regulatory standards, comparable to those for commercial aircraft. Vertical is developing a world-class training programme for pilots, ensuring that EMS teams can safely and effectively operate these new vehicles.

The impact of eVTOLs on EMS could be profound, offering faster, greener and more versatile solutions for medical transport. As battery technology, infrastructure, and regulatory frameworks continue to evolve, eVTOLs are set to play a key role in modernising emergency response: it’s not if, but when.

On Thursday 28 November, several hundred guests from the air ambulance sector gathered together to celebrate some of the industry’s greatest achievers and achievements. The Kwik Fit-sponsored Air Ambulance Awards of Excellence, presented by AAUK Ambassador, TV and radio presenter Charlotte Hawkins, once again brought the sector together to reflect on another year of lifesaving work.

CELEBRATING

Breaking Barriers

Winner: Great Western Air Ambulance Charity

Sponsor: WEL Medical

Campaign of the Year

Winner: Air Ambulance Charity Kent Surrey Sussex

Highly Commended: London’s Air Ambulance Charity

Sponsor: Kwik Fit

Charity Supporter of the Year

Winner: Tom Budgett, Dorset & Somerset Air Ambulance

Highly Commended: Laura Bird, East Anglian Air Ambulance

Sponsor: Tower Lotteries

Doctor of the Year

Winner: Dr Laura Bland, Dorset & Somerset Air Ambulance

Highly Commended: Dr Tim Nutbeam, Devon Air Ambulance Trust

Sponsor: Leonardo Helicopters

Critical Care Practioner of the Year

Winner: Neil Bizzell, Dorset & Somerset Air Ambulance

Highly Commended: Sarah Walter, Magpas Air Ambulance

Sponsor: Zoll

Innovation of the Year

Winner: Air Ambulance Charity Kent Surrey Sussex Sponsor: Aeroptimo

Pilot of the Year

Winner: Captain Steve Norris, East Anglian Air Ambulance

Sponsor: Babcock

Charity Staff Member of the Year

Winner: Sam Disney, Magpas Air Ambulance Sponsor: Kwik Fit

Young Person of the Year

Winner: Ethan Ross-Smith, Great Western Air Ambulance Charity

Sponsor: Sloane Helicopters

Operations Support Staff of the Year

Winner: Scott Todd, Magpas Air Ambulance

Sponsor: SES

Charity Team of the Year

Winner: Essex & Herts Air Ambulance Trust - Retail Team

Sponsor: Lottery Fundraising Services

Lifetime Achievement Award

Trustee of the Year

Winner: Mike Beale, Scotland’s Charity Air Ambulance

Sponsor: Charisma Charity Recruitment

Winner: Gillian Bryce, Dorset & Somerset Air Ambulance

Sponsor: Airbus

Chair’s Award

Winner: Heléna Holt, Devon Air Ambulance Trust

Conference speakers energise the community

Dr James Nayyar

The AAUK Annual Conference sponsored by SES brought together the air ambulance community to learn from a wide range of speakers bringing information and innovation for the benefit of the industry at large. Among the speakers were:

James is a HEMS Fellow at The Air Ambulance Service and spoke on Enhancing Pre-hospital Paediatric Care. He shared with delegates the key differences and challenges that paediatrics brings, the value of focused training, and how collaboration can make all the difference. The disparity of working with paediatrics compared to adults is not just the physical body and presentations but also the environment of where the child is likely to be found, who will be around, high emotions, safeguarding issues and more.

Dr Andy Lockyer

Andy is Medical Director, GWAAC; EM Consultant, Bristol Royal Infirmary; and importantly for this presentation, Trustee, Dharura: Global Emergency Care. He spoke impressively about how overseas volunteering from the NHS can bring benefits to both the UK and the rest of the world through partnerships that allow health systems and teams to offer mutual development, knowledge sharing, skills and innovations.

Imogen Ward and Tobin Aldrich

In what has become a highly valued annual address, Imogen and Tobin from fundraising consultancy AAW laid out the current trends across fundraising and what this meant for air ambulances in particular. The 2023 statistics revealed that 56% of all income was individual giving, with grants and legacies the next two most important, followed by regular giving. Once again there was a timely reminder that those dream major gifts come along very rarely, representing just 4% of income in 2023. Similarly, corporate giving is down and a very difficult sector to crack unless you’re a big-name charity.

Imogen and Tobin ran through some figures relating to the air ambulance sector only, which gave a fascinating context, both in terms of the broader industry and also its history. Air ambulance income grew rapidly between 2015 and 2020; growth was driven by lotteries, followed by legacies - but donations did not increase. Since 2020, growth has slowed down sharply for lotteries and legacies, but donation income is growing fast, driven by air ambulances’ investment in regular giving and some major appeals for new fleets. Air ambulances are still behind the curve on diversification, and the community and events element remains fragile. Imogen and Tobin went on to lay out the opportunities for air ambulances to grow their income.

There was a fascinating presentation by Remarkable Partnerhsips on unlocking corporate partnerships with AI; and Sophie Mitchinson spoke passionately about optimising inclusivity in PHEM.

James Nayyar
Tobin Aldrich

Celebrating 26 Extra Years of Life

Sheep farmer Derek Colton was working alone in a remote field on the south Cornish coast when he had a sudden cardiac arrest.

Derek and his wife Jenny run a small farm in Probus and a sheep contracting business, which takes him all over the Duchy. That day, in May 1998, he had a contract to inject some lambs at a site in Trewollock.

He had gathered the flock off the cliffs and walked about half a mile back to the yard where he put the sheep in their pen. Just as Derek loaded his dogs back into his Land Rover, he started to feel unwell. He said: “I began to feel a little bit dizzy. The pains started in my chest and they got worse and worse. I’ve never experienced pain like that.”

Luckily Derek, who was only 50, had his mobile with him. “I thought I’ve got to do something, I couldn’t stand up, it really was unbearable”, he said. “I thought, I’ve got to phone for an ambulance.”

The 999 call handler asked Derek where he was, the name of the farm and a map reference - but Derek didn’t know. He gave the best directions he could, and he was instructed to leave his mobile on.

The ambulance crew managed to track Derek through his phone. Derek said: “I’m not sure on the timescale, but not long after, I heard the noise of the air ambulance. It landed right in the field next to the sheds where I was. The next thing I knew they were putting me in the back of the helicopter. I can’t remember anything of the journey, but I remember them landing right outside A&E, and there was an army of people there waiting for me.”

The Cornwall Air Ambulance crew airlifted Derek to Treliske Hospital in Truro, where he went into intensive care.

Derek was in hospital for around a week, but miraculously didn’t need surgery. Now almost 25 years later, Derek is still on tablets and has regular check-ups with his doctor but has suffered no further problems with his heart.

After the incident, Derek and Jenny started to get back to normal. His aim was to carry on doing demonstrations with the sheepdogs at the Royal Cornwall Show. They spoke about it with the organisers and everybody there helped out, so Derek didn’t have to do any of the lifting or carrying. He ended up doing the demonstrations for all three days that year.

“Without the air ambulance I don’t think I would be sitting here now”, added Derek. “I’ve never had such excruciating pain. If it wasn’t for Cornwall Air Ambulance I probably would have died.” Since his cardiac arrest, Derek and Jenny have done what they can to support Cornwall Air Ambulance, and Derek’s name is among those on the bottom of the AW169 helicopter.

He urges all other farmers and people who work alone and in rural locations to always tell someone where you are and to carry a fully charged mobile.

Arcade Arrest

On 1 May this year Sam, who is from Hitchin, was in Yarmouth for the day with her son. They’d been into the arcades and as they walked out, Sam collapsed. She says, “The only thing I can remember was I walked out of the arcade, I said my son’s name, which was all echoey, and everything was like slow motion and then I don’t remember anything else.”

Fortunately Page, who is community training manager and a critical care paramedic at East Anglian Air Ambulance (EAAA), happened to be out on a day trip with her husband Luke, who is also an advanced paramedic at EAAA. Sam collapsed about two metres away from them. Page says: “It became clear very quickly that she was in cardiac arrest so I immediately started chest compressions and asked Luke to call 999. Because Sam had such rapid bystander CPR and we were able to deploy defibrillation very quickly, we had actually managed to resuscitate Sam before any medical services arrived. So on the arrival of the air ambulance, Sam was already talking to us, asking where her son was, and wondering what had happened.”

“It was nice coming round properly and seeing my boy and my partner and it was like ‘oh my god’, and everything just started to sink in then about what had actually happened,” said Sam. “If I hadn’t received the CPR when I did, I wouldn’t be here now.”

Jordan, a critical care paramedic for EAAA called to the incident, adds: “There are lots of things to consider on the way to scene, including whether there is bystander CPR ongoing and whether there is a defibrillator available. If those two things are available and happening before we arrive, then the chances of survival are increased significantly.

“We landed on the beach, we could see the ambulance in front of us, and we received a handover from Luke and Page. They had managed to restart Sam’s heart before we got to scene, and we opted to go by land ambulance because Sam was already on the vehicle and it was probably going to be the quickest way of getting her to hospital.

“Sam’s outcome was really positive and that was largely down to the bystander CPR and early defibrillation that she received. Without that, all of the other interventions that we do don’t have too much of an effect.”

Derek on his farm with his sheep and faithful companion Bill the sheepdog.

LIFE SAVING SOLUTIONS

WEL Medical’s innovative Basic Life Support products are used by healthcare professionals and communities alike across the UK. The company is distinctive for the way it listens closely to its customers and what they need, and collaborates with manufacturers to deliver real-world, workable solutions that are of great benefit to the emergency medicine sector and associated services.

The service certainly doesn’t stop with a product’s sale, as WEL Medical also strongly believes in supporting its customers to be confident in the effective and safe use of its products and ongoing care of them.

The company has four main brands to enhance healthcare organisations’ and communities’ emergency healthcare provision. The iPAD portfolio of AEDs (Automated External Defibrillators) includes the iPAD SPR, a new, next-generation AED with a USB data transfer, including real time log event and ECG trace, and it can record up to five events and three hours per event. It has become the gold standard in intuitive public access AEDs.

This initiative gained urgency after Danish player Christian Eriksen’s collapse at Euro 2020, where timely CPR and defibrillation saved his life.

The company also sells the DefibSafe defibrillator cabinet in response to customers’ desire to buy both defibrillator and cabinet from the same supplier. The DefibSafe is lightweight, cost-effective and has many design features lacking in other units. Since its launch in 2014, there have been thousands of DefibSafe units placed all over the UK; it was one of the cabinets chosen by the British Heart Foundation as the cabinet for the £1 million Government fund for public access defibrillators in 2015.

The iPAD SP1 has been successfully installed in huge numbers across the UK, is being used with every UK NHS ambulance service for community public access schemes and also within many ambulance services themselves.

WEL Medical has worked in partnership with the Premier League to supply AEDs to thousands of grassroots football clubs across England.

WEL Medical also supplies industry-renowned Brayden CPR Manikins, the first ever manikins to allow users to visualise the effects of CPR. The manikin range now includes the Brayden OBI, an anatomically accurate CPR manikin representing various ages and races, ensuring training programmes reflect the communities they serve. With a conversion kit available, this is a brilliant and cost-effective solution to allowing for better inclusivity and diversity within training programmes, thereby increasing the chances of better outcomes in an emergency.

WEL Medical is the leading UK importer and distributor of Boscarol portable emergency suction pump units too.

For more information about these products, go to www.welmedical.com

Growing your Lottery Fundraising

Lottery fundraising plays a crucial role in air ambulance charities’ income, providing significant, consistent fundraising to help charities sustain their life-saving operations. ComBee, Bee Ethical’s specialised lottery platform, has recently been chosen by East Anglian Air Ambulance to provide its lottery fundraising and the company is now hoping to provide its scalable, secure solution to other air ambulance charities who can benefit from its reliable technology, expertise and innovations.

For charities with established lotteries, ComBee offers a streamlined migration process, allowing supporters to continue payments with enhanced options and a better user experience. The platform also easily integrates with existing systems, supporting a cohesive approach to managing lottery fundraising alongside broader operational goals.

ComBee already works with a number of charitable organisations, including the Veterans Foundation, which is now raising £15 million annually through its lottery. The company has been able to build effective lottery programmes through incentivised giving, fostering consistent engagement and financial support.

Why ComBee?

Bee Ethical has honed the product to maximise income in a number of ways. ComBee automates manual processes, freeing teams to focus on fundraising and community engagement. By reducing the potential for human error and ensuring consistency, the system supports compliance, making lottery management smoother and more reliable.

ComBee’s platform ensures data protection, secure payments and full compliance with lottery regulations. The system provides secure age verification, while advanced technology supports responsible play by helping identify and exclude flagged individuals. This commitment to security builds trust with supporters, allowing charities to focus on their mission.

ComBee supports recurring card payments and digital wallet options like Apple Pay and Google Pay, giving supporters more flexibility and helping charities adapt to evolving trends. Importantly, ComBee secures the first payment at point of interest, reducing drop-off through the sign-up process. The platform is optimised for online acquisition thanks to its fast downloads, data analytics and automated onboarding for effective, seamless digital campaign conversion.

ComBee’s Give-Back initiative upgrades a player’s experience by creating a sense of belonging within the lottery community, strengthening supporter connection and loyalty.

If you’re looking towards future growth, ComBee’s scalability allows charities to manage larger player bases and complex lottery structures without adding operational strain, which helps establish a foundation for long-term growth.

To learn more about how ComBee can enhance your lottery fundraising in support of your fundraising goals, please contact our team on: contact@bee-ethical.com or visit bee-ethical.com

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