Provider profile: Scotland’s Charity Air Ambulance

Part of a wider air medical response

Unlike air ambulance charities in other parts of the UK, SCAA operates alongside a publicly funded air medical service operated by the Scottish Ambulance Service (SAS), a subdivision of Scotland’s National Health Service (NHS Scotland).

“They operate two rotary aircraft, and two fixed-wing,” said Craig. “In Scotland, we’ve got a very strong public/third-sector partnership. So we work very closely with them, and we’re integrated into their (NHS Scotland’s) system.”

SAS also provides paramedics to SCAA, Craig explained: “We have a service-level agreement … where they provide the paramedics and we pay for that service.”

In essence, he noted, the two air ambulance providers operate as equal partners, forming a combined fleet of six aircraft capable of responding to callouts across the entire country – and sometimes beyond – coordinated by NHS Scotland.

“We cover all of Scotland, as do they. In fact, we even sometimes cover the north of England, and that’s working with local services over the border,” he continued. “We certainly don’t fill in the gaps – we complement! We’re a fully integrated service, so we don’t decide who goes where – an air asset is deployed where the patient needs it most.”

We’re a fully integrated service, so we don’t decide who goes where – an air asset is deployed where the patient needs it most

The challenges of flying in Scotland

Craig explained that due to the wide area operated by SCAA, the service tends to have longer response times than some of its counterparts in other parts of the UK, in part because of the large area being served.

“We don’t fly 10 or 15 minutes,” he explained, adding that Scotland has roughly a tenth of the total air ambulance provision of the UK – in line with it being home to around a tenth of the total population – but approximately a third of the UK’s landmass.

Additionally, Scotland is home to rough, mountainous terrain, as well as “about a hundred islands”, which cannot be served by a ground-based emergency response.

Beyond just the landscape, SCAA also has to contend with the weather. “We can have all the four seasons in one day!” Craig declared, adding that, as a result, “pilots in Scotland – particularly helicopter emergency medical services (HEMS) pilots – have to be a different breed … from a flying perspective, compared with their colleagues in the rest of [the UK]”.

More fortunately, while incidents in urban areas do occur, they tend to be on a smaller scale than those encountered in places such as London, Craig noted. Consequently, while landing an aircraft in a Scottish city is no easier than it is south of the border, there is often less of a need. When responding to such incidents, SCAA is therefore more likely to deploy a “land response”, he explained, “because it’s easier, safer, and possibly quicker”.

By contrast, SCAA’s air response is most vital in rural areas, where road journeys can be long and slow: “If you’re on the west coast of Scotland, some road journeys by land can take 45 to 50 minutes, whereas in an aircraft, it can take 15 to 20 minutes.”

If you’re on the west coast of Scotland, some road journeys by land can take 45 to 50 minutes, whereas in an aircraft, it can take 15 to 20 minutes

A key cause of missions to rural areas, Craig noted, is agricultural incidents, which he estimated “account for roughly 10%” of all callouts.

“When we’re talking about ‘agricultural’, we mean industrial machinery, because on farms they operate different kinds of machinery – but equally they could get trampled by a cow, or by livestock,” he explained.

Dedicated supporters

As a charity, SCAA is reliant on donations from the public to maintain its operations.

“We are 100% funded by the Scottish public,” said Craig. “A lot of people do events, and [then there are] people who give on a month-to-month basis. We’re also now an organization that’s mature in our development, and we’re finding that supporters are leaving gifts in their will. And again, like most air ambulance charities, we have a very successful lottery.”

He added that, as well as private donations, the charity receives support from Scottish businesses and other corporate organizations through sponsorships.

While the recent economic climate has been challenging, Craig said that

We’re very grateful and thankful for the support we have from so many people in Scotland

SCAA was weathering the storm – primarily due to the dedication and support of the public.

“I think, like any organization, you start to find challenges – whether that’s going through the cost of living crisis, high levels of inflation, or recession, or even a global pandemic,” he said. “But people still find ways to support the charity, even though they’re probably feeling it themselves from a household perspective. One thing we’re very proud of … is how consistent and reliable our donors are. They’ve been with us for a long time.”

“I guess we’re now at a place where we’re coming out of that cost of living crisis – I know it still exists for so many people, but from our perspective we’re very grateful and thankful for the support we have from so many people in Scotland,” Craig added.

The future of SCAA

Ultimately, it’s about making sure that we’re there for everyone in Scotland

Looking back on SCAA’s work over the past decade, Craig is positive about the future of the charity. He notes that since launch, SCAA’s supporters have now raised over £60 million, while the service itself has just recently attended its 6,000th callout.

“As for the future,” he concluded, “I hope that we can continue to evolve the charity in the same way. I’m not too sure what the next decade is going to bring to the charity right here, right now, but I hope it’s one of continued growth and development. And ultimately, it’s about making sure that we’re there for everyone in Scotland.”