Article Text

Download PDFPDF
Perceptions and culture of safety among helicopter emergency medical service personnel in the UK
  1. Adam Chesters1,
  2. Philip H Grieve2,
  3. Timothy J Hodgetts3
  1. 1East Anglian Air Ambulance, Cambridge, UK
  2. 2Reach Air Medical Services, Santa Rosa, California, USA
  3. 3Emergency Medicine and Trauma, University of Birmingham, Birmingham, UK
  1. Correspondence to Dr Adam Chesters, East Anglian Air Ambulance, Cambridge Airport, Cambridge, CB5 8RX, UK; achesters{at}


Background The use of helicopter emergency medical services (HEMS) has increased significantly in the UK since 1987. To date there has been no research that addresses HEMS pilots and medical crews' own ideas on the risks that they view as inherent in their line of work and how to mitigate these risks. The aim of this survey is to describe and compare the attitudes and perceptions towards risk in HEMS operations of these staff.

Methods A questionnaire was administered electronically to a representative selection of HEMS doctors, paramedics and pilots in the UK. A number of questions were grouped into common themes, and presented as Likert scales and ranking where appropriate. Descriptive and comparative results were presented and statistically analysed.

Results The target sample of 100 consecutive respondents was achieved. All questionnaires were entirely completed. Respondents attributed the most risk to night HEMS operations without the use of night vision goggles, commercial pressure and mechanical aircraft failure. There was no statistical difference in overall perception of safety and years of experience (p=0.58) or between professions (p=0.08). Those who had experienced a crash were more likely to believe that HEMS operations are not inherently safe (p=0.05).

Conclusions We have surveyed a cross-section of the HEMS operational community in the UK in order to describe their perceptions of safety and risk within their professional life. Two-thirds of respondents believed that HEMS operations were inherently safe. Those who did not seemed to be influenced by personal experience of a crash or serious incident. We support increased operational training for clinical crewmembers, an increased emphasis on incident reporting and a culture of safety, and careful attention to minimum training and equipment requirements for all HEMS missions.

  • prehospital care

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors PHG had the idea for the research. AC, PHG and TJH participated in the construction, review and revision of the survey and in the data collection and analysis. All listed authors took part in the preparation of the manuscript and read and approved the final submission.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Additional data available on request and at the discretion of the authors. The full results of the survey are available on request.