London’s Air Ambulance Annual Review 2017/18
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Contents A Look Back from Our Chairman A Look Forward from Our Chief Executive A Year in Highlights About London’s Air Ambulance Our NHS Partners Medical Director’s Report Our Vision, Mission and Values Mission Data Our Patients Improving Awareness of London’s Air Ambulance Launch of Our Patient Booklet From Roadside to Recovery Our Role in Major Incidents Physician Response Unit Plans for the Future The Institute of Pre-Hospital Care Our Finances Thank You to Our Supporters
4 5 6 8 9 10 12 13 14 16 18 19 20 22 24 26 28 30
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A Look Back from Our Chairman The past year has been one of significant development for London’s Air Ambulance. We have continued to provide leading pre-hospital care to the people of London and at the same time we have strategically invested for the long-term growth, stability and success of the charity. In the year under review the charity received almost £9m in income. We have been particularly pleased to see our income from individual donors grow threefold as our supporter base develops and an increasing number of people in London commit to support our cause. During the financial year 2017/18 we treated a total of 1,749 patients by helicopter during the day and rapid response cars at night. Our total expenditure during 2017/18 was £7.9m. We are constantly planning ahead to generate the financing required to sustain our service. This will include, for instance, the need to replace our helicopters in the next five to seven years as they come to the end of their useful life. The charity is therefore investing in fundraising to ensure our performance will expand to meet these financial requirements. We are implementing a strategy to increase individual giving, led by face-to-face fundraising, digital marketing and new campaigns. The continued success of our service is due in no small part to our close partnerships with Barts Health NHS Trust and London Ambulance Service NHS Trust. I would particularly like to thank them for their contribution to our charity and their role in supporting our medics. Their unswerving commitment to us is hugely valued. I must also thank the city’s emergency services and trauma networks. While our teams do all that they can at the scene, we form only a part of London’s emergency response and a part of a patient’s treatment pathway. It is a privilege to be part of this highly dedicated and professional service community. On behalf of the Board of Trustees and everyone involved in the charity, I would like to express our grateful thanks to all our supporters. We would not be able to carry out our vital work without your backing and outstanding generosity. We are proud to serve this wonderful city, and are humbled to be empowered to do so by your unfailing support.
Mark Vickers Chairman of the Board London’s Air Ambulance
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A Look Forward from Our Chief Executive This year marked my first as London’s Air Ambulance’s Chief Executive. We have been working hard to develop a strategy to grow our charity over the next five years to meet our mission of saving more lives in London through our rapid response and cutting-edge care. We expect that we are going to need to double income over the next five years to meet our core operational requirements and our ambitious clinical aspirations. I’m looking forward to seeing new projects come to fruition, from growing our existing methods of fundraising, to the development of legacy and major donor programmes. With the right investment over the coming years, we will be able to continue our pioneering, courageous and compassionate approach to pre-hospital care. I must take this opportunity to thank all of the charity’s operational and fundraising staff for their hard work, and for making me feel so welcome in my first year. Implementing our new strategy has taken time and dedication, and we are still in a period of transition. I feel privileged to be a part of a team that has wholeheartedly embraced the challenge and put all of their efforts behind our service. I would also like to thank our volunteers for the invaluable support they provide the team. Whether giving up their time to help at our collections, in our office, our shop or elsewhere, their dedication is humbling and inspirational. I am so grateful for the time they give to our charity. An ongoing challenge was confirmed in a recent survey showing that whilst most of the people of London have heard of us, two thirds are unaware that we are a charity. I have therefore been delighted to welcome Louise Robertshaw as our first Director of Marketing and Communications to help us convert the overwhelming public good will into long term support. Louise brings a wealth of charity communications experience, which she will use to help develop our strategy and achieve our goals over the next five years. I would finally like to give my personal thanks to all our supporters. You play a vital role in our treatment of patients, and allowing our service to save lives. For this, we are truly grateful. I am excited to see what the next few years will bring. I hope you will join us for the journey.
Jonathan Jenkins Chief Executive London’s Air Ambulance
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A Year in Highlights April
May
June
July
August
September
11 consultants are appointed to enhance our duty crew and deliver our consultant led model. London Ambulance Service and the Metropolitan Police raise £2,865 through a charity rugby match.
Fearless fundraisers go over the edge to raise over £100,000 in our Helipad Abseil. Our golf challenge raises £20,000.
Jonathan Jenkins becomes Chief Executive of our charity. 6
Businessman Carl Palmer sets off on a 40,000 mile clipper race around the world for our charity.
October
November
December
January
February
Artist Jeremy Houghton hosts an exhibition in aid of our charity.
The Physician Response Unit is expanded to be a seven-day service for the first time.
Our team wins three Association of Air Ambulances Awards of Excellence.
We deliver the first Pan London Trauma Nursing Conference.
March
Former patient Sacha and his family tell their story in a video shared with our supporters.
Our patient booklet, ‘Difficult roads can take you on a beautiful journey’, is launched.
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About London’s Air Ambulance London’s Air Ambulance is the charity that delivers an advanced trauma team to critically injured people in London in partnership with Barts Health NHS Trust and the London Ambulance Service. Our team at all times includes a trauma doctor and paramedic, as well as a consultant on most missions. The team perform advanced medical interventions, normally only found in the hospital Emergency Department, in time critical, life-threatening situations. Our missions commonly involve serious road traffic collisions, falls from height, industrial accidents, assaults and injuries on the rail network. Based at The Royal London Hospital and founded in 1989, we operate 24/7, using a helicopter from 08:00 to sunset and rapid response cars at night and in adverse weather conditions. The Physician Response Unit (PRU), is staffed by a senior doctor and a London Ambulance Service Emergency Ambulance Crew (EAC) member, and carries advanced medication, equipment and treatments in its car which would usually only be found in hospital. The PRU enables the emergency department to be taken to the patient, meaning treatment can take place at scene or at home, potentially avoiding a trip to hospital. London’s Air Ambulance has an international reputation for clinical excellence and delivers advanced procedures which have been adopted across the world, including pre-hospital open heart surgery, blood transfusion and Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), a pioneering technique to stem internal bleeding in trauma patients.
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Our NHS Partners We operate in partnership with both Barts Health NHS Trust (“Barts Health”) and London Ambulance Service NHS Trust (“London Ambulance Service”). Barts Health employs and remunerates the registrars who are attached to us, typically for six months and the consultants who are permanently associated with the service, as well as providing direct financial support in the form of a monthly grant and the helipad facilities required for our operations. London Ambulance Service similarly employs and remunerates the paramedics who are attached to us, normally for nine months. As part of their rota, an advanced trauma paramedic operates from the London Ambulance Service Emergency Operations Centre and is responsible for dispatching our team to the most critically injured people in London, 24 hours a day. 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.
London Ambulance Service
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Medical Director’s Report Our medical team has seen a successful but challenging year. We have continued our efforts to ensure that as many of our patients not only survive, but enjoy the best quality of life after trauma. Our teams attended two major incidents in the London Bridge attack and the Grenfell Tower fire, and a significant incident in the Finsbury Park Mosque attack. In the days that followed, we received overwhelming support from the public. I cannot say thank you enough for the kind words of support and donations that followed these incidents. While our role changes at a major incident, we aspire to give the same quality of care that we provide daily when treating critically injured patients. 2017 was the first year we attended more stabbings and shootings than road traffic collisions. However, despite our collective sadness at this statistic it won’t change our focus on ending deaths from injury in London and we stand behind those working to reduce the rate of these incidents. I am proud that a service like ours can be there to give patients the best possible care when they need us the most. We continue to innovate and improve our service to ensure that more patients survive. I would like to express my gratitude and pride to my colleagues for their dedication and professionalism that they have shown throughout the year. The last year has seen many developments for our service, including the launch of our remodelled PRU, our new consultant model, and, thanks to funding from ICAP, a new fleet of rapid response cars on the road. I am looking forward to seeing what the next year will bring, including our first whole blood trial, the introduction of ‘zone one’ REBOA and the use of extracorporeal membrane oxygenation (ECMO), a technique to artificially oxygenate blood and pump it round the body, to treat out-of-hospital cardiac arrest patients. These innovations will hopefully allow us to save even more lives.
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These advances would not be possible without opportunities for knowledge sharing and joint initiatives in trauma care. This year, we hosted the London Performance Psychology in Medicine Symposium, a chance to explore how we can improve the delivery of complex care in high pressure situations. In December, we held the first Pan London Trauma Nurses Conference, led by our charity’s Patient Liaison Nurse, Frank Chege. This provided those who work with trauma patients the opportunity to share learnings on this complex group. We also continued to host Clinical Governance Days, giving the opportunity to not only share our learnings, but hear from others and develop our practice. The Institute of Pre-Hospital Care has enjoyed another year at the forefront of the field and has been a hub for education and innovation. We have seen the third year of our intercalated BSc in Pre-Hospital Medicine deliver another cohort of outstanding students in collaboration with Queen Mary University of London. I am excited to see the future of trauma medicine develop with the support of our service. There is no way that we would be able to do any of the above without you, our supporters. Our status as a charity allows us to push the boundaries of pre-hospital care, and it is thanks to you that we can do so. Thanks to you, 1,749 patients received the vital care they needed in the last year. I am so proud of the service we have built together. Thank you.
Gareth Davies Medical Director London’s Air Ambulance
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Our Vision
To end preventable deaths in London from life-threatening injury.
Our Mission
To save more lives in London through rapid response and cutting-edge care.
Our Values
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Compassionate
Courageous
Pioneering
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.
We are prepared to achieve our mission in demanding environments. We are authentic, honest and not afraid to challenge and take calculated risks.
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.
Mission Map 2017 *Number of patients treated in calender year 2017
75 74 26
79
70
50
Brent
99
Westminster
Ealing
37 45 39
107
34 City Of London
Wandsworth
98
51
53 Lambeth
Redbridge
Hackney
Islington
23
Kensington & Chelsea
Waltham Forest
Haringey
Camden
Hounslow
30
43
56
Hammersmith & Fulham
17
Barnet
Harrow
74 Hillingdon
Enfield
103
82
Southwark
86
33 39
Newham
Havering
Barking & Dagenham
Tower Hamlets
59
Greenwich
28
Lewisham
Bexley
Richmond
19
18
Merton
61
Kingston
19
Sutton
65
Bromley
5
Croydon
Outside London
In 2017 our advanced trauma doctors and paramedics treated
1,797 patients In financial year 2017/18, our team treated‌ Penetrating Trauma
Road Traffic Collisions
Falls
Other
552 patients
500 patients
402 patients 295 patients 13
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Our Patients Robert’s story Robert was travelling home from a night shift when he came off his motorbike and collided with a lorry at 40mph. As well as several other injuries, one of his lungs had collapsed and the other was filled with blood. Our team made incisions on either side of his chest to treat the injuries to his lungs and allow them to re-inflate so that Robert could be safely transported to hospital. Following 45 days in hospital, Robert was able to return home to his two children. While on the ward, he promised girlfriend Jemma that he would propose when he got better. The wedding date is set for May 2019.
June’s story On her way back from work, 80-year-old June was hit by a car outside Kingston Hospital. She had sustained several injuries, the most serious of which was a bleed on the brain. Alongside London Ambulance Service, our medics resuscitated and stabilised June at the scene to ensure she could be transported to a major trauma hospital. While her injuries sadly have had a lasting effect, she has relearned how to walk and talk. When she returned home from hospital, she was awarded the Freedom of the Borough of Kingston, an honour given to those who have contributed above and beyond to the community. Her 15-year-old granddaughter now aspires to be a paramedic because of the care our medics provided that night.
Trang’s story Trang had only been in London for a few minutes when she needed help from our team. Travelling to a university open day with her daughter Caitlyn, she collapsed after taking a few steps off the plane. She had suffered a pulmonary embolism (blood clot in the lung) and couldn’t breathe. When our team arrived, they were told Trang had suffered a cardiac arrest and had been given CPR to get her heart beating again. The team administered general anaesthetic to take over her breathing and ensure maximum delivery of oxygen to her lungs, before transporting her to St George’s Hospital. There, she was treated for her blood clots and was finally able to return home to the USA a month later. Her daughter is now studying in the UK, and Trang returned to visit our team in February 2018.
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Improving Awareness of London’s Air Ambulance In April 2017, we conducted a brand review to find out
Our charity is now exploring ways to raise awareness of our
service.
Marketing and Communications functions joined together, and
more about what people in London know about our
work and engage more supporters. In February 2018, our
suspected; while 80% were aware of London’s Air
we welcomed Louise Robertshaw as our first ever Director of
The results showed something we already
Ambulance, only one third knew that we are a charity.
Marketing and Communications. The role will guide our charity
We are left with a challenge. There is a great deal of good will
engage supporters old and new.
and support for our work in London, but we struggle to reach potential donors when they don’t know we need their help. We hope that if more people in London are aware we rely on them, more will join our mission.
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into our 30th year and beyond, exploring creative ways to
September 2017 We launch our dispatch video, counting the cost of our service and encouraging viewers to ‘help our message take off’ by sharing the message on social media.
December 2017 Our first ever Christmas campaign, ‘It wouldn’t be Christmas for us without London’s Air Ambulance.’ Robert and Jemma’s story is told across London.
September 2018
2019 and beyond
National Air Ambulance Week 2018; a national campaign across Air Ambulances to show that without the public’s support, we cannot continue our work.
Continue delivering integrated marketing and fundraising initiatives to inspire and connect with the people of London.
January 2019 Our charity turns 30, giving us the opportunity to celebrate our work with the city we serve.
February 2018 Louise Robertshaw joins from Guide Dogs to lead our Marketing and Communications team.
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Launch of Our Patient Booklet When your life has been turned upside down by serious injury, the road ahead can be hard to comprehend. At these times, it can be invaluable to hear from those who have been on the journey you are about to take. In February 2018, our charity launched our patient booklet, ‘Difficult roads can take you on a beautiful journey’, which narrates the individual and inspirational recovery journeys of 10 of our ex-patients and their families. We hope that the booklet will be a source of strength and positivity to those recovering from trauma. The unique insights of our patients can be a source of strength for others and offer useful strategies to cope with the journey ahead. The booklet was written by our Patient Liaison Nurse, Frank Chege, Dr Chris Episkopos and Dr Siobhan Williams, who interviewed and worked with the patients to tell their stories. London’s Air Ambulance would like to thank The City of London Corporation’s charity, City Bridge Trust, for their support and The Gerald Micklem Charitable Trust for generously funding this book. We would also like to thank our ex-patients and their families who have been kind enough to share their stories with us. Lastly, thank you to all our supporters for enabling us to be there when our patients need us most.
“It’s important to remain positive, it does get better. It takes determination and strong will.” - Andy “There is a light at the end - don’t dwell on the future. Live for the now.” - Aderonke
- Sacha
- Jack
- Aderonke 18
- Andy
After injury; from roadside to recovery From Roadside to Recovery A patient’s recovery continues long after our trauma team’s on-scene interventions. To help patients on their recovery journey and working alongside the hospitals is our charity’s Patient Liaison Nurse, Frank Chege. The role of Patient Liaison Nurse provides a critical interface between rapid on-scene treatment and the patient’s continuing recovery, providing support and signposting for patients and their families. Frank’s work currently includes patient follow up, and building a support network with other charities and patients. This support can be invaluable in helping patients make the transition from serious injury to independent living. In addition, Frank helps to facilitate consultations for bereaved families. We hope in the next year to employ a second Patient Liaison Nurse to further the support that we can give our ex-patients.
Case study: Ronke Ronke was on her way to work when she was suddenly hit by an out of control car. She was behind a set of metal railings which took the initial impact; however, they buckled under the force, striking her right leg. Our advanced trauma team sedated Ronke, placed her leg back into place and anaesthetised her at the scene before transporting her to hospital. Unfortunately, surgeons at the hospital had no choice but to amputate her leg. On the ward, Frank arranged for Ronke to receive a visit from the ‘Limbless Association’, a charity that matches patients to other amputees that have experienced similar amputations or accidents. “I met a man who had a below knee amputation fifteen years previously. It really didn’t bother him; he was getting on with life – this really helped to motivate me.” Ronke is now back at work and continuing to recover from her accident. In Financial Year 2017/18: • • • • •
180 bedside visits were made. 19 peer-to-peer support opportunities were facilitated. 17 consultations for bereaved families were provided, giving them the opportunity to meet and hear from the teams who treated their loved ones. 54 patients and their families were signposted to other organisations that are able to provide vital and muchneeded support outside of the health service remit. 45 patients visited the helipad to meet the teams that looked after them.
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Our Role in Major Incidents In the last year, we attended the Grenfell Tower fire, the London Bridge attack and the Finsbury Park Mosque attack. We form a crucial part of London’s emergency response to major incidents, working closely with numerous organisations including the London Ambulance Service, Metropolitan Police, British Transport Police, City of London Police and London Fire Brigade to ensure London’s emergency infrastructure is world-leading. London’s Air Ambulance supports the frontline medical response, and we aim to provide the same quality of care during a major incident as we do on a daily basis. However, our role in a major incident does change somewhat. We are responsible for scene management and casualty clearance, as our medical teams are trained in rapid assessment and diagnosis. We work with London Ambulance Service to ‘triage’ patients – a process for sorting injured people into groups based on their need for or likely benefit from medical treatment. We scrutinise our response after every major incident to ensure that we deliver the best possible response should the unthinkable happen again. We are always learning. Our charity would like to extend our support to those who were and still are affected by these tragic events, as we remember those that we sadly lost. We wish you strength to face the days ahead.
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Inside the control room
Alongside our charity’s frontline trauma team, a London’s Air Ambulance advanced trauma paramedic sits in the LAS Emergency Operational Centre (EOC) at Waterloo as part of their shift rotation. The EOC monitors in excess of five thousand 999 calls that come in each day, with our paramedic looking for the five to six people who are so seriously injured that they need our medical expertise before they reach the hospital. On the night of the London Bridge Attack, Bill Leaning was on duty. Saturday 3rd June began as a normal day. “I came in, sat down at the desk, started monitoring the calls,” said Bill. “The calls start to come in and you see more and more… There’s something more going on.” Bill did not initially let his colleagues know what he suspected they were responding to, to ensure that they kept calm and collected under the circumstances. “You’re potentially putting your colleagues at risk... Your stomach flutters a bit and then you start to think about what you’re going to do. My job is to make sure that patient gets the best possible care, and to make sure that that patient gets a team that are safe and secure.” Once a major incident was declared, a pager was sent out to all our medical staff; nine teams in total arrived at the helipad to volunteer their help. Bill dispatched five teams. 48 people were treated by the emergency services that night.
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Physician Response Unit In October 2017, the Physician Response Unit (PRU), the joint service between our charity, London Ambulance Service NHS Trust and Barts Health NHS Trust was expanded thanks to funding from Tower Hamlets Together. Previously an eight hours a day, five days a week service, the PRU now responds to 999 calls 12 hours a day, seven days a week. The PRU brings the Emergency Department to the patient, meaning patients can be treated at scene and often avoid having to go to hospital. Staffed with a senior emergency doctor and an EAC in the car, the clinical experience of the medics enables the PRU team to treat a wider range of illnesses and injuries at scene compared to ambulance crews which take many emergency patients to hospital. The PRU carries advanced medication usually only found in hospital, such as instant result blood tests, urine tests and sutures to stitch serious wounds. By enabling patients to remain at home the PRU not only cuts treatment times by hours but focuses on improving patients’ experience. By avoiding hospital, people can recover in their home or community and avoid any associated risks that can come from extended hospital stays.
In its first six months the PRU: • Treated 1,077 patients. • Treated and left 68% of those patients in the community. • Saved local health services an estimated £661,628. The team hope that the PRU model will be replicated in other areas across London and the UK.
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Plans for the Future We will: In partnership with Barts Health NHS Trust and London Ambulance Service NHS Trust, continue the provision of a 24 hours per day, 7 days per week service. Examine how we can improve equality of service to areas that are a challenge to access quickly. Continue to work with London’s emergency services to develop our response to major incidents.
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Work with Barts Health NHS Trust to continue to evolve the delivery of the new clinical model. Support clinical trials, including of ‘whole blood’ (delivering a combination of red blood cells and plasma as opposed to the current standard of red blood cells) and ECMO, in the pre-hospital field. Continue to work with our NHS partners and local authorities to ensure that the value of the PRU is recognised and provided with long term support.
Continue to support patients and their families through our Patient Liaison Nurse and fund a second Patient Liaison Nurse to manage the increasing work. Launch an MSc in Pre-Hospital Care in collaboration with Queen Mary University of London. Continue to undertake pre-hospital care research and drive world-class innovation. Grow awareness of our charity status through campaigns led by a newly appointed Director of Marketing and Communications.
Secure sustainable, long term and diverse income streams for our charity by: • • • • • • •
Increasing and developing our charity’s regular giving. Expanding community fundraising. Implementing and growing a legacy programme. Growing the London’s Air Ambulance lottery. Increasing the number of corporate partnerships and sponsorships. Securing long-term grants and donations from charitable trusts, foundations and livery companies and statutory sources. Delivering major donor initiatives.
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The Institute of Pre-Hospital Care In 2013, The Institute of Pre-Hospital Care at London’s Air Ambulance (The Institute) was founded to drive excellence in pre-hospital care standards and practice through research, innovation and education. The Institute fosters collaboration across medical disciplines and institutions dedicated to improving outcomes for people afflicted by critical injury and illness.
Education
The Institute has seen another exceptional year. We have delivered training and education to a total of 757 doctors, paramedics, nurses and other professionals through existing and new courses, and produced insightful and innovative research. BSc in Pre-Hospital Medicine The Institute’s education practice is led by Dr Gareth Grier. The Institute and Queen Mary University of London’s (QMUL) Barts and The London School of Medicine and Dentistry are now in the fourth year of running the UK’s first Intercalated BSc degree in PreHospital Medicine. A new MSc in Pre-Hospital Medicine is currently in planning with QMUL’s Barts and The London School of Medicine and Dentistry. Pre-Hospital Medicine is a growing field that is now recognised as a subspecialty by the General Medical Council. 2017/18 was another successful year for the BSc degree. Our cohort of 21 students received outstanding results, and we look forward to following their careers over the years to come.
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Three exceptional students from this cohort were selected to receive our Beaverbrook Scholarship, kindly supported by The Beaverbrook Foundation. The scholarship programme covers the full cost of the students’ tuition fees for the duration of the degree, as well as providing funding for students to attend appropriate courses and conferences to supplement their studies. The London Performance Psychology in Medicine Symposium In June 2017, The Institute launched a new symposium, The London Performance Psychology in Medicine Symposium. This was built on the foundations of the ‘High Performance Workshop’ launched in 2016 in collaboration with UK Sport. The symposium was a meeting for clinicians, cognitive and sports psychologists, safety experts, elite performers and educationalists, and had 199 attendees. The event allowed us to explore how to best equip clinicians to deliver complex patient care in challenging situations. Pan London Trauma Nurses Conference The Pan London Trauma Nurses Conference saw a group of 400 trauma nurses gather from across the Pan London Major Trauma System. The conference was by nurses, for nurses and was the first entirely aimed at trauma nurses. The day explored the challenges of nursing this complex patient group and gave those in attendance the opportunity to meet and engage in shared learning. As part of multidisciplinary training, The Institute continues to run a number of other world-class courses and training programmes. It works closely with other organisations and institutions to deliver bespoke courses on various aspects of pre-hospital trauma and medical care including the London Ambulance Service, UK Sport, Metropolitan Police and the Military to name a few.
Research The Institute’s research practice, led by Professor David Lockey, draws on London’s Air Ambulance’s 29 years of patient data to study the effectiveness of pre-hospital medical interventions and address topics of pressing concern to the international pre-hospital care community. In 2017/18, London’s Air Ambulance contributed to many publications, abstracts and presentations in the UK and overseas. London’s Air Ambulance has again produced more research output than any other UK pre-hospital organisation. The range of work produced has covered previous work and more recent activities including airway management, haemorrhage control and major incident management. London’s Air Ambulance clinicians have continued to be in high demand at regional, national and international meetings as speakers. As well as lectures, a number of research abstracts have been presented.
Innovation The Institute’s innovation practice, led by Dr Gareth Davies, works closely with London’s Air Ambulance to devise safer, faster and more effective treatments to critically-injured and ill patients in a pre-hospital environment. Priorities for innovation are informed by London’s Air Ambulance case studies; current, peer-reviewed research; and in-hospital procedures with potential for effective adaption to a pre-hospital environment. These innovations become part of the care that London’s Air Ambulance provides to criticallyinjured patients daily. The Institute’s innovation practice builds on a foundation of London’s Air Ambulance clinical ‘firsts’, including a procedure for safe pre-hospital thoracotomy. The Institute would like to say thank you to all of the agencies that we have worked with this year, including QMUL, Barts Health, London Ambulance Service, Metropolitan Police, RNLI, London Fire Brigade, Transport for London, British Transport Police, the Military and UK Sport.
BSc in Pre-Hospital Medicine students*
41
Underground training course attendees
46
Trauma Sciences Summer School students
29
PEER (REBOA) Course candidates
45
UK Sport ‘High Performance Workshop’ delegates
15
MoD placements
2
Advanced Paramedic Practitioner (LAS) Course candidates
10
PHCC candidates
46
Fellowships
4
*The academic year runs from 1 August to 31 July, therefore the number of BSc students given includes both academic years 2016/17 and 2017/18
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Our Finances 1% Collections
2% Institute 5% Events 5% Corporate giving 2% Gifts in kind
48% Commercial (lottery, sponsorship, retail)
Total income £9 million
23% Individuals
3% Trusts and foundations 11% Barts Health NHS Trust
Where our funding came from
How we spent our funding
In 2017/18 we raised almost £9m (consolidated income) from our supporters and partners (comparative figure from 2016/17 £9.2m). All income streams performed well, with corporate and individual donations increasing by 54% - from £1.6m to £2.5m following a decision to invest in individual giving. Income from our lottery, sponsorship and shop increased by 15% from £3.7m last year to £4.3m this year.
It cost approximately £7.9m (consolidated costs) to provide London with an advanced trauma care service for the last financial year.
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 318 additional hours during which the helicopter was launched on 83 occasions and treated 65 critically injured patients. 28
We have ambitious clinical aspirations, which we hope will enable us to meet our mission and save more lives. To ensure we can fulfil these, we anticipate that we will have to double our income over the next five years. The decision was therefore made to invest in our fundraising function now, so that we can meet these growing costs in the future. For this reason, half of our total expenditure went directly towards funding our charitable activities, and half went towards our fundraising function to ensure the stability and success of our service.
Income 2018
£0.3 million
£1.1 million
£7.9 million
£3.7 million
2017/18 £9.0 million
£7.4 million
2016/17 £9.2 million
£7.4 million
2015/16 £9.4 million
£7.4 million
£9.5 million
2014/15
£4.6 million
Expenses
£4.3 million
Income 2017
£4.1 million
Income
Trusts & Foundations
Lottery
Other Income Streams
How resilient are we? As of 31 March 2018 we have sufficient unrestricted cash reserves to fund nine months’ operational costs should all our funding sources cease. Investment strategy For every £1 we spend on raising funds, we generated more than £2 in income. With the aim of doubling the income of the Charity in the next five years to safeguard its future, we have made substantial investment in fundraising in the past two years and will continue to invest in fundraising over the coming years.
For every pound of spending, 50p was spent delivering our service and 50p went towards fundraising. This follows a strategic decision to invest significantly in growing individual giving (including lottery). This requires upfront funding to recruit new supporters to provide long-term, sustainable income. Our Charitable Spending Ratio* as calculated by the Charity Commission BETA version is 78% (2016/17 70%). This is calculated as charitable spending (including governance costs) as a percentage of our income available for charitable spending.
*Calculated using the methodology published by the Charity Commission on the BETA version – www.beta.charitycommission.gov.uk 29
Thank You to Our Supporters The achievements in this Annual Review would not be possible without our supporters. We are very grateful to all the individuals, companies, trusts and organisations that give their time, money and energy to our life-saving charity. We could not help our patients without you. We would like to say thank you, on behalf of everyone here at London’s Air Ambulance, our patients and their families. We are truly humbled by your devotion to our work. Volunteers The hard work and dedication of our unpaid volunteers never ceases to amaze us. Their support stretches across all areas of our fundraising, from organising bucket collections and collecting charity pots, to running our shop, helping in our office and delivering talks in the community. Our dedicated team are outstanding ambassadors for our charity, and we would like to thank them, from the bottom of our hearts, for all that they do for us. In 2017/18, a total of 165 volunteers supported the charity, with 64 taking part in volunteering activity on a regular basis (more than once a month). Our National Air Ambulance Week activity in 2017 included more than 50 volunteers taking part in charity collections across London. Bucket collections alone raised a total of £28,524 last year.
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Volunteer case study: Ally Ally began volunteering for London’s Air Ambulance in 2012 after a face-to-face fundraiser knocked on her door. Her first bucket collection was in Trafalgar Square, on a rainy day with a vintage London bus. Since then, Ally has undertaken three abseils and a sponsored run for our charity. She also persuaded Middlesex FA to adopt London’s Air Ambulance as their charity for the last two years, a partnership that has so far raised over £4,000 (the equivalent of two potentially life-saving missions).
“When you are out and about collecting you always come across people who have been helped by the London’s Air Ambulance team. Their stories are very moving and rewarding. These patient stories make fundraising so worthwhile.”
Individual supporters Whether they have been supporting our charity for years or have recently joined our mission, we are so grateful for the support of those who donate to our charity. This is only made the more special by the core of our supporter base being the people our charity serve; the people of London. Income from individuals is a critical part of our income, and we couldn’t fly without you. We would like to thank all of our cash and regular donors and lottery and raffle players. Our family of individual supporters has grown significantly in the last year. Individual giving has increased threefold, while our lottery has seen a 16% growth in income. Each year, we run a full calendar of events encouraging our supporters to take on a challenge to raise money for our service. Supporters can run, cycle, abseil and more to help our charity. Our Helipad Abseil is an annual event that sees participants descend the 17 floors of The Royal London Hospital. The 2017 event was our largest yet, with over 200 participants raising over £100,000 for London’s Air Ambulance. Many also choose to take on their own events, such as sponsored swims, walks and world-record attempts. It all adds up to make sure that we can deliver our service 24/7.
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Our Corporate Supporters Allianz Insurance Plc
Macquarie Group Foundation
Brit Group Services Ltd
MBN Promotions
BTG Group Plc
MFS International
C & C Management Services Ltd
MG Limited
Canopius
Minova Management Services Ltd
CIS Security
Mishcon de Reya LLP
Chubb Group Holdings Inc
Mitsubishi Corporation International (Europe) Plc
City Sports Management Ltd
Newton Investment Management Ltd
EE
Phoenix Group
Epoch Capital Ltd
Professional Security Magazine
ERS Insurance Group Ltd
Santander UK Plc
Financial Ombudsman Service
Saracens FC
Foxtons Group Plc
Tennants Consolidated Ltd
Geographers’ A-Z Map Company Ltd
The London Helicopter
Hogan Lovells International LLP
TMD Technologies Ltd
Home Builders Federation
Tokio Marine Kiln Group Ltd
LDC (Managers) Ltd
Wells Fargo
Lloyds Bank Foundation
Our Ambassadors Lord Maxwell Beaverbrook
Julia Leal
Martin Gilbert
Sir Stirling Moss OBE
Ward Hamilton
Sir Stephen O’Brien CBE
Richard Harris
Sir Harry Solomon
Bernardo Hartogs
Juliet Solomon
Graham Hodgkin
Paul White
Mike Hussey
Dr Alastair Wilson OBE
Dr Hilary Jones
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Case study: Tokio Marine Kiln Tokio Marine Kiln (TMK) are a key corporate partner and have supported our charity for the last three years. We share a creative partnership that engages both staff and the insurance sector. The partnership has so far raised over £70,000 for our charity. In 2015 TMK supported our charity to create City Bounce, a fun new take on five-a-side football that saw junior city workers play wearing inflatable zorbs to raise money for our charity. More recently, the international insurer became our official partner for London Beach Rugby. The event, hosted next to City Hall, raised over £28,000 for our charity. London’s Air Ambulance created unique digital content including team line up and player profile videos in a popular Premiership style. These were shared on social media to raise awareness of the event and on big screens on the day. An exciting day with a festival feel, the tournament provided a great opportunity to increase brand awareness and cemented the relationship between TMK and London’s Air Ambulance.
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Our Trusts, Foundations and Livery Companies A.S. & Mrs E.M. Lloyd Charitable Trust Anna and Colin Frizzell Trust Aspect Charitable Trust Beaverbook Foundation Clare King Charitable Trust County Air Ambulance Trust David and Claudia Harding Foundation Dixie Rose Findlay Charitable Trust Edith Murphy Foundation Ettling Charitable Trust G.M. Marriage Charitable Trust Gerald Micklem Charitable Trust Golden Bottle Charitable Trust Heathside Charitable Trust Hobson Charity Limited Mactaggart Third Fund Misses Barrie Charitable Trust Mrs Maud Van Norden’s Charitable Foundation Persula Foundation Sandra Charitable Trust Schroders Charity Trust Stanley Foster Charitable Trust Swire Charitable Trust The Astor Foundation The Baker Charitable Trust The Bothwell Charitable Trust The Broadley Charitable Trust The C.A. Redfern Charitable Foundation The City of London Corporation’s Charity, City Bridge Trust The Doris Pacey Charitable Foundation The Dr. Mortimer and Theresa Sackler Foundation The Drapers’ Charitable Fund The Foresters Charity Stewards UK Trust The Geoff And Fiona Squire Foundation The Grace Trust The Gunmakers’ Charitable Trust
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The Henry Surtees Foundation The Honourable Company of Air Pilots The James Tudor Foundation The John and Cecilia Gordon Charitable Trust The John and Lorna Trust The Joseph Strong Frazer Trust The Lexus Foundation The Lynn Foundation The Mackintosh Foundation The Modiano Charitable Trust The Morrisons Foundation The Ormsby Charitable Trust The Orr Mackintosh Foundation Limited The P.T. Fenwick Charitable Settlement The Roger Raymond Charitable Trust The Thomas Sivewright Catto Charitable Settlement Foundation The TJX Foundation The Trevor Chinn Charitable Trust The Tylers and Bricklayers Charitable Trust The Vandervell Foundation The Worshipful Company of Actuaries Charitable Trust The Worshipful Company of Builders’ Merchants The Worshipful Company of Chartered Architects The Worshipful Company of Chartered Secretaries and Administrators The Worshipful Company of Gold and Silver Wyre Drawers The Worshipful Company of Launderers The Worshipful Company of Parish Clerks The Worshipful Company of Tallow Chandlers The Worshipful Company of Tax Advisers
With thanks to the Henry Surtees Foundation and The Morrisons Foundation, our service has purchased a set of cutting-edge ultrasound machines. The new devices enable our advanced trauma teams to make faster and more accurate clinical decisions – when time is of the essence.
Case study: Beaverbrook Foundation In 2014, the Beaverbook Foundation generously committed £100,000 over five years to help fund the creation of The Institute of Pre-Hospital Care at London’s Air Ambulance and develop The Beaverbrook Scholarships for the Intercalated BSc in Pre-Hospital Medicine. Robert Willmore, a 2016/17 Beaverbrook Scholar, shares his journey so far. “The BSc offered an invaluable foundation in clinical knowledge, non-technical skills and academia. I was fortunate to benefit from the generous support of the Beaverbrook Foundation, which opened a wealth of new interests, contacts and learning opportunities outside of the standard curriculum.
“Patients have undoubtedly benefited from all that I learnt. After graduating, I witnessed a man collapse in cardiac arrest on a beach. Using the skills learnt in the preceding months, I successfully resuscitated the patient and he walked out of hospital a week later, hand-in-hand with his eight year-old daughter. “My experience as a Beaverbrook Scholar has fuelled my passion for emergency medicine and a determination to aspire to the high levels of care provided by some of the world’s best pre-hospital clinicians.” The list of trusts, foundations and liveries on the page opposite shows all who have donated over £499 in the financial year 2017/18.
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For more information please contact: E info@londonsairambulance.co.uk T 020 3023 3300 @LDNairamb London’s Air Ambulance Visit londonsairambulance.co.uk 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).