London's Air Ambulance Charity Annual Review 2020/21 by London's Air Ambulance Charity

CONTENTS Introduction

Strategic objective 3 - Connecting with the

About us

People of London

Our NHS partners

Our Patron

Our objectives

London’s Air Ambulance in the community

A look back with Mark Vickers

Air Ambulance Week

Medical Director report

Christmas Campaign

The impact of COVID-19

Our Crew

The year in highlights

Strategic objective 4 - Doubling Income Strategic objective 1 - Saving Time

Our supporters

Mission Map 2020

Our corporate partners

Helipad redevelopment

Challenge events

Up Against Time Appeal

Financial update

Strategic objective 2 - Outstanding Care

Strategic objective 5 - Our Culture

Clinical innovations

Our values

The Physician Response Unit

New trustees

The Institute of Pre-Hospital Care

Culture review

Supporting our patients

Case study – Lauren

Last words 50

Looking ahead with Jonathan Jenkins

ABOUT US When London calls, every second counts for our teams and our patients. Whether by helicopter or rapid response car we take the hospital to the roadside, delivering a senior doctor and paramedic to the patient when time is of the essence. When a patient has been critically injured it is vital to reach them as quickly as possible so we can give them the best chance of survival. For 32 years we have been there, travelling across London within minutes to provide life-saving care at the scene. Our vision is 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. We are a charity that works alongside the NHS and our life-saving service is made possible only because of our supporters and partners. We also provide the Physician Response Unit, a unique community emergency medicine service. All our work is based on our knowledge that taking the hospital to the patient saves time and saves lives.

OUR NHS PARTNERS London’s Air Ambulance operates in partnership with and is supported by Barts Health NHS Trust and the London Ambulance Service NHS Trust. Barts Health NHS Trust provides the doctors as well as the helipad facility at The Royal London Hospital, where London’s Air Ambulance is based. London Ambulance Service NHS Trust provides paramedics who are seconded to the service. A flight paramedic operates from the London Ambulance Service control room and is responsible for dispatching the team from London’s Air Ambulance to the most critically injured people in London, 24 hours a day. The Physician Response Unit (PRU) is a collaboration between London’s Air Ambulance, the London Ambulance Service (LAS), Barts Health NHS Trust and local Clinical Commissioning Groups. London’s Air Ambulance can only be there for the people of London with the continued support of its partners.

Whether it’s a large-scale tragedy like the Westminster Bridge terror attacks and the Paddington rail disaster, or individual emergencies like road traffic or workplace accidents, every day, people need our help. When London calls, the clock is ticking to get to a patient. London’s Air Ambulance can be there in time to provide cutting-edge medical care thanks to your support.

OUR OBJECTIVES 01 Saving time

Treating everyone who needs us, when and where they need us

02 Outstanding care To improve patient care and to end preventable deaths

03 Connecting with the people of London

To increase the number of charity givers in London who support our service

04 Double income

To ensure our financial security and sustainability over the next five years to fund our organisational objectives

05 Our culture

Continue to develop a supportive and enabling environment that gets the best out of our people

A LOOK BACK

With Mark Vickers, Chair of the Board of Trustees

There can be no doubt that the past year has been profoundly different to any other in our 32 year history. One that has been hard for us all, and none more so than for our NHS partners. Whilst at times it may have felt that there has not been much to celebrate, I can see, through it all, so much to be proud of. The service has responded to the challenges it has faced with outstanding agility and professionalism, both clinically and from the Charity perspective. Our service remained operational 24/7, but the pandemic still had a noticeable impact, on both the types of missions and the way of working. The outstanding commitment and professionalism of our crews was demonstrated in spades as the teams adapted and ensured the extraordinary care given to our patients never diminished. Nowhere was this shown more acutely than in the response from the Physician Response Unit, led by Dr Tony Joy. Whilst trauma care continued, the service also pivoted to become a vital part of the COVID-19 response in East London communities. Throughout this time, the clinical teams were led by Medical Director, Tom Hurst, and Lead Clinician, Anna Dobbie. Both had

only been appointed to their roles in January 2020, but they could not have led the teams more effectively through the novel, complex and fast-moving situations of COVID-19. We are profoundly indebted to them for keeping the service functioning at its optimum during this challenging period. There were also some new faces behind the scenes at the Charity. In April, we were delighted to welcome four new trustees to the Board. Gemma Sherrington, Brigadier Tim Hodgetts, Dr Margot Gosney, and James Thomas have brought a wealth of experience across the charity, medico-military, technology and medical research sectors.

None of this would have been possible without our partners, Barts Health NHS Trust and London Ambulance Service. We thank them hugely for their continuing support. Massive thanks too to all our staff who have been outstanding in the most challenging of times. To all our supporters and volunteers – a heartfelt and very special thank you. With everyone pulling together as you did, we can reflect with pride on surviving the most difficult of years and that throughout we remained there for the people of London whenever a life was on the line.

The biggest impact of the pandemic on the Charity’s operations has undoubtedly been felt by our fundraising teams. The lockdown meant a pause on almost all of our regular activity. However, despite the limitations on what we could do, the Charity team rose to the challenge magnificently with innovative ways of fundraising trialled. We were also privileged to continue to receive the benefit of HRH The Duke of Cambridge’s patronage. Most gratifyingly though our regular donors stayed with us, a testament to their loyalty and compassion and their appreciation of how vital our service is.

MEDICAL DIRECTOR REPORT The last year has been a year like no other for the clinical staff of London’s Air Ambulance, with the impact of the COVID-19 pandemic felt both personally and professionally. Staff have stood shoulder to shoulder and have been there for the patients of London and for each other. I thank them for their dedication and compassion during this very dark and difficult year. I’m immensely proud that despite the challenges, we did not drop a single shift, and I also thank our fire fighters, pilots and operational staff for their amazing work in keeping our service running. Our Physician Response Unit (PRU) colleagues operate an amazing service and they have risen to the challenges of COVID-19 more directly of any team in the London’s Air Ambulance family. Developing new ways of working, the PRU enabled patients with cancer or who were coming towards the end of their lives, to remain at home with expert medical input, if that was their wish. The PRU is leading the way nationally in the field of community emergency medicine, and so it was fitting to see them be ‘highly commended’ at the Health Services Journal awards. As Medical Director, it is my duty on behalf of all the clinicians in the service and the patients that we care for, to thank all those who make our mission possible by

raising the funds needed to support this service. I would also like to thank our NHS partners – Bart’s Health and the London Ambulance Service. Despite the challenges that the last year brought, the service has not stood still. We have introduced point of care ultrasound scanning, enabling our air ambulance clinicians to scan patients at the scene of accidents or on the way to hospital, helping them to detect critical but hidden injuries sooner. We have also deepened our collaboration with the London Ambulance Service, with London’s Air Ambulance now providing doctors to work alongside incident commanders at major incidents. There are exciting developments ahead of us. In the next year we will launch an additional medical team, covering the busiest period of the day, to enable us to reach more patients, even quicker. We also plan to appoint another senior paramedic to the service, and invest more in the training and development of paramedics, recognising how vital they are to excellent patient care. We continue to innovate and strive to do the very best we can, to push the boundaries of what is possible in pre-hospital care, to inspire and train the next generation of clinicians, and to ensure when we reach the scene of an accident, we can give every patient the best possible chance of survival.

DR TOM HURST, MEDICAL DIRECTOR

THE IMPACT OF COVID-19 Clinical Impact At the height of lockdown in April 2020 fears about the pandemic were running justifiably high. As it became clear that the NHS faced being overwhelmed, serious conversations took place behind the scenes of the service to decide whether we should stop providing a 24/7 trauma team and instead focus on the COVID-19 response. There was a clear answer to this though – we were needed and we had a duty to be there for critically injured patients. The service offered up help to the COVID-19 response where possible, putting our assets on the national register and many of our staff were either seconded to the response or volunteered to help. Patient numbers dropped during the first weeks of lockdown as people heeded the call to stay at home and thereby save lives. Sadly, though, trauma patient numbers soon started to rise and the teams were once again operating close to pre-pandemic levels. However, with more people at home, the types of missions changed, with more domestic incidents and, tragically, more suicide attempts.

Day-to-day things changed too. The teams were in full PPE when treating patients, performing complex roadside operations in protective equipment. Divider screens were put into the aircraft to keep the cockpit and cabin separate. At the helipad, masks were mandatory and only duty crew were allowed to be there. It was a different (and difficult) way of working but our crews adapted and the extraordinary care given to our patients never diminished.

Fundraising Impact The lockdown meant a pause on almost all the regular activity we rely on to bring in vital funds. Events were cancelled, community fundraising had to stop and the face-to-face recruitment of new donors had to cease. Amongst the events that couldn’t go ahead was the annual abseil which raised £132,000 in 2019. The cancellation of the London Marathon cost us an estimated £82,000. Our community fundraising – such as bucket collections and supermarket stalls – had to stop. However, the biggest impact was having to stop the face-to-face recruitment of new donors to play our lottery or become a regular giver. This means we now face a £6 million gap in our forecast income over the next five years – a time when the Charity is looking to raise an additional £15 million on top of its annual running costs to purchase two new helicopters. However, we took the opportunity to test new ways of recruiting donors, particularly during the lockdowns while advertising rates were low, including TV and digital. We now plan to run a TV advertising campaign every Christmas as a result of the testing and our engagement of new donors online continues to grow. We also started the planning for a large-scale capital appeal to raise the funds we need to replace our helicopters: the Up Against Time Appeal.

AUGUST

THE YEAR IN HIGHLIGHTS APRIL

Our pioneering PRU expanded this month, adding an extra car to deliver a Community Emergency Medicine service running for longer hours, from 08:00 – 23:00, seven days a week.

MAY

We welcomed four new Trustees to our Charity board; Tim Hodgetts, Gemma Sherrington, Margot Gosney, and James Thomas.

JUNE

With our face-to-face fundraising paused due to ongoing COVID-19 restrictions, we found other ways to continue to raise vital funds. We took advantage of low media rates and ran our television campaign again in June with great results.

JULY

Our Patron HRH The Duke of Cambridge joined a Zoom call with our ops crew to hear about their frontline work and learn more about day-to-day operations with our service.

After months of lockdown and restrictions, we were able to re-launch our face-to-face fundraising. It is a vital source of income for us and we were excited to be back out on the streets of London speaking to supporters.

SEPTEMBER

We marked Air Ambulance Week by saying a big thank you to all those who kept us flying through the pandemic. The BT Tower was lit up with a special message of thanks!

NOVEMBER

OCTOBER

Eight year old Teddy raised money for us in memory of his best friend. Teddy ran a mile around his local park, his target was £1,000 but ended up raising an incredible £3,700.

Our first integrated Christmas campaign, ‘London’s Christmas Mission’ launched. We called on new and existing supporters to come together to join us and help us keep London’s local charity in our skies. Donations totalled over £112,000.

MARCH

DECEMBER

There was a bonus episode of our podcast, Picking Up The Pieces released this month. Hosted by comedian Adam Kay, crew Dr John Chatterjee and paramedic Steve Jones spoke about their experiences of dealing with trauma.

FEBRUARY JANUARY

We marked the end of one of our longest most successful corporate partnerships with Phoenix. Over six and a half years employees raised an incredible £1.4 million for us and other air ambulance charities.

2020

We celebrated Valentine’s Day by asking supporters to show their love for London. We ran lots of activities including sharing recipes prepared by paramedic Richard WebbStevens for people to celebrate at home, and created special digital Valentine’s cards for people to download.

We teamed up with Intelogy and Microsoft to create and build an app that our advanced trauma teams now use every day to assist with their life-saving work. The digital checklists save time and avoid duplication, helping the medics focus on treating patients with confidence, knowing they have the right equipment with them.

2021

VALENTINES DAY 2021

Can you spare the cost of a mince pie and a coffee? 14

15 15

STRATEGIC OBJECTIVE 1 - SAVING TIME

MISSION MAP 2020 In 2020, our advanced trauma doctors and paramedics treated 1,494 patients. Travelling to scene either by helicopter or rapid response car, the teams arrived within minutes, ready to deliver rapid response cuttingedge care for these critically injured patients.

LEAD CLINICIAN Anna Dobbie “In 32 years the service has treated over 42,000 patients and we have learnt that trauma never stops. Every second of every day someone might need our help, and that was no different during the pandemic.

The Mission Map shows where our patients were treated across the 32 boroughs of London. Wherever we were needed in the capital, our teams were there, every second of every day.

“When the klaxon goes off, that means a patient may be so critically injured that they don’t have time to get to hospital and need instant intervention at scene. The earlier a patient is treated, the better their chance of survival. The earlier we can get there, the better.

Of the 1,494 patients treated, the mechanisms of injury were:

•

Stabbings and shootings: 529 (36% of total)

•

Road traffic collisions: 371 (25%)

•

Falls from height: 330 (22%)

•

Other: 264 (17%). These include rail incidents, industrial accidents, drownings and medical emergencies, including cardiac arrest.

“During the pandemic, despite all the challenges, we managed to keep the service running 24/7 because we knew our unique speciality was needed.

1,494 Patients

“I am extremely proud of the crews and thankful to our partners, Barts Health NHS Trust and London Ambulance Service, for doing everything they could to make sure our doctors and paramedics were able to treat 1,494 critically injured patients in 2020 and give each one the very best chance of survival by getting there as quickly as possible.”

STRATEGIC OBJECTIVE 1 - SAVING TIME

HELIPAD REDEVELOPMENT In 2020/2021 we started initial work on the redevelopment of our helipad base at The Royal London Hospital. Construction will be under way by September 2021 and it is due for completion in the early part of 2022. This is a significant project funded by the charity, Barts Health NHS Trust and the Department of Health and Social Care. We were grateful to also receive a very generous grant of £550,000 from the County Air Ambulance Trust HELP Appeal to enable us to undertake this project. The new facilities are being constructed under the helipad flight deck on the 17th floor of the Royal London Hospital. They will include: •

An elevated ready/operations room underneath our flight deck for pilots, fire crew and medical team. This will provider quicker access to the aircraft for faster dispatch and is anticipated to save 20-30 seconds off each launch.

•

A quiet space for post-mission debriefs and case analysis.

•

A “safe space” for on-duty teams to find respite after challenging missions.

•

A large multi-use training room/simulation theatre for teaching, moulages and kit checks.

•

Rest pods for frontline crews.

By reducing the time it will take to get the helicopter airborne, we will be able to respond to our patients even faster, improve training and make sure our crews have the space they need for their mental health and well-being. It will also ensure that our world-class, world-renowned service, has the facilities to reflect this.

UP AGAINST TIME APPEAL Work started this year on the most ambitious capital appeal the charity has seen in its 32-year history. By 2024 both our helicopters will need replacing at a cost of £15 million. This amount will need to be raised on top of the approximate £9 million it costs to deliver the service each year. To emphasise the vital need for two new helicopters, the Up Against Time Appeal will focus on the importance of time – both to deliver our service and save lives, as well as the urgency of raising the additional funds.

Every time the klaxon sounds, we are up against time to save lives in London. When an injury is so serious that there is no time to get to hospital for treatment, our crews are the only ones who can perform emergency surgery at the scene. Our helicopters get us to the patient’s side in 11 minutes. As a charity, we are up against time to replace our helicopters by 2024, and we need to raise £15 million to do it. The private phase of the appeal will begin in summer 2021, with a public launch planned for September 2022. We hope the Appeal will unite London around our vital life-saving cause, seeing major donors, Trusts, Foundations, businesses, politicians, media, volunteers and the general public come together. 19

STRATEGIC OBJECTIVE 2 - OUTSTANDING CARE

CLINICAL INNOVATIONS London’s Air Ambulance has been at the forefront of clinical innovations since its inception in 1989. From pioneering a doctor on board to carrying blood, we count a number of firsts to our name. Thanks to our work thousands of patients in London, in the UK and across the world have survived who otherwise may not have. The service doesn’t stand still and is continually innovating ways to prevent unnecessary deaths from trauma and the procedures carried out before patients reach hospital are becoming more complex and challenging. Members of our team from multiple disciplines participate in research and quality improvement projects, in an effort to improve the care we provide to patients, innovate new therapies and advance pre-hospital care in support of our overall mission to save more lives in London through rapid response and cutting-edge care. In line with our value of ‘pioneering’, in 2020/21 our team shared their experience of emergency surgical airways, publishing a paper documenting the largest cohort of prehospital emergency surgical airway cases to date. We are working in collaboration on projects with colleagues across London, such as the Centre for Trauma Sciences at Queen Mary, University of London and London Ambulance Service. In addition, we are building

THE PHYSICIAN RESPONSE UNIT

new partnerships with colleagues from air ambulance services across the UK through our participation in the National HEMS Research and Audit Forum. We recognise that the best science is delivered through strong partnerships. This year also marked a first for our service as we were awarded our first National Institute of Health Research grant to support a study seeking to determine ways to improve care of patients injured in terrorist attacks.

The Physician Response Unit (PRU) is a collaboration between London’s Air Ambulance, London Ambulance Service, Barts Health NHS Trust and local CCGs. It is staffed by a senior emergency medicine doctor and an ambulance clinician and carries advanced medication, equipment and treatments usually only found in hospital. The service responds to 999 calls, treating patients in their homes who would otherwise have often required an ambulance transfer to hospital.

Looking forward

In 2020/21 the PRU treated 2,715 patients in the community (2,362 in 2020), of which 1,994, 74% (69% in previous year) were managed in the community rather than being conveyed by ambulance to an Emergency Department (ED).

Given the impact of COVID-19 over the past year, many of our research efforts were required to be paused. However, all except for our ECMO study (Sub-30) are currently recruiting again and we hope to see Sub-30 restarting again in the near future. We are collaborating with the QMUL Centre for Trauma Science to undertake a trial of a drug to protect patients’ hearts from damage after blood loss. We are leading a coalition of air ambulances across the UK to work with NHS Blood and Transfusion to conduct a trial of whole blood. We are also now developing the procedures which will enable the use of emergency preservation and resuscitation (EPR) at scene – a technique to cool critically injured people at the roadside to provide a better chance for resuscitative surgery in hospital.

In 2020, the PRU expanded significantly. From April 2020, a second car was launched after funding was secured from CCGs to cover the London Ambulance Service and Barts NHS clinical costs. This is now delivering an extended service running from 08:00 – 23:00, seven days a week. The PRU covers Northeast London with two teams that provide an overlap period for four hours each day during the busiest period of the afternoon. In December 2020, the PRU was asked to extend its geographical footprint to cover additional boroughs in Northeast London, so now covers parts of the large CCG footprint of Barking, Havering and Redbridge. During the COVID-19 pandemic, the PRU made a number of developments to strengthen the support that it offers

the wider emergency care system. It has incorporated specific new clinical pathways taking referrals, not only from London Ambulance Service, but from palliative care teams and inpatient teams. An innovative pathway providing emergency support for patients with acute oncological emergencies was launched in July 2020, covering the large Barts Cancer Network. These pathways not only relieve pressures across the EDs and acute admissions wards of local hospitals, but protect particularly vulnerable groups of patients from risk of coronavirus infection. Not only were the teams saving vulnerable patients a trip to hospital by visiting and treating them in their homes, they created a consultant rota so that ward teams could discharge patients that would normally be waiting to leave hospital. Our medics helped to free up space in hospitals for COVID-19 patients and reduce pressure on a stretched London Ambulance Service. Alongside this they started to support palliative care services to help patients avoid hospital and stood ready to provide transfers for COVID-19 patients when this was necessary. The PRU has published several journal papers and presentations in 2020 relating to the response to the COVID-19 pandemic. It is also attracting increasing numbers of applicants to its fellowship programme, now the largest Emergency Medicine fellowship in the country. We are immensely proud of the innovative work the PRU has been undertaking, which has attracted attention from numerous other health services. 21

STRATEGIC OBJECTIVE 2 - OUTSTANDING CARE

INSTITUTE OF PRE-HOSPITAL CARE

The Institute of Pre-Hospital Care is the educational arm of London’s Air Ambulance and delivers education not only to the clinical teams of the HEMS service and PRU teams, but to many other clinicians outside of London’s Air Ambulance. The objective last year for the Institute was to ‘Consolidate. Refine’ and although faced with many challenges from the pandemic, we used the time to review our courses and ensure that we delivered on this objective. There were considerable challenges to running our degree programmes however we continued to run our BSc in Prehospital Medicine throughout, adapting the programme to enable us to deliver much of the degree online. Although this is certainly not the preferred delivery method as so much is learnt during face-to-face teaching and clinical placements, the faculty went over and above to make the learning experience excellent. We managed to conduct some face-to-face teaching for the cohort where required and in line with government guidelines. Our BSc students have been extremely motivated and have excelled in their exams and course work. We recommenced the MSc in Prehospital Medicine programme in January 2021, after a temporary suspension of the first cohort last year in March 2020,

due to restrictions on education and the redeployment of both the faculty and students to their respective inhospital roles in the response to COVID-19. Our portfolio of short courses was continually delivered throughout the year with adaptations to reflect the guidance at the time, meaning some courses which would ordinarily have external candidates on were more limited to our own team and other courses were adapted to be delivered online so as not to miss out on the expertise of our international faculty. We also delivered a series of online evening lectures to the team to continue the education of our own team and share learnings from projects that the Institute is a part of, such as an evening with our Head Injury Fellow, a lecture on the Medical Response to Terrorist Incidents and the opening of some lectures linked to the MSc programme. In addition to the short courses continuing we were proud to continue to deliver the CPC (clinicopathological correlation) meetings, allowing our current clinical teams to continue their learning in relation to the patients they are seeing. This also allows us to continue to push our understanding and develop interventions with a desire to create the survivors of the future.

In addition to the educational delivery, we have worked to secure funding for some of these areas, namely a scholarship from The Company of Nurses for a nurse enrolled on the MSc in Prehospital Medicine, a bursary for 50% tuition fees for a student enrolling on the MSc in September 2021, along with further support from Zoll for the Resuscitation Science symposium over the next three years. Looking forward we will be transitioning from ‘Consolidate. Refine’ to exploring how we can improve the impact of our Institute work both within London and more widely.

STRATEGIC OBJECTIVE 2 - OUTSTANDING CARE

SUPPORTING OUR PATIENTS Our Patient Liaison Nurse (PLN) is a vital part of our service, providing additional support to patients and their families as they embark on the long and often difficult recovery journey post trauma. The PLN role bridges the gap between the pre-hospital care that our service is renowned for and the patient’s ongoing recovery. This is achieved in the following ways:

•

The provision of follow-ups with patients to provide additional support and guidance.

•

The continued signposting of patients and their families to other organisations that can provide vital and much needed support outside of the health service remit. The continued provision of bereavement consultations for bereaved families, giving them the opportunity to meet and hear from the teams who treated their loved ones.

•

Facilitating patient and family visits to the helipad to meet the teams who looked after them.

•

The involvement of patients in the training and education for both clinicians and the BSc in Pre-hospital Medicine, to help enhance learning through the sharing of patient experiences.

Support during the pandemic There’s never a ‘good’ time to be injured, but the last 18 months have been particularly difficult for our patients and their families. COVID-19 has necessitated strict visiting restrictions in hospitals which in turn has made it extremely challenging for patients and families at a time when that support network is most important. The PLN has had to adapt to providing additional support to patients and their families virtually. Although this was initially daunting, it has evolved into a very effective, convenient, and far wider reaching mode of support which will now almost certainly continue post pandemic for bedside support, peer-to-peer support and even bereavement consultations.

STRATEGIC OBJECTIVE 2 - OUTSTANDING CARE

SUPPORTING OUR PATIENTS LAUREN’S STORY (told by her mum, Pauline) When a person is critically injured, time doesn’t just stand still for them. Family, friends and loved ones are all affected. The impact of trauma is far reaching and often what is critical to a patient’s survival is the support they can draw on from those they are closest to. Here one of our patient’s mothers shares her perspective on the day that her life changed forever.

Christmas 2019 was the best ever. My family were all there, including my three children and the house was full of fun and laughter. Little did we know what was just around the corner. On New Year’s Day, my husband and I were woken up by a phone call from the Police. Our daughter Lauren was travelling as a passenger in car which had been in a serious road traffic accident near Heathrow where she worked for BA as cabin crew. She had suffered ‘life-threatening and life-altering injuries’.

On New Year’s Eve 2019, the car Lauren was a passenger in was involved in a serious road traffic collision. London’s Air Ambulance was immediately dispatched to the scene, arriving by rapid response car. Sadly, three of the occupants of the car had injuries that were not survivable. Lauren was treated at the scene by our crew and the emergency services and against all odds, has gone on to make a remarkable recovery.

We live in Scotland, so we faced an agonising flight to London. It was the scariest, most anxious journey ever, with the fear being actually physical, necessitating sick bags and bottles of water which were although desperately needed, were of little comfort. The best of that day was when we arrived at the hospital and confirmed that Lauren was alive. However we were told her prognosis was not great and the full extent of the brain injury would not be known until much later. She also had lacerated lungs and liver, flail chest and required surgery on a number of fractures. Despite the shock of hearing how critical Lauren’s condition was, we were convinced that Lauren would fight. And fight she did, to breathe, to move a toe, to open one eye then eventually the other, to smile, to do things on her own timescale.

The support we received from Frank, London’s Air Ambulance Charity’s Patient Liaison Nurse, who visited us several times and still keeps in touch, was without doubt above and beyond our expectation of any emergency service. The visit from Frank and the three air ambulance crew was also a highlight for us all and Kevin and I will be forever grateful for both their life-saving skills, keeping Lauren alive until St Mary’s could work their magic, and their compassion and kindness to us. This accident changed Lauren’s life forever and it altered the course of our lives too; however, we are all too aware that others were not as fortunate and the same heroes who contributed to our future also had to experience the trauma of three young people and their families having their future taken away. We know we are the lucky ones, but I don’t think the impact of this tragedy will ever leave us.

I remember the overwhelming feeling of gratitude when we saw these four grown men looking emotional at meeting Lauren. Despite the fact they no doubt have to deal with people at their most vulnerable every day, they made us feel that Lauren was special, we mattered and they cared.

(TOP) LAUREN FEENEY, POST-ACCIDENT (BOTTOM) LAUREN AND HER FAMILY, PRE-ACCIDENT CHRISTMAS 2019 26

STRATEGIC OBJECTIVE 3 - CONNECTING WITH THE PEOPLE OF LONDON

OUR PATRON

Our Patron - HRH The Duke of Cambridge We are privileged to receive the benefit of HRH The Duke of Cambridge’s patronage. In 2020, The Duke joined two events with our crew to hear about their frontline work and learn more about day-to-day operations with our service. During the height of the pandemic, HRH also gave permission for our crews to land at Kensington Palace to refuel whilst our usual location was closed as a result of lockdown. This enabled the team to save valuable time as otherwise the pilots would have had to fly out of London to refuel. It ensured that London’s life-saving service was more available for critically-injured patients, with no delay in response time. To mark Air Ambulance Week the Duke also released an open letter pledging his support to the air ambulance community of which he was previously a part. We look forward to continuing to work closely with our Patron in the years ahead to promote our world-leading service and further connect with the people of London. We are immensely grateful to The Duke for his support.

STRATEGIC OBJECTIVE 3 - CONNECTING WITH THE PEOPLE OF LONDON

LONDON’S AIR AMBULANCE CHARITY IN THE COMMUNITY Online talks Due to the pandemic most of our face-to-face activity in the community was put on hold, so we challenged ourselves to find new ways to engage with our supporters. To celebrate Volunteers’ Week in June 2020 we delivered our first online community talk, the success of which led to 21 talks over the year, reaching over 800 people. These included talks to local community groups, schools and youth groups.

CASE STUDY: TOWER HAMLETS EDUCATION PARTNERSHIP In November 2020, our CEO Jonathan and Medical Director Tom gave an online talk for a group of Headteachers from Tower Hamlets schools taking part in a High-Performance Leadership Programme organised by Tower Hamlets Education Partnership. The aim was for the teachers to explore how leaders in organisations outside of education think strategically, make decisions, build teams and solve problems. It was amazing to get the chance, even in lockdown, to speak to people and be able to share our experience and knowledge. Feedback was really positive:

Virtual bucket collections Every year our incredible bucket collectors raise vital funds to keep our service flying, by collecting through their personal networks, at their workplaces, at supermarkets and at stations throughout the capital. But with physical bucket collections unable to go ahead, we created Virtual Bucket Collections, allowing the public to safely support London’s Air Ambulance Charity from home. Supporters were able to personalise their collection and we gave suggestions of fun ways to host, such as arranging a virtual work dress down or ‘dress up’ day, or customising photos of supporters shaking their bucket from a dream location or favourite holiday hotspot.

CASE STUDY: TIM “Over 30 years of police service, I’ve seen countless times how London’s Air Ambulance has saved so many lives and made the difference at the most critical times. The air ambulance also saved the life of my brotherin-law who had a major heart attack in a very remote location. Without the aircraft and crew - he would not have survived. We’re all so grateful and I wanted to do anything I could to support this amazing team, so when I saw a social media appeal by the charity for Volunteer community presenters, I didn’t hesitate! “I’ve given talks to community groups, schools and at youth events, as well as taking part in the helipad abseil. But COVID-19 has changed all this and meant our public-facing role is not currently possible. With other volunteer presenters, we came up with our own youth-focused online presentations and I contacted cadet units across London who were operating online sessions. The feedback was brilliant and engagement with young people excellent!”

We were blown away by how our supporters embraced this new way of fundraising. Thanks to them, our virtual bucket collections raised an incredible £19,685.

“I just wanted to thank you so much for your time and input last night. It was a really rich learning experience and we loved how you brought leadership challenges to life with practical examples and humility. It felt like a super-charged hour of professional learning and reflection.”

James Hale, Director of Leadership and Development, Tower Hamlets Education Partnership

STRATEGIC OBJECTIVE 3 - CONNECTING WITH THE PEOPLE OF LONDON

AIR AMBULANCE WEEK A thank you to London

Public support

In Air Ambulance Week 2020, we celebrated by saying a huge ‘thank you’ to each and every one of the supporters who kept us flying during the pandemic.

We were delighted to receive support from celebrities and politicians during Air Ambulance Week.

We released a special video message of thanks from our crew, featuring our doctors, paramedics, fire crew and pilots, expressing their gratitude for the generosity and support of London in making sure they continued to reach the capital’s most critically-injured patients in need of life-saving care. As an extra thank you to supporters, on 10 September the BT Tower displayed a special message of gratitude to Londoners. Our CEO, Jonathan Jenkins, gave an interview to BBC Radio London, raising awareness of Air Ambulance Week and encouraging listeners to ‘look up’ to see the thank you message proudly displayed on the BT Tower.

“To the people of London, your support saves lives. It’s because of you that when London calls, we’ll be there. Thank you from all at London’s Air Ambulance Charity.” 32

STRATEGIC OBJECTIVE 3 - CONNECTING WITH THE PEOPLE OF LONDON

CHRISTMAS CAMPAIGN

OUR CREW

London’s Christmas Mission

Christmas with the crew

At Christmas 2020 the charity launched its first-ever integrated Christmas fundraising campaign. We called on new and existing supporters to come together to join London’s Christmas Mission and help raise the funds needed to keep London’s local charity in our skies.

We gave our supporters a glimpse into what life is like on the frontline during Christmas as part of London’s Christmas Mission. Consultant Dr John Chatterjee spoke to supporters about his work over the festive season.

What’s it like working at London’s Air Ambulance over the Christmas period?

Our primary objective was to inspire supporters to donate and generate much-needed income to help plug the income gap caused by the pandemic.

London’s Air Ambulance is as much a family as it is a job, we look after each other and have been together for many tough and joyful times. I know that especially those on secondment and the overseas medics would have spent a lot less time with family than they’d like and, with the stresses of the job, it’s tough. But hopefully the team spirit brings some solace to the hard work.

But we also wanted to thank supporters for their ongoing support and increase engagement by sending messages to the crew via a special Christmas bauble – which were later collated and sent on to the crew working over the Christmas period. We received over £112,000 in donations and 1,200 crew messages.

Also for our patients and their families any time is a bad time to suffer injury or loss, but at Christmas it must be especially tough for them and the thought of being able to ease whatever we can brings some comfort.

How do you feel about working at London’s Air Ambulance over the Christmas period? The job is always a privilege. I’ve worked over Christmas in all my roles in the NHS, but like the rest of the key workers we have to keep the service running and it’s like a little secret club only we are in while the rest of the city gets time off. I am always pleasantly surprised at how kind-hearted strangers are to our patients and to our teams.

Picking Up The Pieces – Crew Mental Health In 2019 we launched our own podcast, Picking Up The Pieces, to explore how our patients and their loved ones cope when they have experienced trauma. The first series focused on our patients, and in 2020 we released a special bonus episode, to help people understand more about the realities of life on the frontline, looking at how our crew process the trauma they witness on a daily basis. Hosted by writer and comedian Dr Adam Kay, consultant Dr John Chatterjee and paramedic Steve Jones spoke to Adam about their own experiences with mental health challenges, as well as exploring how PTSD can manifest differently for different people.

DR JOHN CHATTERJEE

STRATEGIC OBJECTIVE 4 - DOUBLING INCOME

OUR SUPPORTERS

We aim to double our income by 2025, to ensure we can fund the replacement of our helicopters and car fleet, continue to deliver our life-saving service 24/7 and to continue to invest in innovations to save even more lives. The Charity continued to invest in its fundraising activity throughout the COVID-19 pandemic, to ensure we are in the best position possible to raise the income we need in future years. This meant there was a year-on-year income growth of 3% despite the challenges. The restrictions on fundraising face to face throughout the pandemic has had a significant impact on our speed of growth though. For large parts of the year, we were unable to acquire new supporters to our regular giving and lottery products; we were not able to undertake community fundraising and engagement activities; fundraising events were cancelled; and we were unable to meet with major donors and corporate partners. This meant our expenditure on fundraising activities was also reduced (£4.5 million compared to £5.6 million in 2019/20). We are hugely grateful to all our supporters who stayed with us and continued to donate or volunteer throughout the pandemic.

Individual supporters

Legacies

We are reliant on regular giving and lottery players for almost 70% of our income. Income from individual donations increased by 18% over the period, primarily down to the previous year’s investment in regular giving and investment in new appeals. At the end of March 2021, the volume of active regular donors had marginally declined year on year with 29,000 donors (2020: 31,000). This reduction was due to our inability to acquire new donors via face-to-face fundraising for much of the year. Despite not being able to fundraise via face-to-face activity, we continued to invest in Direct Response Television and digital channels to recruit new regular donors.

Income from legacies grew by 60% year on year. This was primarily due to a number of unexpected large legacies being received during the period. We sent our first legacy marketing campaign to 25,000 supporters in September 2020 and this resulted in a potential legacy income pipeline of £10.5 million from our existing supporters (based on industry standard conversion rates).

Lottery At the end of March 2021, the number of chances in our lottery had reduced year on year to approximately 102,000 (down from 113,000 in March 2020). Income from the programme reduced by 2% in the period because of the impact of not being out face-to-face canvassing.

Annual supporter survey We sent our annual supporter satisfaction survey in March 2021: 95% of our supporters stated that they were either proud or very proud to support us; 94% were happy with the level of communication they received from us. We are delighted that our supporters continue to feel very engaged with the Charity, despite the difficult external environment.

STRATEGIC OBJECTIVE 4 - DOUBLING INCOME

OUR CORPORATE PARTNERS It is always the aim with our corporate partnerships to develop sustainable sources of income for the charity and great relationships based on a common purpose which also provide meaningful levels of engagement for our partners. We are lucky to work with fantastic corporates that believe in our vision and mission and provide us with vital financial support. With our usual face-to-face opportunities to meet with our partners drastically removed, we moved online, holding our first virtual corporate event in May 2020. The success of this encouraged us to host similar events through the year, enabling us to remain engaged and in touch despite the challenges.

CASE STUDY: Herbert Smith Freehills We marked the official end to our two-year partnership with HSF in December 2020 after the company extended their partnership by eight months. Overall they raised £125,344.40 for our charity, including £6,954 in pro bono legal support. We were incredibly lucky to have two ex-patient champions at HSF, Aderonke and Dan, who demonstrated in the most powerful way, how vital support from corporate partners is to ensure we can be there when every second counts.

CASE STUDY: Dan Hudson In April 2011, Dan was cycling home from work and was 300 yards away from his house when he had his accident. He suffered multiple fractures to his left leg and pelvis, was bleeding severely and both his lungs had collapsed. He was left in a coma for six weeks, hospital for 15 weeks, off work for nearly nine months and with life-changing injuries/conditions. Dan has since gone on to raise huge amounts for the Charity, completing a cycling challenge in 2013 with a colleague from HSF and this year embarked on an epic challenge – to complete five fundraisers in one year. He started with the virtual London Marathon in October 2020, and will also complete a second London marathon in 2021, two Royal Parks halfs plus participating in the Charity’s new Miles for Missions challenge which will launch in Spring 2021.

STRATEGIC OBJECTIVE 4 - DOUBLING INCOME

CHALLENGE EVENTS

Our fundraisers have baked cakes, swum lengths of their garden, hosted quizzes and online singalongs, lit up their houses at Christmas, fundraised in memory of their loved ones and done everything in between in the last year to help us raise the £9 million it costs us each year to make sure our life-saving team can continue to be there when London needs us.

Usually we take part in a number of challenge events each year, from the London Marathon to our helipad abseil. However with in-person events postponed or cancelled, we had to come up with new and innovative ways of raising money.

SPOTLIGHT: Shane

2.6 Challenge 26 April 2020 should have seen us cheering on our runners at the 40th London Marathon. However, with the UK still staying at home to protect our NHS, we asked our supporters to take part in the London Marathon’s 2.6 Challenge instead – a call for all stay-at-home superheroes to fundraise in whatever way they could to support the UK’s charities.

Shane undertook an epic trek challenge for our charity. Shane raised money by hiking 250 miles around Richmond Park while wearing a weighted backpack and dragging over 25kg of tyres. To make it that bit harder, he completed his challenge in the middle of winter, facing wind, rain and snow as he walked for 14 days. Shane raised over £1,500 for our Charity and will soon take on a new Miles for Missions challenge.

To be part of the challenge, you had to complete a fundraising activity based on the numbers 2 and 6. Our supporters leapt to the task – from back garden marathons to a 2.6 km swim in a paddling pool! Many also took up the Helicopter Challenge – completing an exercise move called the Helicopter 26 times. One of our marathon runners joined forces with her friends and family to complete as many 2.6 challenges as they could over one day. The amazing efforts of our supporters meant that even during lockdown, over £23,000 was raised to keep our life-saving service operational. We also developed our new virtual challenge event, Miles for Missions, ready to be launched in the summer of 2021.

TAKING PART IN THE 2.6 CHALLENGE

“None of us ever want to be in a position of needing London’s Air Ambulance but knowing that they will be there if we do, is so important and worth all the effort of fundraising”

SHANE, ONE OF OUR EPIC SUPPORTERS

STRATEGIC OBJECTIVE 4 - DOUBLING INCOME

FINANCIAL UPDATE In 2020/21 we raised £14 million (consolidated income) from our supporters and partners. It was a challenging time, but with the work of our team and help from our generous supporters we managed to sustain our income from the previous year. Our expenditure was reduced as we were unable to carry out our planned fundraising activities, leading to a large reduction (93%) in events income with our annual gala postponed and lottery lines beginning to reduce. Trusts and Foundations offered us great support though (up 89% on the previous year) to help us through the pandemic.

Trading 40%

Gifts in Kind Corporate & 2% Events 3%

Community 2%

Individuals 25%

Our supporters continued to donate generously both in cash and gifts in kind. Every stream of income is vital to the ongoing sustainability, growth and development of the Charity.

£14.1m

Full income 2021/21

£9.2m

£13.6m

£10.5m

£7.9m

£9.0m

£7.9m

£11.8m

Income/Expenditure history

Total Income

% of Total Income

Corporate & Events

415,311

Community

316,356

Individuals

3,478,087

Trusts & Foundations

824,493

Raffle

135,724

Legacies

1,079,540

Major Donor

78,870

Gift Aid

722,557

NHS Trust and Government)

962,441

Investments

36,221

Shop

939

Institute

126,082

Trading

5,661,102

Gifts in Kind

294,310

Trusts & Foundations 6% Raffle 1%

Institute Shop 1% >0.5%

Investments >0.5%

Grants 7%

Gift Aid 5%

Major Donor 1%

Legacies 8%

Grants (inc. Barts Health

2017/18 Expenditure

2018/19 Income

2019/20

2020/21

STRATEGIC OBJECTIVE 4 - DOUBLING INCOME

FINANCIAL UPDATE Where our funding came from In 2020/21 we raised £14 million (consolidated income) from our supporters and partners (comparative figure from 2019/20 £14 million). It was a challenging time but with the help of our generous supporters we managed to sustain our income from the previous year. Our expenditure was reduced as we were unable to carry out our planned fundraising activities, leading to a large reduction (93%) in events income with our annual gala postponed and lottery lines beginning to reduce. Trusts and Foundations offered us great support though (up 89% on the previous year) to help us through the pandemic. Our supporters continued to donate generously both in cash and gifts in kind. Every stream of income is vital to the ongoing sustainability, growth and development of the Charity.

How we spent our funding It costs approximately £9 million (consolidated costs) to provide London with an advanced trauma care service 24 hours a day, seven days a week. From helicopter fuel and pilot salaries, to ultrasounds and medical kit bags – donations from our supporters provided the vital funds needed for us to carry on saving lives in the capital. As well as delivering our core services, we invested in strategic projects including trialing some world-first clinical interventions, redeveloping our helipad facilities and a digital transformation project.

Although we operated 24/7 throughout the pandemic, much of our usual fundraising activity ground to a halt. This meant that our expenditure on fundraising was reduced during the year (£4.5 million compared to £5.6 million in 2019/20), which is why our total expenditure reduced slightly this year.

How resilient are we? Reserves are held to protect our Charity in times of challenge, either from a sudden fall in income or unexpected significant expenditure. They also allow us to plan for the future and invest in vital clinical and operational projects. Our Trustees have agreed a strategy whereby sufficient unrestricted cash reserves are held to meet, as a minimum, the cost of six months of operational costs. The Charity has achieved this goal whilst balancing day-to-day running of the Charity, with planned future capital expenditure and operational objectives. As of 31 March 2021, we had sufficient free reserves to fund nine months of running costs, as well as £6 million in designated funds earmarked towards the replacement of our two helicopters, our CRM project and the redevelopment of our helipad. Although we have a strong financial foundation, the past financial year has been like no other. The pandemic has had a significant impact on our Charity finances and we are now facing a £6 million gap in our planned income over the next five years. We will continue to invest in fundraising and build up our reserves as

we work towards planned capital expenditure, including for two new helicopters in 2024. Continuing investment in our fundraising will result in a projected one-off deficit in 2021/22. With continued support we will then break even in 22/23 and then forecast a return to surplus in 2023/24.

Investment Strategy In 2018, we set out two strategic goals for the service; to save time and deliver outstanding care. To achieve these goals, we committed to connecting with the people of London and doubling our income over a five-year period. We have made a significant investment in bringing regular donors onboard, the costs of which will be recouped over the duration of their commitment. We will continue to invest in this recruitment so that we can sustain diverse income streams and guarantee the future of our world-leading service. We face an incredible challenge ahead – we need to replace our helicopter fleet in 2024 at an estimated cost of £15 million. We have moved forward with plans for the biggest fundraising appeal in our history to raise this extraordinary amount – all the while knowing that we still need to raise the £9 million it costs to deliver the service and fundraise every year. We know we can’t afford to halt investment as our supporters are vital to our plans.

“We need to think about the future. We will need to replace our helicopter fleet in the years ahead and the current crisis has put our day-to-day finances under severe strain. It is vital that these plans are not compromised - we simply can’t afford to put this on hold. With you standing with us, we will be ready. Thank you” Dr Tom Hurst, Medical Director

STRATEGIC OBJECTIVE 5 - OUR CULTURE

NEW TRUSTEES

OUR VALUES

We continue to develop a supportive and enabling environment that ensures our people can be at their best, both within the Charity and whilst working alongside our partners - always staying true to our organisational values.

This year four new trustees joined our Board, bringing with them exciting new ideas and experience from a diverse range of sectors including the technology and medical research areas. Gemma Sherrington Gemma is a member of the Executive Board at Save the Children UK. Gemma has over 15 years of fundraising and marketing experience, previously working for NSPCC, Cardinal Hume Centre and WaterAid.

Brigadier Tim Hodgetts Tim is an emergency physician with over 35 years of military experience and has treated victims of conflict in Northern Ireland, Kosovo, Iraq and Afghanistan. Tim specialises in military emergency medicine and pre-hospital care. He is also a Commissioner at the Royal Hospital Chelsea and co-Founder of the registered charity citizenAID.

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 challenging 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.

Dr Margot Gosney Margot is a Geriatrician also trained in Medical Oncology. She was appointed Senior Lecturer at the University of Liverpool in 1992 and Professor of Elderly Care Medicine University of Reading and Honorary Consultant in Elderly Care Medicine at the Royal Berkshire NHS Foundation Trust in 2003.

James Thomas James is Chief Technology Officer for Wellcome, an independent health research foundation, where he is responsible for leadership of technology and digital services. Prior to working at Wellcome, James had an extensive career in the private and public sectors including technology leadership roles in the NHS.

STRATEGIC OBJECTIVE 5 - OUR CULTURE

CULTURE REVIEW This year the Charity undertook an independent review of Culture, Diversity & Inclusion encompassing all personnel involved in the service – from Charity through to frontline staff through to Trustees. The aim was to assess the culture of the organisation and enhance further the positive relationships between all parts of the wider organisation, including the operational, Charity, Board and executive teams. Everyone was invited to contribute by way of survey, focus groups and individual interviews. Engagement in the review was higher than previous pan-service reviews. Whilst the review was broadly positive, there are areas that we must improve on as an organisation, as teams and as individuals, and the directors asked colleagues to think about these in their teams. Each team invited a director and/or trustee to come and listen and learn from the feedback, which helped the directors focus on the key priorities: •

•

Values and behaviours - holding ourselves accountable and being responsible in everything we do for the benefit of the service, and ultimately, our patients. Diversity and inclusion – the actions we take to become more cognitively diverse and actively seek to embrace differences of opinion, background and experience.

•

Connecting with each other – working to reconnect teams and integrate new colleagues into the organisation, renewing and re-energising after the impact of COVID-19.

•

Clarity and accountability – making it clearer in terms of key principles and responsibilities to empower decision making, to encourage and trust in knowledge, judgement and experience.

There are numerous workflows and actions in train to underpin these four areas which are reviewed at monthly Director meetings for progress, and key milestones are now reported back to the Trustee Board.

•

We held a Facebook quiz for staff and supporters, led by one of our pilots, Captain Andy Thomson.

•

We also thought about our wonderful supporters and volunteers who are a vital part of our team. We held virtual events to keep everyone up to date about the charity and service. We also gave them regular phone calls to check in and make sure they were ok.

Next steps •

Support all our people to be leaders through learning and opportunity, including understanding and investing in the individual development of our talented team.

•

Regular well-being checks of the organisation, particularly during the COVID-19 pandemic period, to ensure that our teams are supported fully.

•

We are reviewing our ways of working post COVID-19 to ensure that the learnings and adjustments as to how we work are taken forward and included within our culture and our peoples’ well-being. We will aim to keep flexible working wherever possible as our team would like.

Staying connected during lockdown With the ability to connect in person diminished during the pandemic, we focused on ways to keep teams in touch with each other. •

Christmas party – we had a Zoom Christmas party with a quiz and other interactive activities.

•

We ensured our teams were able to get together and enjoy each other’s company in many different activities, such as outdoor picnics (when restrictions allowed) and Zoom team building sessions that included everything from wreath making to pizza baking.

LOOKING AHEAD

With Jonathan Jenkins, Chief Executive Officer

Last year I said that we wouldn’t know what the following year would bring and 12 months on we are still in uncharted territory as we look ahead. I am however extremely confident that our resilience and passion for the cause will continue to guide us through these difficult times. The impact on our finances has been significant, especially as it is coinciding with a period of huge ambition for the Charity and service. Thanks to our strong financial performance over the last few years though we have been able to maintain investment in our operations and fundraising. Continuing this investment will result in a projected one-off deficit in 2021/22 but we forecast a return to surplus in 2022/23. Thanks to the service living our values - compassionate, courageous and pioneering - our plans can continue apace. Thanks too to the belief our partners and supporters show in our mission to save more lives in London through rapid response and cutting-edge care. The last year has seen the Charity move forward with plans for the biggest fundraising appeal in our history. By 2024 we will need to replace our helicopter fleet at an estimated cost of £15 million. The aviation team have been carefully considering the aircraft that we will select,

taking into account the need for room for the life-saving equipment we carry, the number of clinicians on board to deliver the rapid-response care, and also the space an aircraft will need to land – a major consideration in the built up, urban environment of London. Meanwhile the fundraising team are planning for the launch of the appeal to raise this extraordinary amount – all the while knowing that we still need to raise the £9 million it costs to deliver the service and fundraise every year. It is a hugely ambitious, but exciting time for the organisation. As part of our goal to save time we are also progressing with another vital aspect of making our response quicker. Soon we will be “breaking ground” – albeit 300ft up – on the redevelopment of our helipad space. This will see the duty crew room moved closer to the helideck to save crucial seconds, and provide more space for training, alongside space to rest and decompress after difficult and complex missions.

The clinical teams will continue to focus on what more can be done to end preventable deaths, with Zone 1 REBOA introduced to the pre-hospital procedures we can perform, and the ECMO trial ongoing. Operationally we will look at how we can save time by introducing an extra team in the winter months when the aircraft can’t operate in as many hours and exploring whether night flying will be possible. As you can see, despite the distraction and complications of COVID-19, our ambitions have not been tempered. For the last 32 years, London’s Air Ambulance has been there every day, and we owe it to the people we serve, to make sure we continue that service. Thanks to our supporters, our volunteers, our colleagues, our partners Barts Health NHS Trust and London Ambulance Service, and the people of London, we will be able to continue saving lives when London calls.

We also recognise the need to improve our data and digital records, so will be continuing to invest in these areas. The CRM project will support our ability to connect to our donors and the people of London. At the helipad the clinical digital transformation project also continues. The more insights we have on our patients, the more we can help our future cohort of patients.

THANK YOU We couldn’t do what we do without our supporters. We are continually humbled by those who donate, play our lottery, give up their time, take on challenges and more to help us be there when a patient is critically injured. Whether you have been with us from the start, over 30 years ago, or have more recently joined our family, thank you. You are a vital part of our team and we are proud to be funded by you.

Our corporate supporters Aberdeen Standard Investment Banham Bank of England Bryan Cave Leighton Paisner LLP Byrne Group Canary Wharf Contractors Fund CIS Security Ltd Credit Agricole CIB Epoch Capital Ltd ERS Insurance Group

Euroclear Foxtons Hall & Woodhouse Herbert Smith Freehills LLP ICAEW Informa International SOS LDC Lionside Limited MFS International Mountford Piggott NatWest Markets Phoenix Group Sequel Shearman & Sterling LLP Tokio Marine Kiln Group Wells Fargo Winckworth Sherwood LLP

Trusts, Foundations and Livery Companies Astor Foundation Bothwell Charitable Trust Bridor Trust Cadogan Charity

Charles S. French Charitable Trust Chestertons Foundation County Air Ambulance Trust (HELP APPEAL) Department for Health and Social Care Edith Murphy Foundation Frazer Trust Gisela Graham Foundation Heathside Charitable Trust Highfields Charitable Trust Joron Trust Jules & Cheryl Burns Trust Lancashire Foundation Misses Barrie Charitable Trust Modiano Charitable Trust Saracens Foundation Sir John Beckwith Charitable Settlement Sylvia Waddilove Foundation UK The Anthony Gold Solicitors’ Charitable Trust The Barratt Developments Plc Charitable Foundation The Barry & Peggy High Foundation The Belvedere Trust

The Company of Art Scholars’ Charitable Trust The Company of Nurses The Dudley and Geoffrey Cox Charitable Trust The Gerald Micklem Charitable Trust The Golden Bottle Trust The Grimsdale Charitable Trust The Horner Charitable Fund The Hospital Saturday Fund The Jane Gibson Charitable Trust The Juliet & Hans Rausing Trust The Mactaggart Third Fund The Oak Foundation The Sanderson Foundation The Sandra Charitable Trust

The Stanley Foster Charitable Trust The Swire Charitable Trust The Trevor Chinn Charitable Trust No2 The Vandervell Foundation The William Grant Foundation The Worshipful Company of Builders’ Merchants The Worshipful Company of Chartered Secretaries and Administrators The Worshipful Company of Glovers The Worshipful Company of Insurers The Worshipful Company of Launderers The Worshipful Company of Security Professionals

The Worshipful Company of Tallow Chandlers’ Benevolent Fund The Worshipful Company of Tylers and Bricklayers Tijou Charitable Trust Warwick Trust Weald Welfare Trust

The Innovation Circle Founding Members The Beaverbrook Foundation Philip Broadley Tim Hennock Rahul Moodgal Simon Witts

THANK YOU

For more information please contact: E: info@londonsairambulance.org.uk T: 020 3023 3300 londonsairambulance.org.uk @LDNairamb Registered Charity 801013