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  • Oh oh.... We are back to one of those IAC v IRCG threads. Lets get back to basics , the costs of the EAS put on the Dail record by the Minister has got to be correct(circa 700k) if there is one thing that Civil Serpents won't do, is put their minister up to mislead the Dail, that is a red card offence for all, particularly in the calm backwater that is the Dept of Defence.

    The aforementioned bunch of boys and girls in the Department of Defence do not want the IAC in the EAS business, bottom line is mission creep and the AC become a dedicated service and it will in some way draw on the Defence Budget. The EAS project was set up by the Department grudgingly after 6 months of fighting whilst the people of the west bumped up and down in ambulances on the road to Galway etc . Read between the lines in the 135 prang report, EAS was a daytime service to use pre approved LZs only ( in order to skew the figures and keep them low) , the AC and HSE want to prove the requirement for a service and expanded the number of LZs out to get the numbers up.

    Now we have two services in operation , an AC service daytime only EAS and CG HEMs assets on call, we are paying for both, approx a mill a week for the CG and the 700 k in the 12 months( ish for the AC) . Both services are necessary and We the taxpayer are getting more VFM for our tax dollars.

    The HSE and the Dept of Health don't give a shxxt who drives the Helis as long as they have a fig leaf to close more hospitals with more heli support, the Dept of Defence don't want the AC doing it, coz they don't like us doing stuff that costs money and is grown up ( that applies to any and all military activity BTW), the IRCG and Dept of Trans are delighted to prove more VFM and the AC are delighted to have a job that gets them flying in a practical way that is giving experience for their crews,maybe potential medevac overseas if we wadi the white paper ban.

    MB just because the HSE advised on the fit out doesn't endorse the service, the medics advised me what to put in my first aid kit , doesn't make it the DMC approved kit. Can we get over all this nonsense and admit ( grudgingly ) that both services are complementary and necessary and lose the conspiracy theories that the HSE are pro one service provider over another, they really don't care about the colour of the chopper, why would they care as long as the service is VFM to them and works ...great, good news all round for the HSE.

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    • TP I do think the service should be focused on the patient but I'm not naive enough to think that that's the only focus. Commercial interests and the drive for profit are always below the surface but you could probably say that about the entire health industry.

      I like the way you try and box things off nicely but others have differing views and I know I'm repeating myself here but the IRCG contract is a SAR contract not a SAR/HEMS contract. Otherwise there'd be no need for an EAS. The a/c now have a HEMS capability - great, can and do make a significant contribution but extensive use of them in the HEMS role will eat into the hours allocation and lead to additional costs. I bet a S92 hour is dearer than a 135 or 139 hour.

      Full stats on EAS available from The DoD but blood and stone comes to mind. Maybe they'll make a decision first?
      Last edited by Pure Hover; 28 June 2013, 15:55.

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      • FAO Pure Hover



        Says HEMS, and has done since 2010

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        • Read the Title

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          • What does it matter whose budget the cost of these Helicopter operations come from be it the HSE, Coastguard or Dept of Defence, at the end of the day its coming from my pocket and yours, I have no problem in my tax going on these life saving operations by the Air Corps and the Coastguard, both are wonderful services to the public and are worth every cent. The cost per flying hour of any of the helicopters should not matter when a persons life is in danger at sea or on the land.
            Last edited by Brian McGrath; 28 June 2013, 16:59.

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            • True Brian, but what about building stats at the expense of patients by increasing their waiting times? Not good enough at all. The trial was set up to see if the demand was there, it obviously is.
              Now it's time to establish a service, integrated with all frontline emergency services.
              I think one thing we all agree in is its badly needed, I personally don't care who does it.

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              • Originally posted by Pure Hover View Post
                Read the Title
                What a reply! I'll take it you read the document and you have no come back.
                It has been planned to be a multi purpose service, SAR, HEMS, external load ops, possibly NVG, pollution sampling and anything else the CG may require.

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                • If the IRCG/CHC contract allows HEMS ops (if it has for the past 3 years why hasn't been used that much)?
                  We are paying for it after all.

                  EAS is a pilot service only, I'd say the only reason it has been extended is until the S92s get up and running or a few Roscommon TDs will be shouting in the Dail.

                  Regarding AP cover, it doesn't matter if an AP is on scene or not, if there is hopefully the patient is stabilised. But can a P maintain the care the AP may have started.

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                  • Lets get back to basics , the costs of the EAS put on the Dail record by the Minister has got to be correct(circa 700k) if there is one thing that Civil Serpents won't do, is put their minister up to mislead the Dail, that is a red card offence for all, particularly in the calm backwater that is the Dept of Defence.
                    JBM, I dont doubt that when the figures were released they were at least in the ballpark but that was before the trail even started and was based on the 135. Now after at least 11 months of operations with the 139 instead of the 135 the cost can only have escalated well beyond the 700k quoted before the operation started. The final cost of this trail hasnt been released to the public and I doubt it ever will.

                    The aforementioned bunch of boys and girls in the Department of Defence do not want the IAC in the EAS business
                    I think you are probably correct and mostly because of my point above. The problem is that when the IAC dont see eye to eye with their masters they are very adapt at quietly plying the political game to put DoD in a position were their boss, the Minister, just tells them to do it.

                    The HSE and the Dept of Health don't give a shxxt who drives the Helis as long as they have a fig leaf to close more hospitals with more heli support
                    I agree but again undercurrents are running within the system were sections of the HSE want to retain 'their train set'. To do that means proving the need for the service to be run by a 'dedicated' asset even if its not needed and not necessarily best for some of the patients.

                    Can we get over all this nonsense and admit ( grudgingly ) that both services are complementary and necessary and lose the conspiracy theories that the HSE are pro one service provider over another, they really don't care about the colour of the chopper, why would they care as long as the service is VFM to them and works ...great, good news all round for the HSE.
                    Unfortunately this is where our thinking diverges. How do we know both services are required? Based on operational figures of a trial service started when there were zero HEMS operations in the country and mostly flown when there was only one other HEMS operation in the country?? What about when there are 4 HEMS operations in the country as well as the EAS? Is that really value for money?

                    Its very simple to sort out. Take the entire taskings for all 5 bases (HEMS and CG tasks) and stick them in a computer system that will allocate each HEMS operation based on the nearest asset to the patient. Do it in real time so CG aircraft on CG taskings cannot be utilized and see what happens. If the outcome is the the missions flown during the trail are to a great extent covered by the CG helicopter then there may be no need for the EAS or maybe it will definitively show the need for the EAS. However, basing future plans based on data retrived during a time when operations were about to change is utterly flawed, wont provide VFM and certainly wont provide the best outcomes for patients.

                    TP I do think the service should be focused on the patient but I'm not naive enough to think that that's the only focus. Commercial interests and the drive for profit are always below the surface but you could probably say that about the entire health industry.
                    And with the CG operations, which I presume you are refering to, the commercial aspect is already taken into account. Its a fixed price contract.

                    I like the way you try and box things off nicely but others have differing views and I know I'm repeating myself here but the IRCG contract is a SAR contract not a SAR/HEMS contract. Otherwise there'd be no need for an EAS.
                    Yes it is. The EAS was set up when there were no HEMS operations in place because they wanted to close Roscommon A&E. However, thanks for agreeing with my thoughts that when there are 4 HEMS bases in the country that there is no need for the EAS. Of course a data crunch should be done to confirm or deny this.

                    extensive use of them in the HEMS role will eat into the hours allocation and lead to additional costs. I bet a S92 hour is dearer than a 135 or 139 hour.
                    Yes an S92 is more expensive but to use an IAC-isim, its already paid for. Its already been shown that the 300 mission flown by the EAS would equate to about 6-7 missions to each base per month. Allowing a very generous 2hrs per mission thats 12-14 flight hours per month. No increase in cost just a small reduction in training time flown which will have very little effect as crews can still get non SAR specific training done during the HEMS operations and still have plenty of hrs for SAR training. Its not a problem and its certainly not an additional cost requirement.

                    In the end its simple. Crunch the data for the trail based on the operational capability of the State post Jan 2014. If an EAS is needed kept. If its not, its not.
                    Last edited by Tadpole; 28 June 2013, 19:28.

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                    • Originally posted by Tadpole View Post
                      Its very simple to sort out. Take the entire taskings for all 5 bases (HEMS and CG tasks) and stick them in a computer system that will allocate each HEMS operation based on the nearest asset to the patient. Do it in real time so CG aircraft on CG taskings cannot be utilized and see what happens. If the outcome is the the missions flown during the trail are to a great extent covered by the CG helicopter then there may be no need for the EAS or maybe it will definitively show the need for the EAS. However, basing future plans based on data retrived during a time when operations were about to change is utterly flawed, wont provide VFM and certainly wont provide the best outcomes for patients.

                      Yes it is. The EAS was set up when there were no HEMS operations in place


                      Yes an S92 is more expensive but to use an IAC-isim, its already paid for..
                      Nearest AVAILABLE asset

                      According to someone here, HEMS has been part of CHC contract since 2010!

                      It is already paid for because it is already built into the contract

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                      • Originally posted by DeV View Post
                        If the IRCG/CHC contract allows HEMS ops (if it has for the past 3 years why hasn't been used that much)?
                        We are paying for it after all.

                        EAS is a pilot service only, I'd say the only reason it has been extended is until the S92s get up and running or a few Roscommon TDs will be shouting in the Dail.


                        Regarding AP cover, it doesn't matter if an AP is on scene or not, if there is hopefully the patient is stabilised. But can a P maintain the care the AP may have started.
                        DeV, the S92 contract will be a SAR and hems contract. This has been the plan for 3 yrs.
                        The Shannon 92 has been the only hems approved a/c to date. The reason it is only used less is because the hse's protocol is to always use EAS first and only request CG assets if it is un available.
                        Since October last the HSE have been implementing the use if a/c for certain calls. The CG and the IAA had agreed terms and scenarios where s61's could assist. These calls would be the most serious types where the person may well die without helicopter intervention. When all bases are operating 92's they will be available for the full range of hems missions if they are requested.

                        As for the P taking over from an AP, this is common practice on the road. It is covered in the PHECC Clinical practice guidelines for continuity of care. Paramedics can transport patients that have has AP level interventions. After all paramedics transport patients between hospitals every day, these patients have had doctor level of care yet the paramedics are qualified to care for them during the trip.
                        Last edited by Meatbomb; 28 June 2013, 20:32.

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                        • If the IRCG/CHC contract allows HEMS ops (if it has for the past 3 years why hasn't been used that much)?
                          We are paying for it after all.
                          Simply Dev because its the new contract with the S92s, which by the way you arent paying for until each base goes live, not the old one on the S61s. The 3 years is reference to the time from the tender request to service implementation not the amount of time that HEMS has been available on CG aircraft, I think you should reread the post.The new contract is due for full service at the end 2013 at which time the country will have 4 24/7 365 HEMS capable aircraft, as per the requirements of the CG contract. However, as already pointed out by MB the HEMS service has already been in use with the Shannon S92 and will be in use at each of the bases as the S92 is rolled out before the end 2013.

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                          • Nearest AVAILABLE asset
                            Thats also included in the post Dev. You really do need to read things a little more carefully:
                            Do it in real time so CG aircraft on CG taskings cannot be utilized and see what happens.

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                            • A fair amount of 61 ops are essentially amb ops by way of extraction of already rescued/stabilised Tangoes as seen on tv in the R117 series of documentaries and the extension of 92s to "land" ops should not prove to be a culture shock to the stakeholders.Main diff seems to be the initial coordinating agency.

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                              • So Danno if the S61's can't do HEMS maybe that's the reason they're not been tasked and the NAAC and the IRCG are operating to their brief. May change when all 4 bases have changed over which I think is this end of this year? Anyone care to update?

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