LAA Annual Review 2013/14

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Support London’s Air Ambulance

London’s Air Ambulance Annual Review 2013/14

We are extremely grateful to all our supporters for their donations. Our service would not exist without your support.



Page Chairman & Medical Director’s Report 4 Chief Executive Officer’s Report 5 Our Mission &  Values 6 Delivering Our Mission 7 Our Strategic Objectives 8 25 Years Saving Lives 9 Our Patients 11

Our Supporters Our Partnerships Our Finances Our Sponsors Our Thanks

12 14 16 17 18

Our Trustees

Dr. Gareth Davies (Chair during Review period), Maxine Barnes, Paul Lavender, Professor David Lockey, Mark Vickers, Sam Walker, Dr. Anne Weaver, Michael Weiss.

p a M n o i s 2013 Mis 69 41

In 2013 our advanced trauma doctors and paramedics treated

1818 PATIENTS and attended two major incidents

64 48



City Of Westminster

Hammersmith & Fulham





32 34



141 Kensington & Chelsea


















64 Lambeth






Richmond upon Thames


Waltham Forest



Barking & Dagenham

Tower Hamlets









Outside London










t r o p e R ’s r o t c e r i D l a c i d e M & n a m r i a Ch I am pleased to report that the last year has been one of tremendous progress for our charity. Significant investment has been made in the organisational structure to support and grow fundraising activities. The Board of Trustees are confident that a robust infrastructure is now in place to financially support our strategic operational goals as well as to ensure the sustainability of the Charity.

London’s Air Ambulance has been a leader in the development and practice of pre-hospital care in the UK and abroad for the last 25 years. In 2013, The Institute of Pre-Hospital Care at London’s Air Ambulance was founded to drive excellence in pre-hospital care standards and practice through research, innovation and education; and by fostering collaboration across medical disciplines and institutions dedicated to improving outcomes for people afflicted by critical injury and illness.

As doctors, we see first-hand the difference that supporters of London’s Air Ambulance make on the streets of London every day. In the year this report reflects on, we have treated 1,744 patients (based on the financial year April 2013 to March 2014). The consciousness that it is the support of the London community that gets our advanced trauma team to the side of seriously injured people is humbling.

I have been part of this organisation for over 20 of its 25 years. It has been a tough but enjoyable journey. As we are commemorating this milestone, I would like to thank all those who believed in our mission and enabled us to continue. Without you, we wouldn’t be able to rise to the challenges of our job.

We constantly strive to push the boundaries of pre-hospital care and save even more lives. This year, we have worked closely with The Royal London Hospital to introduce the world’s first pre-hospital REBOA, balloon surgery that is used to control catastrophic internal bleeding. This new technique allows us to control severe pelvic haemorrhage, an injury most commonly


associated with cycling incidents and falls from height, at the roadside and prevent the patient from bleeding to death before they reach hospital. I am pleased to say that, as accounts closed, we performed the world’s first pre-hospital REBOA. This is a ground breaking move not just for London but it will also translate into lives saved beyond the borders of the Capital as we continue to share innovations across the globe.

Thank you for your contribution,

Dr Gareth Davies Chair of Trustees & Medical Director at London’s Air Ambulance

t r o p e R ’s r e c i f f O e v i t u c e x Chief E London’s Air Ambulance has been serving London and saving lives on its streets for 25 years, thanks to your support. We are pleased to report that the total incoming resources for the year amounted to £4,802,180, a growth of 13.8% year on year. Our mission is to provide our patients with the world’s most innovative and effective pre-hospital care. This year we have focused on building an organisational structure that will allow us to diversify our income streams and enhance the financial sustainability of the service. Operationally, the Charity aims to acquire a 2nd helicopter and introduce extended daylight flying hours in 2015. Data suggests that this will enable us to reach a further 400 patients per year by helicopter, simply the most effective way to deliver our advanced trauma team to the side of critically injured people. Although our fundraising for the 2nd helicopter has been greatly boosted by the £1 million awarded to the Charity from the LIBOR fund, we face an ongoing challenge as the annual cost of the service will rise to £6 million per year.

Whilst we are currently in a position to look to the market for the 2nd aircraft, the associated annual cost increase of £0.5 million generates even greater need for support from London’s community. We are confident that the charity team is now strong enough to deliver on this fundraising challenge. This financial year saw significant demands on investment and cost directly associated with our single helicopter, including the cost incurred by commitment to a relief aircraft contract necessary to ensure greater resilience for London. In combination with an unavoidable move from an NHS funded office and investments in the fundraising infrastructure and The Institute of Pre-Hospital Care at London’s Air Ambulance, the costs in this financial year totalled £4,815,689, an increase of 29.8%. Whilst the investments in the fundraising infrastructure were made with long term objectives in mind, we have already seen the return on investment in this financial year. Indeed, London’s Air Ambulance Trading Limited that encompasses the lottery scheme, a vital source of regular income for the charity, has reported an increase in operating income of £404,555. Thank you and we are excited for the year to come.

Graham Hodgkin CEO London’s Air Ambulance


s e u l a V & n o i s s i M r Ou Mission

About London’s Air Ambulance

Our mission is to provide our patients with the world’s most innovative and effective pre-hospital care.

In partnership with Barts Health NHS Trust and London Ambulance Service, London’s Air Ambulance is the charity that delivers an advanced trauma team to critically injured people in London. The service provides pre-hospital medical care at the scene of the incident and serves the 10 million people that live, work and commute within the M25.

Values Our values sit at the centre of everything we do.


We believe that our passion drives us and makes our organisation unique


We each perform a critical role and together we provide our world-leading service


We each strive to be the very best in our field and to deliver it in the best way possible


We constantly innovate in order to achieve excellence in all that we do


We demonstrate flexibility and strength in our determination to achieve our goals


We demonstrate honesty and integrity through the openness of our communication


Based at The Royal London Hospital and founded in 1989, the service is unique in that it operates 24/7 with the helicopter running in daylight hours and rapid response cars taking over at night. The average cost of a mission is £1,577. The team, which at all times includes an advanced trauma doctor and paramedic, perform advanced medical interventions normally only found in the hospital emergency department, in time critical, life threatening situations. Missions commonly involve serious road traffic collisions, falls from height, industrial accidents, assaults and injuries on the rail network. The Physician Response Unit, a fast response car, staffed by a doctor and Emergency Care Practitioner, carries specialist drugs and equipment to treat a range of medical emergencies including patients who collapse in cardiac arrest. A high level of diagnostics and treatment can be initiated on-scene, giving the optimal outcome for the patient and often avoiding admission to Accident & Emergency Departments. London’s Air Ambulance has an international reputation for clinical excellence and delivers pioneering procedures which have been adopted across the world. Several of our Standard Operating Procedures were developed in close association with the military.

n o i s s i M r u O g n i r e v i Del Serious trauma is the most common cause of death for people under 45 and leads to more lost years of life nationally than cancer and heart disease combined. London’s Air Ambulance’s clinical excellence translates into measurable, often life-changing, benefits for the patient population served. Recent research shows that doctor-led advanced trauma care reduced the death rate from serious trauma by 30-40%, and by 48% in the most severely injured patients. Published studies demonstrate that London’s Air Ambulance achieves superior results, relative to cited comparisons, in several critical scenarios: • Traumatic cardiac arrest survival rate of 7.5%, compared to published international rates of 0-3%. • Open chest surgery long-term survival rate of 17.8%, compared to predicted 0%. • Emergency anaesthesia success rate of 99.2% in over 7000 patients with no airway-related death.

We were the first air ambulance service in the UK to: • Safely perform the following medical procedures

at the scene of the incident: Thoracostomy (procedure to re-inflate collapsed lungs), resuscitative thoracotomy (open chest surgery), Rapid Sequence Intubation and delivery of anaesthesia. • Provide a 24-hour service: Our 5 rapid response cars carry the same medical team and kit to incidents when we are currently unable to fly (during darkness, in adverse weather conditions and when the helicopter is offline for maintenance). • Carry blood on board: Enabling pioneering pre-hospital blood transfusions. • Operate under a formal clinical governance

programme: Promoting knowledge-transfer among doctors and paramedics and ensuring the absolute highest standards of care. Our pioneering procedures have been adopted throughout the UK and all around the world. We continue to be at the forefront of developing and delivering innovations in pre-hospital care. Extensive work has been done in the year of this report to develop Resuscitative Endovascular Balloon Occlusion of the Aorta in a pre-hospital environment. This was successfully launched in February 2014. This is a world-first for performing this procedure in the pre-hospital environment.


s e v i t c e j b O c i g e t a r Our St As well as continuing to deliver on our mission as outlined above, our strategic objectives for 2014/2015 are to: Acquire a 2nd helicopter and extend our daylight flying hours

Develop & deliver a schools outreach programme

We will fundraise for a vital 2nd helicopter and to extend flying times during daylight hours. London is the only major capital city with only one emergency medical helicopter. Currently London’s Air Ambulance operates just one helicopter serving a population of more than 10 million people. Elsewhere in England and Wales there are approximately 30 HEMS aircraft covering a population of circa 44 million people; a ratio of 1 helicopter per 1.5 million people. A 2nd helicopter will give the charity greater resilience during maintenance periods and will facilitate an enhanced state of operational readiness to major incidents.

We are currently seeking funding to develop an innovative interactive Science, Technology, Engineering & Maths (STEM) app designed to inspire the next generation of trauma doctors, paramedics, pilots, aviation engineers and fire crew. This ground-breaking educational resource will raise the aspirations of young people and inspire a new generation of enthusiastic, technologically skilled young people with a keen desire to pursue STEM subjects and careers.

The charity directly employs our pilots and fire crew and although we have permission to fly daylight hours all year round, we are currently constrained to a maximum duty roster of 12 hours for each member of the aviation team. Consequently, during the summer months we are losing a material number of daylight hours, leaving the service dependent on delivering our Advanced Trauma Team on the ground via our Rapid Response cars, under blue lights. In addition we also have mandatory maintenance schedules requiring the helicopter to be taken offline limiting our coverage for London further. Our dispatch data shows that with additional funding to secure a 2nd helicopter and to recruit additional crew we could reach a further 400 patients per year via helicopter, clearly the most efficient way to deliver our life saving service to our patients.


London’s Air Ambulance is currently researching prevention programmes and the scope to work in partnership with other organisations to help reduce serious traumatic injuries.

Grow our Institute of Pre-Hospital Care Through its research, innovation and education activities London’s Air Ambulance has influenced clinical guidelines, governance standards, and the practice of air ambulances in the U.K., Europe and Australia. The Institute of Pre-Hospital Care at London’s Air Ambulance was founded to build on and expand this influence. Its mission is to drive excellence in pre-hospital care standards and practice through research, innovation and education. 2013/2014 was a pivotal year for the Institute with the launch of the UK’s first Intercalated BSc degree in Pre-Hospital Medicine in partnership with Queen Mary University of London’s Barts and The London School of Medicine and Dentistry.

s e v i L g n i v a S s r a 25 Ye In 2014, London’s Air Ambulance has celebrated 25 years of saving lives in the UK’s capital. The charity has taken this milestone as an opportunity to thank the London community and businesses for their vital support. On 9th January, the day London’s Air Ambulance was established, the words of thanks and encouragement to support the charity could be heard from media across the Capital - from the BBC through City AM and Metro to the borough newspapers. The anniversary wishes arrived from all over the country, including messages of appreciation from the Prime Minister, the Mayor of London and the Heads of Emergency Services.

It is thanks to the generosity of the public that London’s Air Ambulance could commemorate this milestone. Thank you.

“I  would like to thank everyone involved in the vital work London’s Air Ambulance has done over the last 25 years to deliver life-saving treatment to thousands of people. It is a charity that has become very close to the hearts of all Londoners, as I am sure the many dedicated people who help to run the service will attest”

David Cameron.


Michael, the father of four, fell off a ladder while renovating his home.

MECHANISM OF INJURY Max was knocked off his motocross bike by a vehicle three times the size and power of his.

34% 27% 23% 16%

Road Traffic Collisions Falls from Height Penetrating Trauma Other (Rail Incidents, Industrial Accidents etc)

Doris and her family were on their way home on New Year’s Day when their car collided head on with another vehicle. 10

Chrishan was run over by a car when cycling home from work.

s t n e i t a P r Ou

RAYAN’S STORY 16 year old Rayan could have been yet another teenager to die from a knife attack in London. His heart stopped after he had been stabbed in the chest. The London’s Air Ambulance team performed an open heart surgery and administered a blood transfusion at the roadside, literally giving him life when he was clinically dead.

IRIS’S STORY Iris fell down the stairs while playing with her sister. There was a possibility that she might have suffered a life threatening head injury – she has had a seizure and was unresponsive. “We feared the worst and no one wanted to risk moving her but, within what seemed like minutes, London’s Air Ambulance was on scene making the right assessment,” says Iris’ mum Sarah.


s r e t r o p p Our Su

Based on historical data we treat on average, 6 people every 24 hours in London that are so seriously injured that they need advanced life-saving medical treatment on scene, before they reach hospital. Thanks to donations from our supporters, our trauma doctor and advanced paramedic can be by their side within minutes to perform medical procedures normally only found in the hospital emergency department, giving them the best possible chance of survival. 12

We rely on support from individuals, companies, trusts and foundations, livery companies and community and statutory organisations in order to continue saving lives and to further develop our world-leading service. Our strategic objective will be to diversify income generation with particular emphasis on sustainable income programmes. We also have an extensive volunteer programme which is mutually beneficial; enabling our volunteers to develop new and pre-existing skills and allowing us to harness the enthusiasm and dedication of our supporters.

Support from Companies Support from our corporate partners is vital to our work. Staff from a multitude of companies have committed time and energy to challenges and events, raising thousands of pounds for London's Air Ambulance. These partnerships raise awareness of our service to brand new audiences and ensure that we can continue to grow as an organisation. In addition to working with staff and stakeholders of large city firms, London's Air Ambulance also works strategically with companies across a range of different platforms to enhance our service.

Support from Trusts and Foundations We are supported by a growing range of Trusts, Foundations and Livery Companies. Donations and grants are awarded to support our core services; specific innovative projects; life-saving medical equipment; or for groundbreaking educational outreach projects.

Support from Community and Statutory Organisations We believe our service has been mandated by the people of London for the people of London and because of this we have a very strong community fundraising programme, raising funds through collection tins and boxes, at local events and from local clubs and societies. We also receive an annual grant from the Barts Health NHS Trust which we are extremely grateful for.

Regular giving programmes A key strategic priority over the coming year is to grow our regular giving programmes. These are our lottery programme and our new individual giving scheme. These sources of revenue allow our supporters to be active donors to the charity on a regular basis, creating a deeper affinity with our charity. The funds generated through regular giving programmes provide vital predictable, sustainable income for the charity.


s p i h s r e n t r Our Pa London Ambulance Service We greatly value our partnerships with Barts Health NHS Trust and the London Ambulance Service (LAS). Barts Health employs and remunerates the advanced trauma doctors who are seconded to the service, as well as providing some direct financial support and the helipad facility for the charity’s operations. LAS similarly provide paid paramedics who are seconded to the service. A London’s Air Ambulance advanced trauma paramedic operates from the LAS control room and is responsible for dispatching us to the most critically injured people in London, 24 hours a day.

In September 2013 London’s Air Ambulance appointed the UK’s first Patient Liaison Nurse for trauma patients. The position aims to assist London’s Air Ambulance patients with their transition back to independent living, bridging the gap between the rapid on-scene pre-hospital treatment that the charity is renowned for and the patient’s long term rehabilitation. The City of London Corporation’s charity, City Bridge Trust, has generously awarded a grant to fund this ground-breaking role for three years; recognising the charity’s standards of clinical excellence and the absence of equivalent support elsewhere in the Capital’s emergency infrastructure. City Bridge Trust Chief Grants Officer David Farnsworth said this: “City Bridge Trust is committed to tackling disadvantage in London by supporting charitable activity across Greater London. We are delighted to be supporting Londoners by funding the Patient Liaison Nurse role at London’s Air Ambulance and providing unprecedented assistance to trauma patients in the capital beyond the acute phase”.

Frank Chege has taken up the position after having worked alongside London’s Air Ambulance as an Emergency Nurse at The Royal London Hospital for the last seven years. For him, “understanding your injuries is the beginning of the recovery process. Following up with our patients and their families will allow us to explain the pre-hospital medical care they received and identify any unmet needs they might have.”


In 2013 we were nominated as BlackRock’s Charity of the Year partner and in the course of 12 months, employees from the asset management firm raised in excess of £260,000 towards the 2nd helicopter. During that time the BlackRock London Office took on challenges to raise money ranging from the Virgin Money London Marathon to the British 10K; the BlackRock Cycle Challenge to the Prudential RideLondon-Surrey 100 and even travelled across India in a Rickshaw. BlackRock staff fully embraced the charity and their invaluable support has helped London's Air Ambulance get a step closer to realising its dream of acquiring a 2nd helicopter for London.

Partnering with EE, London’s Air Ambulance is enhancing road and airborne dispatch with two 4GEEenabled initiatives. The first is a bespoke mapping application for the rapid response cars to help improve navigation. The second, which is in development, should reduce the time it takes to dispatch the helicopter and cars. The solutions are delivered over 4GEE and are a step change from reliance on manual and paperbased processes We are incredibly grateful to all our corporate partners for their continued support.


s e c n a n i Our F OUR INCOME (%)














It costs approximately £5 million per year for the service of advanced trauma care to be provided to critically injured patients in London, 24 hours a day, 7 days a week. In 2013/2014 London’s Air Ambulance raised £4,000,487 excluding investment income of £7,651 (9.6% more than last year) from individuals, trusts and foundations, companies, community groups and statutory grants. We are extremely grateful for the generosity of our partners and supporters and rely on this in order to continue saving lives and improving patient outcomes.



Note: Based on stand-alone charity audited accounts and excludes investment income

We are absolutely committed to spending our income as efficiently as possible and scrutinise how every pound is used. The majority of our income (62p in every pound) is spent directly on delivering an advanced trauma team to critically injured people in London. We spend on average 3p of every pound on governance. We believe it is important to invest in fundraising because this allows us to secure sustainable income for the charity in the future. For every £1 we spend on fundraising we generate more than £3 in income.

In 2014/2015 we are also fundraising for a vital 2nd helicopter – London is the only major capital city with only one emergency helicopter. A 2nd helicopter will provide resilience and cover during periods of maintenance and during major incidents. We are also planning to expand our flying hours in the summer months to provide helicopter coverage during the extended daylight hours. This will cost our charity an additional £1.1 million per year.

s r o s n o p S Our We are extremely grateful to all of our supporters. We would like to extend a special thank you to our helicopter and rapid response car sponsors:

greener smar ter



Patrons of London’s Air Ambulance His Grace the Duke of Westminster

Mike Hussey

Mark Vickers

Earl of Arran

Sir George Iacobescu CBE

General Sir Roger Wheeler GCB, CBE

Lord Maxwell Beaverbrook

Sir Stephen O’Brien CBE

Paul White

Philippe Chappatte

Charles Rifkind

Julia Leal

Dr Richard Chartres

Sir Simon Robertson

Dr Alastair Wilson

Glenn Earle

Jeremy Sandelson

Sir Stirling Moss OBE

Simon Elliott

Sir Harry Solomon

Dr Hilary Jones

Martin Gilbert

Maurice Thompson

Zac Goldsmith, MP

Baroness Jo Valentine


s r e t r o p p u S r u o o t Thanks We are deeply grateful for the generosity of our sponsors and company supporters who make the work we do possible. Company Supporters Air Charter Services

Information Providers User Group (IPUG)

Simmons & Simmons

A-Z Maps

Institute of Chartered Accountants Scotland (ICAS - London Office)


Baker & McKenzie Berkeley Group BlackRock Canary Wharf Group Daiwa Capital Markets Deloitte DLA Piper EE Fairview Feref Frogmore Galliard Heron Hogan Lovells HSBC (London Retail banking)

International SOS Johnson Mathey Land Securities LDC M&G Investments Marcol Mortimer Spinks Mubuloo Northern Petroleum Ocean Outdoors Parkeray Reuben Brothers RLM Finsbury Rothschild Saracens


Vocalink WPP Group Xchanging XL Group Zoll

Our Trust, Foundation and Livery Company supporters: ICE Futures Charitable Trust

The Lynn Foundation

Tennants Consolidated

The Mactaggart Third Fund

The Albert Hunt Trust

The Michael and Ruth Jacobs Charitable Trust

The Basil Samuel Charitable Trust

The Misses Barrie Charitable Trust

The Beaverbrook Foundation

The Mistra Trust

The Chandris Foundation

The MK Charitable trust

The City Bridge Trust The Coutts Charitable Trust The Donald Forrester Trust The Doughty Hanson Charitable Foundation The Dudley and Geoffrey Cox Charitable Trust The Ettling Charitable Trust The Flow Foundation The Freemasons’ Grand Charity The Gerald Ronson Foundation The Golden Bottle Trust

The Ormsby Charitable Trust The Roger Vere Foundation The Sheila Whitley Trust The Stanley Grundy Foundation The Thousandth Man - Richard Burns Charitable Trust The Tinsley Foundation The Tompkins Foundation The Vandervell Foundation The Wessex Youth Trust

The Heathside Charitable Trust

The William Hill Foundation

The Hintze Family Charitable Trust

The Worshipful Company of Drapers

The Hospital Saturday Fund

The Worshipful Company of Chartered Secretaries

The James Tudor Foundation

The Worshipful Company of Security Professionals

The Lexus Foundation

The Worshipful Company of Tylers and Bricklayers

The Lewis Family Charitable Trust

The Worshipful Company of International Bankers


For more information please contact: Graham Hodgkin, Chief Executive Officer E T 020 7220 5470 @LDNairamb London’s Air Ambulance visit Registered Charity London’s Air Ambulance is the registered charity that delivers an advanced trauma team to critically injured people in London. Registered Charity (801013).