News from nowhere

Confidence in London’s helicopter ambulance service has taken a nosedive in the wake of disturbing evidence presented at a recent inquest.

The coroner heard how a land ambulance reached a 79-year-old road accident victim in central London within 7 minutes, yet was told not to move her from the scene, but wait for the helicopter to arrive-despite the fact that a hospital able to treat her injuries was just 4�minutes away by road.

The woman waited over half an hour for the helicopter to turn up, and eventually reached the Royal London Hospital 50 minutes after the accident, where she died of her injuries.

The coroner described the sequence of events as ‘bizarre’.

The case has raised serious doubts over whether helicopter ambulance services are a sensible way to spend scarce health service resources, especially in urban areas.

Such doubts have not been dispelled in the light of research evidence which suggests that actual benefits to patients may be slight or non-existent.

The inquest came one week after the publication of a study in the British Medical Journal which concluded that only those patients with the most severe injuries might benefit, but that across the helicopter’s caseload as a whole there was ‘no evidence that it improves the chances of survival’.

So given the weak evidence for effectiveness, the ‘questionable decisions’ about the deployment of the helicopter and the £883,000 annual bill to the NHS for the London helicopter’s running costs, will the hospitals running helicopters now reconsider their worth?

It seems unlikely. Despite the evidence, the Royal London Hospital believes that the helicopter is ‘a major benefit to the people of London’, and denies that there is any financial incentive to the hospital in bringing patients across the capital for major trauma care.

Yet the suspicion remains that increasing competition between London trusts may be an important part of the motivation for retaining the helicopter ambulance.

In the US, where many large cities have such services, evidence of effectiveness is equally weak. US hospitals continue to run helicopters, frequently at a loss, largely for the high profile promotional benefits they bring.

Of course, it couldn’t happen here.