London's Air Ambulance Annual Review 2018/19

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London’s Air Ambulance Annual Review 2018/19


CONTENT 04

A look back - with Mark Vickers, Chairman

06

A look forward - with Jonathan Jenkins, CEO

08

A year in highlights

10

About us

11

Our NHS partners

12

Mission map

13

Our strategic objectives

Strategic objective - Save Time 14

Saving time, saving lives

Strategic objective - Better Care 16

Dr Gareth Davies, Medical Director, reflects on 30 years of saving lives

18

Our patients

20

Picking up the pieces

21

Being there for our patients

22

Critical innovation

24

Physician Response Unit

26

Institute of Pre-Hospital Care

Strategic objective - Connecting with the people of London 28

London’s Air Ambulance in the community

30

Parliamentary reception

Strategic objective - Our culture 31

Our values

Strategic objective - Double income 32

Fundraising highlights of the year

34

Our finances

36

Thank you to our supporters

03


A LOOK BACK With Mark Vickers, Chairman

On 9th January 2019, London’s Air Ambulance Charity marked 30 years of saving lives in London. Accompanied by those at the heart of our history, those impacted by our work, and those driving the future of the charity, the day was a wonderful opportunity to celebrate the accomplishments of our service. As part of the celebrations, we welcomed His Royal Highness, The Duke of Cambridge, to our helipad. A former air ambulance pilot himself, The Duke flew our non-operational aircraft to The Royal London Hospital to meet former patients and staff past and present. It was clearly evident that Prince William has a strong, first-hand understanding of how an emergency service like ours can make a difference to patients and we were delighted that The Duke took the opportunity of his visit to announce his patronage for our 30th anniversary campaign. As patron, His Royal Highness is making a hugely valuable contribution as a champion of those working on the frontline, and highlighting the importance of our work as a charity. We also hosted collections across the capital to celebrate our anniversary with the city we serve. I was humbled to hear that over £8,500 was donated to our volunteers across the capital to help us mark this milestone. Our volunteers have always shown

unswerving dedication, as well as being our voice in the community and getting the word out to the people of London, but to have this level of support on our 30th anniversary was truly special. In this landmark year we have been overwhelmed by the continuing support of the people of London. We are pleased to report that in 2018/19 £11.9m was donated to London’s Air Ambulance Charity by our generous supporters and partners, with a number of income streams delivering strong growth. In line with our ongoing focus on individual giving, we have seen a significant 75% year-on-year increase from individual giving, while at the same time seeing an impressive 20% increase in lottery income. We have been pleased to develop exciting new corporate partnerships in the previous year, including major charity of the year partnerships from Bank of England and Herbert Smith Freehills and ongoing support from Foxtons. We have also received the wonderful news that some of our longer-term partners, including Tokio Marine Kiln and Shearman & Stirling, have decided to renew their support for our work. These partnerships are immensely beneficial not just for fundraising, but for reaching more potential supporters and, providing pro-bono support and knowledge sharing across our organisations.

Our total expenditure for the 2018/19 year was £9m. In this time, we treated 1669 patients; and this we achieve by helicopter from 0800 to sunset and rapid response cars by night or in adverse weather conditions. Our fundraising spend was lower than we planned this year, as we established relationships with agencies who recruit new lottery and regular giving donors. We will continue the planned investment in our fundraising programme but the reduction in investment this year will mean we will not see the planned growth for another year. I must also thank our partners Barts Health NHS Trust and London Ambulance Service NHS Trust for their critical roles in delivering our life-saving service. Our NHS partners share our passion for innovative patient care, and it is through this that we can continue to work together to push the boundaries of pre-hospital care. During this financial year the Board saw the retirements of Dr Gareth Davies, Professor David Lockey and James Charrington as Trustees of the Charity. All have brought unique expertise to the Board and will be greatly missed. The end of his tenure as trustee also sees Dr Davies step down from his role as Medical Director, a position he has held since 1996. Professor David Lockey has been a medical trustee of the charity for more than 13 years. I would like to place on record our huge appreciation of the outstanding contribution, the world class medical expertise and the dedicated commitment both Gareth and David have made to London’s Air Ambulance. They have both played an immense role in making London’s Air Ambulance the exemplary service it is today.

I must conclude by thanking our supporters, who together have now kept us flying for over 30 years. Together, we have been able to provide vital, world leading. Your contribution and support has been magnificent. It has been truly humbling to share this landmark occasion with you. On behalf of the Board, our staff, volunteers and patients, I give you our heartfelt thanks.

05


A LOOK FORWARD With Jonathan Jenkins, CEO

Over 30 years saving lives, our organisation has been underpinned by a common vision; to end preventable deaths in London from serious injury. It should come as no surprise, then, that our eyes are fixed firmly on the future of our service, and what we must do next to save more lives in London. To deliver the best possible service in London to everyone who needs it, when and where they need it, we have developed a new strategy for our organisation, which we began delivering in 2018. The strategy, ‘Saving more lives’, consists of five goals alongside a plan that will guide our priorities for the next five years. Our two strategic goals of saving more time and providing better care will ensure that our service can continue to be a world-leading service and do the best we can for as many patients as possible. We know that we will need to replace our fleet of helicopters in 2025, alongside our cars every three years, to continue providing London with a world-class, 24/7 service. Alongside this, the next few years will see numerous other investments in our service, including a redevelopment of our helipad, funding for new interventions and widening our capacity to provide long-term patient guidance and support. However, this

will incur a significant financial commitment, including raising an estimated £16m required to replace our helicopter fleet. To fund these developments, we have set ourselves three enabling goals. We know that we will need to double income over five years, to connect with the people of London, and to invest in our people. This will ensure not only the long-term stability of the charity, but that we excel at our delivery of rapid response and cutting-edge care, ready to meet the demands of running the service. We are making progress against these targets, thanks in no small part to the hard work of staff and volunteers across our charity and clinical teams. In 2018/19, we progressed against our goals to save time and provide better care with the delivery of a new blood product to prevent patients bleeding to death at the roadside; embedded our enhanced clinical and paramedic models; began a project to review our data; and explored options to redevelop our helipad. Our fundraising activity has also moved to meet these demands, including expanding our work in the community; recruiting new lottery players and regular givers; launching a legacy programme; and ongoing investment in our people.

This past year has also seen us redefine our values to provide a common grounding as we work towards delivering on our strategy. Teams from across our charity and clinical operations came together to discuss the principles that we hold to be at the heart of London’s Air Ambulance. After much in-depth discussion, three words came up time and again; compassionate, courageous and pioneering. These three values that guide how we work and to drive us to deliver the best possible for our patients. I must therefore take the opportunity to thank our team for their continued passion, resilience and commitment to our cause. The next year will not see us slow down by any measures, and I am excited to explore new projects such as our fundraising TV advert, the introduction of Life Saving Tea Parties, and further opportunities with our royal patron. I feel grateful to have this team behind our service as we look to the future to build on our activity. Finally, I also must thank our wonderful supporters for the part that they have played in 30 years saving lives. The last 30 years have seen remarkable innovation, progress and above all compassionate care given to the people of London. We will continue to push the boundaries to save more lives in London.

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A YEAR IN HIGHLIGHTS APRIL

A team of Saharan superheroes, including doctors, a paramedic, pilot and former patient, take on the Marathon des Sables and raise over £100,000

2018

MAY

Dr Vidar Magnusson and paramedic Caroline Appleby are given an NHS Heroes award for their life-saving treatment of the UK’s youngest ever shooting victim

NOVEMBER

AUGUST

Our helicopter lands at the HAC in support of long-term partners Saracens

JUNE

We are nominated for a record number of Sainsbury’s Charity of the Year partnerships

JULY

Our Summer Gala brings in an income of over £120,000 for our service

SEPTEMBER

Comedian Hugh Dennis opens our most successful ever helipad abseil, which raised £130,594

OCTOBER

We launch a landmark study trialing a new blood product to treat patients at risk of bleeding to death

After nearly 25 years of service, Helipad and Driving Standards Manager Paul Smith wins the Air Operations Support Staff Member of the Year at the Association of Air Ambulances Awards of Excellence

FEBRUARY JANUARY DECEMBER

New figures reveal that the Physician Response Unit has saved local health services the equivalent of £1.1m

We celebrate our 30th birthday with a visit from our anniversary patron, HRH The Duke of Cambridge

We launch our new patient podcast ‘Picking Up The Pieces’ with Myleene Klass

MARCH

Chief Fire Officer John Power completes 25 years of service

2019

09


ABOUT US

OUR NHS PARTNERS

Every second of every day, London’s Air Ambulance Charity is ready to deliver rapid response and cutting-edge medical care to save lives in the city. Critical injury can happen to anyone, at any time. It is the biggest killer of people under 40. We bring the hospital emergency department to the scene, delivering life-saving treatment to the 10 million people who live and work in London. We operate 24/7, using a helicopter from 08:00 to sunset and rapid response cars at night or in adverse weather conditions. We have a reputation as a world leader of rapid response medical care. We have provided support to the capital in times of great need such as the London Bridge attack, the Grenfell Tower fire and 7/7 bombings. We are proud to have achieved a number of medical “firsts” such as: • The first survivor of open-heart surgery at the roadside. •

The first to use the life-saving REBOA procedure, a technique to stem potentially fatal internal bleeding, at the roadside.

The first air ambulance in the UK to carry out blood transfusions at the roadside.

We also deliver the Physician Response Unit (PRU), a rapid response emergency service. The PRU consist of a senior Doctor and London Ambulance Service clinician that treats patients in the community and to leave them under local community services, thus avoiding the need to be taken to an Emergency Department. The service operates in East London and runs from 08:00 to 20:00, 365 days a year.

We operate in partnership with both Barts Health NHS Trust (“Barts Health”) and London Ambulance Service NHS Trust (“London Ambulance Service”). Barts Health employ and remunerate our doctors who are seconded for six month placements, and our consultants who are permanently associated with the service. They also provide the helipad space on top of The Royal London Hospital, as well as a grant towards operational costs.

London Ambulance Service employs and remunerates our paramedics who are typically seconded for 12 month placements. They also provide the means of dispatching our teams. Patients are treated under the governance of the NHS. The regulatory requirements of the Care Quality Commission are covered by Barts Health and London Ambulance Service for all clinicians attached to the service.

Our pioneering spirit continues to drive us to understand what more we can do to save lives. 11


MISSION MAP 2018

OUR STRATEGIC OBJECTIVES 78

43

58

51

Hillingdon

46

49

68 58

Brent

Westminster

Ealing

Hammersmith & Fulham

44 19

Richmond

21

City of London Kensington & Chelsea

Wandsworth

81

51

41

17 82

57

Outside London

49

Newham

47

62

Barking & Dagenham

38

Bexley

Better care. We will relentlessly seek ways of improving the care we provide to patients and their families in their greatest time of need.

Lambeth

40 60

Croydon

Bromley

We will deliver this objective via two strategic goals and three enabling goals over the next five years: Save time. We will constantly look for ways to reduce the time it takes us to reach and treat patients to ensure we can help everyone in London, whenever and wherever they need us.

Greenwich

Lewisham

Our long-term objective: To deliver the best possible service in London to everyone who needs it, when and where they need it.

Redbridge

Tower Hamlets

Southwark

Kingston

Sutton

Havering

Hackney

Islington

90

Waltham Forest

Merton

13

4

42

85

77

41 27

Haringey

Camden

Hounslow

18

47

Barnet

Harrow

52

Enfield

1656

Patients were treated in calendar year 2018 by our advanced trama doctors and paramedics

Connecting with the People of London. We need to build our relationship with the people of London to successfully deliver our strategic goals. Our culture. People are our greatest asset in being able to deliver our-life saving service. We will invest in the development of our people to ensure we can continue delivering our world-class service for London. Double income. We need to double income over the next five years to fund the improvements we plan to deliver for our strategic goals.

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STRATEGIC OBJECTIVE - SAVE TIME

SAVING TIME, SAVING LIVES Celebrating 30 years of London’s Air Ambulance Charity

Our charity was established by a group of committed, determined and pioneering medics. They recognised that seriously injured patients were dying unnecessarily because of the delay in receiving prompt and appropriate medical care. They understood that every second counts. 30 years later, we have innovated the service we are able to provide at the roadside, but our mission remains the same; to deliver rapid response and cutting edge care to save lives in the city.

2. A ‘safe space’ for our crews to find respite, deliver peer-to-peer support and debrief critical missions. This would also be used for patient and family visits. 3. Education and training facilities for our advanced trauma teams, Physician Response Unit medics and course trainees. 4. Rest accommodation for frontline staff. 5. New storage space to accommodate additional medical and major incident response equipment.

The appeal To mark our 30th anniversary year, we launched an appeal to raise £1m for our charity so that we can save time and save lives in London. Our service has continued to evolve, innovate and grow since our current helipad was designed in the early 2000s. We constantly strive to work faster and more efficiently for our patients, but we now need to make significant developments to our facilities to streamline our operations further. Through the support of the appeal, the redevelopment hopes to provide new facilities including: 1. A ready crew room placed closer to the aircraft for faster dispatch.

We hope that by successfully completing this redevelopment, we will be able to: • Shave valuable seconds off our dispatch time, enabling our team to get to our patients faster. •

Provide more opportunities for our crew to debrief, rest and reflect after jobs, therefore supporting their personal and professional wellbeing.

Provide year round training facilities for our operational crews.

Help The Institute of Pre-Hospital Care continue providing world-leading training in trauma medicine with excellent facilities and without disrupting helipad operations.

Our 30th birthday On the 9th January 2019, we celebrated 30 years of our life-saving charity. The occasion was marked with a visit from HRH The Duke of Cambridge, who flew our non-operational helicopter to our helipad base at The Royal London Hospital. The visit saw The Duke meet with clinicians, paramedics, pilots and crew members to learn about the challenges of working as a first responder in the capital. Prior to the visit, The Duke announced his patronage for our Saving Time, Saving Lives campaign. A former air ambulance pilot himself, The Duke has seen first-hand the impact these first responders have upon the lives of patients with critical injuries. As Patron of the 30th anniversary campaign, The Duke will champion those working on the frontline, and highlight the importance of our rapid response to incidents, and cutting-edge medical care.

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STRATEGIC OBJECTIVE - BETTER CARE

DR GARETH DAVIES, MEDICAL DIRECTOR, RELECTS ON 30 YEARS OF SAVING LIVES In 30 years, we have come extraordinarily far in our delivery of pre-hospital care. It’s hard to believe that once, our service was just a dream of an aspirational group of clinicians. They saw that people were dying unnecessarily. They knew we could make a difference if only we could get there in time. In 1989, if you were seriously injured in London there was nothing like our service to bring specialist care to the scene of the incident. When injuries are critical, so is time, and many patients were not surviving due to the delay in receiving hospital-level treatment. Our service was the answer to this problem; bringing the hospital to the patient to deliver the interventions they needed as quickly as possible. Following several years of lobbying, our first helicopter took flight with the support of Express Newspapers in 1989. We had four years and £4m to prove that we could make a real difference and save lives in London. London Ambulance Service joined The Royal London Hospital (now working under Barts Health NHS Trust) as our NHS partners, building the foundation for this unique collaboration as it runs today. With a doctor and paramedic on board, our first medical teams took to the sky. Not everyone was convinced by our way of working. We were constantly under threat and needed to prove

the impact that a service like ours could have on our patients. to our service. We plan to introduce extracorporeal membrane oxygenation (ECMO), a way to bypass the heart and lungs to keep cardiac arrest patients alive, into the pre-hospital setting. We hope to start performing ‘zone one’ REBOA, which will see us place the balloon higher up the aorta to give a better chance of survival to a wider group of patients. We aspire to deliver these interventions, alongside many others of immense benefit for critically injured patients, in the next few years. We are relentless in our compassionate, courageous and pioneering spirit.

Nevertheless, our team fought on for our service and for the lives of our patients. We strove to improve the care we could provide at the roadside and in 1993, delivered the world’s first successful pre-hospital open heart surgery – a procedure that we now achieve worldleading success rates in – at the side of the road. We continued to make headlines and London rallied round to support us. In 1998 we launched our new helicopter G-EHMS, which was joined by our second helicopter G-LNDN in 2016 following the ‘Your London, Your Helicopter’ campaign. We have been able to be there for London on some of the city’s darkest days, attending the majority of the capital’s major incidents since our inception. We have taken pride in standing beside our emergency colleagues during these terrible events, doing all we can for those sadly affected. The last ten years have seen us revolutionise prehospital care. In 2012 we became the first air ambulance in the UK to carry blood on board to deliver roadside blood transfusions, and in the past year we have enhanced this care to trial a new blood product, ‘RC&Plasma’. Containing essential clotting ingredients,

it is hoped that this will help an increased number of patients with catastrophic bleeding to survive to hospital. We delivered the first pre-hospital REBOA, a technique to stem internal bleeding by inserting a balloon into the aorta, in 2014. We established The Institute of Pre-Hospital Care, providing the opportunity to share knowledge and experience across the medical community, and train the next generation of pre-hospital clinicians. We’ve drastically developed the care we can provide and are now recognised as a world-leading institution. But we have never stopped thinking ahead to who the next survivors will be. The team hope that the next few years will see numerous more interventions introduced

At the end of this financial year, I stepped down as Medical Director following the end of my tenure as trustee. I am immensely grateful to have worked with so many talented, ambitious and caring people in that time, and am so proud of everything that we have achieved together. I know that my successor and the service will continue their dedicated approach to our field, to push the boundaries of care, and to do the best we can for our patients. Thank you to everyone who has helped us get to where we are today. Thank you to everyone who will keep us flying for years to come.

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STRATEGIC OBJECTIVE - BETTER CARE

OUR PATIENTS

Danny

Peter

On 8th March 1997, 15-year-old Danny set off on his bike to do his paper round. An hour later, two policemen knocked at his mother’s door to say that he had been involved in an accident. Danny had been knocked off his bike, hit the car windscreen, flew over the top and landed on his head and shoulder at the back of the car. The helicopter landed nearby and the team treated Danny by placing him in an induced coma to protect his brain before airlifting him to hospital. Danny had sustained a fractured skull, extradural hemorrhage and a fractured collar bone. Despite the severity of his injuries, Danny has made an extraordinary recovery and has kept fundraising and taking part in events for our charity in the 22 years since. He is now married, with two little boys of his own. They recently visited the helipad to hear how we treated their dad.

In 2005, Peter was riding his motorbike when something slippery on the road caused him to lose control. He recalls lying on the side of the road, seeing our charity’s helicopter land behind and the team attending to his injuries before being taken to hospital. The incident and recovery process inspired Peter to take on charity challenges for those that had treated and supported him. However, that wasn’t enough for him. Peter decided he wanted to become an air ambulance pilot to help as many people as possible, and made the incredible decision to sell everything he owned to go to helicopter school. He has since flown all over the world, worked for the coastguard and now flies for the emergency services in London.

“ NO WORDS CAN EXPRESS THE THANKS THAT WE HAVE FOR THIS AMAZING SERVICE”

“ LONDON’S AIR AMBULANCE DIDN’T JUST SAVE MY LIFE

IT CHANGED IT

MAYBE SOMEDAY THE STORY WILL BE COMPLETE, AND I CAN GO FROM

CASUALTY TO CAPTAIN ”

“ I THINK ABOUT WHAT HAPPENED AND HOW THEY SAVED ME THAT NIGHT. IF IT WASN’T FOR THEM, I WOULDN’T BE HERE

AND THAT’S A FACT ” Jemma Jemma was at home with her children when the unthinkable happened. Her ex-partner broke in and attacked her, stabbing her over 20 times in the neck and face. Our team hurried to the scene to treat her and rushed her to The Royal London Hospital. Jemma suffered a stroke as a result of her injuries, and was paralysed down the left-hand side of her body. Nevertheless, Jemma, who is congenitally deaf, made an incredible recovery and was able to retain her sight and ability to communicate with the use of one-handed sign language. In May 2019, she welcomed her fourth child, Zoey, to the family and is now engaged to be married next year.

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STRATEGIC OBJECTIVE - BETTER CARE

PICKING UP THE PIECES

“ AT THE BEGINNING THE DIFFICULTIES WERE COPING

WITH THE PRACTICALITIES OF THINGS. NOW THE DIFFICULTIES ARE

MUCH MORE MENTAL”

STRATEGIC OBJECTIVE - BETTER CARE

BEING THERE FOR OUR PATIENTS Helping our patients to make the best possible recovery from injury goes beyond the acute prehospital phase. Providing ongoing guidance for patients and their families is our Patient Liaison Nurse, Frank Chege. Be it emotional guidance, practical support, signposting to charities and resources or facilitating peer-to-peer opportunities, the Patient Liaison Nurse’s role is invaluable on the road following trauma. Unique upon creation, the impact of the Patient Liaison Nurse has inspired other air ambulances to recruit for similar positions, supporting patients’ recoveries across the country. From October 2017–September 2018, the Patient Liaison Nurse followed up with 333 individuals, supporting their road to recovery in the following ways:

The care our team delivers by the roadside is usually only the beginning of a very long and difficult recovery journey for patients and their families. Often the real trauma begins when patients and their loved ones get home and must adjust to the new practicalities and emotions of lives that have changed beyond recognition. In March 2019, we released our first ever podcast, Picking Up The Pieces. Hosted by Myleene Klass, the series explores how those who have been affected by our work and those around them have rebuilt their lives after serious injury.

Face-to-face follow up with patients and their families, including 196 bedside visits on hospital wards.

Signposted 75 patients and families to organisations and healthcare providers that are equipped to provide specialised support during the recovery and process.

Hosted helipad visits for 44 patients and families to meet the clinical and aviation team members that looked after them.

Facilitated 15 peer-to-peer support meetings.

Facilitated 12 bereavement consultations, giving bereaved families the opportunity to meet the teams who treated their loved ones.

Disseminated our patient booklet - a source of hope and inspiration – to 175 patients and their family members.

We hope in the next year to secure funding to employ two more Patient Liaison Nurses.

We were grateful to be joined by a husband and wife to discuss how serious injury has affected their home lives; two women who have both undergone traumatic leg amputations; the parents of a young boy living with a brain injury; and two mothers who tragically lost their sons to trauma. Each episode explores what happens when the things we take for granted are taken away from us, and how to pick up the pieces after trauma. You can listen to the episodes at londonsairambulance.org.uk/podcast

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STRATEGIC OBJECTIVE - BETTER CARE

CLINICAL INNOVATION

“ AT LONDON’S AIR AMBULANCE

WE ALWAYS WANT

TO GIVE THE GOLD STANDARD OF PATIENT CARE TO OUR PATIENTS ” Dr Anne Weaver

At the heart of our service is a spirit of constant innovation. Our partners Barts Health and London Ambulance Service lead on clinical delivery and we work closely with them to enhance the care we provide to help even more patients survive traumatic injury.

The conference was set up by The Institute to help change the working culture between clinicians, radiologists, pathologists and coroners around death from injury.

2018/19 was no exception, and saw us continue to develop to save time and provide better care to patients in London. This year:

Upcoming

RC&Plasma – New blood product

Pre-hospital extra corporeal membrane oxygenation (ECMO): We will be supporting Barts Health in a trial to assess the feasibility of developing prehospital ECMO within 30 minutes of a call to the emergency services to selected patients suffering out-of-hospital cardiac arrest in London.

Emergency preservation and resuscitation (EPR): We plan to introduce EPR to cool people into suspended animation at the roadside to provide a chance for resuscitative surgery in hospital.

‘Zone one’ REBOA: We hope to perform REBOA higher in the aorta (in ‘zone one’) to treat a wider number of patients suffering catastrophic internal bleeding.

In October 2018, we launched a landmark study in a first for UK air ambulances and pre-hospital care that hopes to reduce deaths from catastrophic bleeding. The two-year study will look at the effectiveness of using a new blood product. The product consists of red blood cells and plasma and can be given as a transfusion to patients at risk of bleeding to death before arriving at hospital. The product contains essential clotting ingredients to help form stronger blood clots and replace lost blood volume, improving a patient’s chances of surviving to hospital. The study hopes to be an important next step on the path to delivering ‘whole blood’ in the pre-hospital setting.

New car fleet

Golden Hour Conference

We unveiled our new fleet of rapid response cars in July 2018. The fleet, funded by a donation from ICAP’s charity day, sees us continue to use three SKODA Octavia Estate vRS cars, now updated to new models to ensure state-of-the-art delivery. The fleet also sees the arrival of two new SKODA Kodiaq Estates, which have increased space to accommodate more medical kit.

November 2018 saw clinicians from across the spectrum of emergency care, as well as those radiologists and pathologists who specialise in interpreting causes of death, gather for The Institute of Pre-Hospital Care’s ‘Golden Hour Conference: Why do injured people die?’ Talks focused on how each could learn from others’ expertise, and opportunities for the future of this complex and important area.

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STRATEGIC OBJECTIVE - BETTER CARE

97%

PHYSICIAN RESPONSE UNIT

OF PATIENTS SAID THEY WOULD RECOMMEND THE PRU

The Physician Response Unit (PRU) is a rapid response emergency service consisting of a senior doctor and London Ambulance Service Emergency Ambulance Crew member (EAC). Delivered in partnership with Barts Health and London Ambulance Service, the service takes the emergency department to the patient. The clinical experience of the medics enables the PRU team to treat a wider range of illnesses and injuries at scene, meaning many avoid a trip to hospital. By taking the emergency department on the road, the service aims to improve patient experiences by avoiding a trip to hospital and allowing them to be treated and to recover in their community. The service was expanded in October 2017 thanks to funding from Tower Hamlets together to run 12 hours a day, seven days a week. New figures released in October 2018 showed that in the remodeled service’s first 365 days: • 97% of patients who filled out a feedback from said that they would recommend the PRU.

The service treated 1924 patients, of which 1288 patients (67%) were treated in the community. Of these, 1085 would otherwise have been taken to an emergency department at hospital.

The PRU saved local health services the equivalent of £1,135,000.

Currently operating primarily in Tower Hamlets and East London, the success of the service has been widely recognised and we hope to see the service replicated in other areas of London and the rest of the UK to allow more patients to benefit from this innovative approach.

THE PRU SAVED LOCAL HEALTH SERVICES AN ESTIMATED

£1,135,000 25


STRATEGIC OBJECTIVE - BETTER CARE

THE INSTITUTE OF PRE-HOSPITAL CARE

The Institute of Pre-Hospital Care at London’s Air Ambulance was founded in 2013 to build on and expand the influence of our teams in the field of prehospital medicine. Its mission is 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.

continues to attract candidates from across the world, helping to develop increasingly productive relationships with countries such as Canada and New Zealand. Candidates who attend the course routinely go on to deliver advanced pre-hospital interventions for patients in their services and introduce London’s Air Ambulancestyle governance to ensure patient safety is of the highest standards. Every member of our own team also takes part in the PHCC prior to sign off.

The Institute has had another successful year. The fifth cohort of the Intercalated BSc degree in Pre-Hospital Medicine, delivered in partnership with Queen Mary, University of London (QMUL), began their studies in September 2018, completing the course just after the end of the reporting period in May 2019. It has been a pleasure to welcome another outstanding group of future doctors, and see them complete this step on their journey with excellent results. The new MSc in Pre-Hospital Medicine, scheduled to begin on 16th September 2019, has begun recruiting for the first cohort of students. The Institute has developed a brand new faculty team to deliver this Masters and the course will be the first of its kind in the world.

Our Pre-Hospital Emergency Endovascular Resuscitation (PEER) course is focused on REBOA. The course evolves each time it is taught in response to lessons learned by our endovascular team during their educational visits across the world. Our service is now recognised as leading the way in the pre-hospital evolution of this type of intervention. The course allows us to innovate further with REBOA, for example with the introduction of invasive arterial monitoring for the first time, and a bespoke new balloon that makes the procedure better and safer for patients.

Our short courses continue to grow and expand. In its thirteenth year, the Pre-Hospital Care Course (PHCC)

In response to our upcoming ECMO trial, the PreHospital Extracorporeal Life Support (PEELS) course was developed by the ECMO team to prepare us for delivering this intervention for patients outside of hospital.

Our PUNCC (Pre-Hospital Underground and Novel Concepts Course) combines specific training for our teams who help those injured on the underground network with rehearsal and preparation for the delivery of all of the novel concepts and ideas that we have in the service pertaining to these incidents. The Pre-Hospital Care Programme (PCP) academic fora, held once a month, continue to attract approximately 300 students each time, with pre-hospital care

achieving an increasingly high profile within the medical school at QMUL. Our research strategy is developing rapidly with a new research and clinical effectiveness lead and new programme around data. Adequate data systems are crucial to the research and innovation of the future and this is a complex piece of work, with collaborations between multiple organisations and stakeholders that should make our systems fit for purpose.

27


Case study: Abercorn School

STRATEGIC OBJECTIVE - CONNECTING WITH THE PEOPLE OF LONDON

Abercorn School have risen to the challenge of supporting our charity, selecting us as their Charity of the Year for three years in a row. Pupils have been supporting our charity through many exciting events, including carol singing, skipathons and movie nights, and have so far raised over £3,400. These events have not only been fantastic fun for the pupils, but have helped them understand the importance of giving back to their community and taking pride in doing so.

LONDON’S AIR AMBULANCE IN THE COMMUNITY

The school has also welcomed speakers from our charity to teach pupils about our service and how the money raised goes towards helping our patients. The talks, tailored to the pupils’ age groups, have always seen children asking insightful questions, and has hopefully proved inspirational to some of our service’s future doctors, paramedics and pilots.

Community is a vital part of our fundraising activity, empowering us to reach those we serve and raise awareness of our cause. To support our efforts we are developing our community fundraising programme as part of our five year strategy to help us to connect with the people of London.

Community groups Giving talks at community groups is another invaluable way of informing others of our work. Volunteer speakers have the opportunity to improve their own skills, while attendees benefit from a unique insight into our work. Last year, we were privileged to deliver 48 talks, and meet hundreds of lovely people supporting our service.

Schools Schools connect with our charity in several ways, including hosting visits and talks from our team and Helivan, fundraising partnerships and using our free educational resources. Our team visited 57 schools and colleges this year and engaged with 4,823 young people. The past year has been no exception, with schools raising £23,782 to support our service. We hope that through these partnerships, we can inform the next generation about our work and inspire the doctors, pilots, paramedics and fire crew of the future

Collections Bucket collections are one of the most important ways for our team to be visible in London’s communities. In stations, supermarkets and more, we are able to reach more people to spread awareness of our work and charitable status.

This past year has seen over £45,000 raised in bucket collections, including an incredible £8,700 collected during our 30th anniversary collections at nine stations across the capital. We were also humbled to have been voted Charity of the Year by 46 Sainsbury’s stores going into our 30th anniversary year and are thankful to all of those who voted in recognition of our work.

Fairs We were delighted to be welcomed to several fairs across the capital in the previous year, including the Woolwich Armed Forces Day, Trinity Christmas Tree Festival and Highgate Fair in the Square. These events are not only a brilliant fundraising opportunity but are a wonderful chance for our team to engage in the community.

Volunteers At the heart of our community fundraising efforts are our volunteers. Those who give up their time to spread support for our work make an invaluable contribution to help us save lives. This year, 65 volunteers took part in regular fundraising activity, giving over 15,000 hours to drive donations and advocacy for our work. We are immensely grateful for the energy and commitment our volunteers bring, and would like to say a huge thank you to our wonderful team.

“ IT’S AMAZING

TO MEET PEOPLE

WHO’S LIVES HAVE BEEN SAVED

THANKS TO LONDON’S AIR AMBULANCE CHARITY ”

Case study: Mario Mario is just one of our network of wonderful volunteer speakers. “This was the perfect opportunity for me to hone my skills while helping my community”, says Mario. “When giving talks people usually approach me at the end and tell me their personal story - sometimes they are former patients or are relatives of those treated by the service. It’s amazing to meet people whose lives have been saved thanks to London’s Air Ambulance Charity.”

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STRATEGIC OBJECTIVE - CONNECTING WITH THE PEOPLE OF LONDON

STRATEGIC OBJECTIVE - OUR CULTURE

PARLIAMENTARY RECEPTION

OUR VALUES

On the 27th February, politicians from across the capital came together to pledge support for our charity at our 30th Anniversary Reception. The event in Parliament, hosted by Tooting MP Dr Rosena Allin-Khan, gave MPs the opportunity to meet our charity’s operational staff, including doctors, pilots and paramedics, and some of our former patients. The team also performed a practical demonstration of a thoracotomy (open heart surgery), engaging attendees in how we are able to save lives at the roadside. An Emergency Department doctor herself, Dr AllinKhan gave an insight into her first-hand experience of

our service’s impact on the prospects of our patients. Alongside London’s representatives, we were also joined by Matt Hancock MP, Secretary of State for Health and Social Care. The Secretary of State spoke to our teams about the impact of our work and innovative new procedures, as well as sharing his support for our service. The event was a highlight of our 30th anniversary celebrations so far, and hopefully inspired London’s MPs to continue to advocate for our service. We would like to say a huge thank you to all who attended and kindly pledged their support.

Whether on our operational or charity team, all those who work for London’s Air Ambulance share in a passion for the work that we do. This passion drives us to deliver the best service we can for our patients. With our new strategy in place, this year we redefined our values to give us a common grounding over the next five years. Our teams came together to discuss what we consider to be intrinsic to our work, and established three new values:

Compassionate We care about people and put them at the heart of everything we do. We are kind, respectful and always keen to listen to feedback.

Courageous We are prepared to achieve our mission in challenging environments. We are authentic, honest and not afraid to challenge and take calculated risks.

Pioneering We embrace and lead change through our innovation and creativity. We are constantly learning, both from our successes and from our failures, to make sure we are always striving to improve.

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STRATEGIC OBJECTIVE - DOUBLE INCOME make we were chosen by staff as one of the Bank’s charities of the year 2018/2019.

FUNDRAISING HIGHLIGHTS OF THE YEAR

A team of 50 members of staff from the Bank celebrated our 30th birthday in January by volunteering for a bucket collection at Liverpool Street Station. Their efforts yielded an outstanding £1,144.

Challenge events

Legacies

Last year saw hundreds of supporters run, cycle, abseil and more to fundraise for the charity. Whether taking part in our events with charity places or organising their own challenge to help, our supporters have brought energy, dedication and determination to our challenge events this year. Highlights included: • 36 runners braved the 2018 Virgin Money London Marathon, raising £83,265.

Gifts in wills, no matter how big or small, can make a huge impact on our service and help to save the lives of future generations of Londoners. This year saw the launch of our first legacy programme, with the appointment of a new legacy manager who will develop a sustainable and stable source of future income, helping secure our service for years to come. We were humbled to receive £553,338 from legacies in 2018/19.

A team of 94 lifesavers completed the 2018 Royal Parks Half for our charity, raising £56,000.

We held our biggest Helipad Abseil yet, with 280 supporters going over the edge of Europe’s tallest helipad and raising £130,594.

Our Prudential RideLondon 100 team was 36 strong, completing the world-famous route, raising £29,209.

A team from our charity, including a paramedic, pilot, fire officer, former patient, our CEO and two of our doctors, braved the ‘toughest footrace on earth’, the Marathon des Sables. By conquering sand dunes, storms and blistering heat over 250km, the team raised over £100,000 to help keep us flying.

Corporate partnerships The previous year has been another successful one for our corporate teams, with local and national partners continuing to pull out all the stops to raise an incredible £524,450 for our service. Several of our corporate partners have now been a part of our family for over five years, and we are immensely grateful for the support they continue to show us year on year. Highlights of the previous year included the renewal of our partnerships with ERS and Shearman and Sterling LLP, and two new key charity of the year partnerships.

Bank of England Thanks to a supporter working for the Bank of England who saw at first hand the difference air ambulances can

The prestigious partnership will see lots of further activity take place over the year we work together, including a leadership talk for the Bank’s senior management team, hosting a session at the Bank of England’s ‘Bring Your Children To Work Day’ and a business networking event. The Bank will match up to £25,000 at the end of the partnership, meaning that potentially over £50,000 could be raised for our charity.

Herbert Smith Freehills With the support and passion of two ex-patients based at the firm, Dan Hudson and Aderonke Joseph, we were selected as Herbert Smith Freehill’s (London Office) charity partner. The 18-month partnership began in November 2018, and in its first few months the firm: • Has hosted a Biennial Bar Quiz, raising an incredible £17,510 for the charity. •

Invited us to run an engaging event for the staff’s children to teach them how we save lives in London.

Will support us with pro bono legal advice when needed during the partnership.

Many of the firm’s staff will raise money for the charity by participating in our challenge events like RideLondon, Spartan Race, Royal Parks Half Marathon, and the Helipad Abseil.

Trusts and foundations Trusts and foundations have continued to make outstanding contributions to our service, supporting us to deliver new initiatives and our world-leading service for London. Over the previous year: • We launched a landmark study looking at the effectiveness of using a new blood product to reduce deaths due to catastrophic bleeding, thanks to funding from Barts Charity, Saracens and The Henry Surtees Foundation. •

The charity received funding from The Hospital Saturday Fund and The Rothera Charitable Settlement to appoint a Head Injury Research Fellow through The Institute of Pre-Hospital Care. The role will be exploring how we best treat head injury patients at the roadside.

We hosted a 30th Anniversary Reception for supporters from across the charity including trusts, foundations and City Livery Companies. The Reception marked defining moments in our charity’s history and provided the opportunity to thank our supporters for helping us get to where we are today.

Individual giving Income from individual givers, which includes cash and regular donors, raffle players, lottery members and legators, continues to increase and is a major part of our future growth plans. We are delighted to have seen a significant increase in income from individual giving. This growth is due to our continued investment in recruiting new lottery members and regular givers. This has mostly been through face to face fundraising, and we expanded our recruitment activity by working with new agency partners Evolution Recruitment Limited and Wesser Limited. We are looking forward to implementing new methods to expand our reach to prospective supporters in the coming year, including through new digital and TV advert campaigns.

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OUR SUPPORTERS HAVE

OUR FINANCES

DONATED GENEROUSLY

Full income 2018/19

2015/16

2016/17

£7.9m

£9.0m

£7.9m

£9.2m

£7.4m

£9.4m

£7.4m

£11.8.m

Income/Expenditure history

BOTH IN CASH & GIFTS IN KIND

Collections 1% Individuals Corporate (inc Gift Aid) Giving 33% 4%

Events 4%

Barts Health NHS Trust 7% Investments >0.1%

Commercial 43%

2017/18

2018/19

Expenditure Income

Where our funding came from

How resilient are we?

In 2018/19 we raised almost £12m (consolidated income) from our supporters and partners (comparative figure from 2017/18 £9m). All income streams performed well with income from individuals increasing by 85%* from £2m last year to £3.8m this year. Income from trusts and foundations almost doubled from £309k to £624k as we started to receive funding towards the planned helipad redevelopment.

We aim to have enough unrestricted cash reserves to meet, as a minimum, the cost of six months of operational costs should all our funding sources cease or in the case of any unexpected significant expenditure. As of 31 March 2019, we have enough unrestricted cash reserves to fund 10 months’ costs. This year we are designating £1m of unrestricted reserves towards a helicopter fund.

Our supporters have donated generously both in cash and gifts in kind and every stream of income is vital to the ongoing sustainability, growth and development of the charity. We continued to provide service for 24 hours, seven days per week using our helicopters and fleet of rapid response cars and this year’s income funded the operation of extended daylight flying hours until sunset each night, resulting in a total of 320 additional hours during which the helicopter was launched on 92 occasions and treated 67 critically injured patients.

We must invest in fundraising to sustain and grow income for our life-saving work, now and in the future. The charity’s long-term aims require significant cash expenditure, particularly the replacement of our helicopter fleet in 2025 at an estimated cost of £16 million. With the aim of doubling the income of the charity in the next five years to support these needs, we have deliberately made substantial investment in fundraising in the past year and will continue to do so over the coming years.

How we spent our funding Trusts and Foundations 5%

Gifts in Institute Kind 2% 1%

Trading (inc. lottery, raffle, shop) 43%

We will need to raise an additional £16million over the next five years for two new helicopters.

It cost approximately £9m (consolidated costs) to provide London with an advanced trauma care service 24 hours a day, seven days a week. Almost half of this went directly towards funding our charitable activities and we made further investment in fundraising to provide future funding to enhance and maintain the service.

Investment Strategy

Our charitable spending ratio** as calculated by the Charity Commission BETA version is 60%. The ratio is defined as charitable spending (including governance costs) as a percentage of the group’s total income available for charitable activities. *Including Gift Aid **Calculated using the methodology published by the Charity Commission on the BETA version at www.beta.charitycommission.gov.uk

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THANK YOU TO OUR SUPPORTERS We couldn’t do what we do without our supporters. We are continually humbled by those who donate, play our lottery, give up their time, take on challenges and more to help us help our patients. Whether you have been there since we began 30 years ago, or have more recently joined our family, thank you. You are vital part of our team; of the care we provide; and of our patients’ journeys. We are proud to be funded by you.

Our corporate partners Aberdeen Standard Investment Allianz Banham Bank of England Bryan Cave Leighton Paisner LLP Bryrne Group CIS Security Ltd Epoch Capital Ltd ERS Insurance Group Foxtons Geographers’ A-Z Map Company Ltd Hall & Woodhouse Herbert Smith Freehills LLP ICAEW International SOS

LDC Lionside Limited LIoyds Bank Foundation MBN Promotions MFS International NatWest Markets Newton Investment Management Ltd Phoenix Group Saracens Savills London Secura Sequel Shearman and Sterling LLP The London Helicopter Tokio Marine Kiln Group Ltd Wells Fargo Winckworth Sherwood

Corporate Case Study: Foxtons Foxtons have been supporting our charity with a fully integrated partnership, including both commercial sponsorship and staff fundraising, since October 2015. A successful Payroll Giving Campaign rolled out to Foxtons staff in early 2016. The team proudly announced over 24% staff take up in 2017, followed by a Payroll Giving Platinum Award. In 2017 we were excited to be invited with Foxtons to present at a Payroll Giving Conference on the success of the campaign. Since then, Foxtons we have supported our charity team with a variety of fundraising events including

trekking Kilimanjaro, the Three Peaks Challenge and cycling hundreds of miles between them. Alongside this, teams from Foxtons have been a consistent and enthusiastic part of our events calendar, taking on the Spartan Race, Virgin Money London Marathon and Prudential RideLondon, and are looking forward to braving their first helipad abseil in late 2019. In addition to their sporting achievements, the team have also organised in bake sales and taken part in our charity collections to help keep us flying. We are therefore delighted that Foxtons have extended their support for an additional two years, continuing the partnership until 2020.

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THANK YOU TO Our Ambassadors Lord Maxwell Beaverbrook Martin Gilbert Richard Harris Bernardo Hartogs Graham Hodgkin Mike Hussey Dr Hilary Jones Julia Leal Sir Stirling Moss OBE Sir Harry Solomon Juliet Solomon Dr Alastair Wilson OBE Paul White Sir George Iacobescu CBE The Rt Revd & Rt Hon Dame Sarah Mullally DBE

Trusts, Foundations and Livery Companies The Aero Section - City Livery Club The Air Pilots Benevolent Fund Aldgate Ward Club The A L Sober Charitable Trust The Adrienne & Leslie Sussman Charitable Trust Anthony Hart Charity Trust

The Ardwick Trust Aspect Charitable Trust The Arsenal Foundation The Assheton-Smith Charitable Trust The Astor Foundation The Austin and Hope Pilkington Charitable Trust The Baker Charitable Trust The Beaverbrook Foundation The Belvedere Trust The Bernard Sunley Charitable Foundation BP Foundation Branbourne Charitable Trust Bright Horizons Foundation for Children The Bothwell Charitable Trust The Cadogan Charity The C A Redfern Charitable Foundation Catherine Cookson Charitable Trust Centurions Trust The City of London Corporation’s Charity, City Bridge Trust Chapman Charitable Trust David King Charitable Trust The Doris Pacey Charitable

Foundation The Dr. Mortimer and Theresa Sackler Foundation Edith Murphy Foundation The Elaine and Angus Lloyd Charitable Trust The Elizabeth Frankland Moore and Star Foundation Ettling Charitable Trust The Family Rich Charities Trust Galinski Charitable Trust The George Bairstow Charitable Trust Gerald Micklem Charitable Trust Gisela Graham Foundation The Golden Bottle Trust The Goreeb and Yateem Trust Fund The Grace Trust Guild of Freemen of the City of London The Gunmakers’ Company Charitable Trust The Heathside Charitable Trust The Henry Surtees Foundation Highfields Trust The Horner Family Fund The Hospital Saturday Fund The James Tudor Foundation

The James Wise Charitable Trust Joseph Strong Frazer Trust The J P Jacobs Charitable Trust Lloyd’s Charities Trust The Lotus Charitable Foundation Mactaggart Third Fund Masonic Charitable Foundation The Michael and Anna Wix Charitable Trust The Michael and Ruth Jacobs Charitable Trust Misses Barrie Charitable Trust Mistra Trust Modiano Charitable Trust Mothercare Foundation Mrs Maud Van Norden’s Charitable Foundation The Ormsby Charitable Trust The Persula Foundation The Phillips Family Charitable Trust The P T Fenwick Charitable

Settlement The Rest-Harrow Trust The Rothera Charitable Settlement The Samuel Storey Family Charitable Trust Saracens Foundation The Sinclair Charity The Slaughter and May Charitable Trust The Stanley Foster Charitable Trust Stella Symons Charitable Trust The Sundarama Trust The Swire Charitable Trust Tallow Chandlers Benevolent Fund The Trevor Chinn Charitable Trust No 2 The Utley Foundation The Vandervell Foundation The Warshaw Family Charitable Trust The Weaver Family Trust

The Webb Charitable Trust The Woodham Trust The Worshipful Company of Builders’ Merchants The Worshipful Company of Chartered Secretaries and Administrators Charitable Trust The Worshipful Company of Curriers The Worshipful Company of Environmental Cleaners Charity Trust The Worshipful Company of Gold and Silver Wyre Drawers The Worshipful Company of Launderers’ Benevolent Trust Fund The Worshipful Company of Security Professionals Charitable Trust The Worshipful Company of Tylers and Bricklayers Charitable Trust Vera Outhwaite Charitable Trust

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For more information please contact: E: info@londonsairambulance.org.uk T: 020 3023 3300 londonsairambulance.org.uk @LDNairamb Registered Charity 801013