November 29 2022
In this HEMS Roundtable, the panel discuss the Leonardo product line focussing on the AW169 and AW109 Trekker. The discussion covers the AW169 and AW109 Trekker, lessons learned from COVID and what the role of the helicopter is in modern healthcare services.
Can you briefly introduce Leonardo Helicopters?
Leonardo Helicopters is an Original Equipment Manufacturer (OEM) with more than 110 years of history that designs, builds, sells and supports civil and military helicopters worldwide. What at the dawn started with the production of planes without engines, our Company has now progressively increased its know-how building models under license for many years before developing its own design with the glorious A109, Lynx and AW101. After many decades, Leonardo Helicopters is now able to provide its Customers with a comprehensive product portfolio, along with a wide offering of support and training solutions. Our helicopters are flying in more than 150 countries with a strong presence in the UK thanks to the former-Westland facilities located in Yeovil, Somerset, only OEM with more than 2500 employees in UK. Focusing on the main subject of these roundtables, our products are proudly supporting the NHS (the National Health Service) with 14 helicopters, approximately 25% of the regional market share, operated and funded through the many fantastic Air Ambulance Charities across the UK. Besides HEMS, Leonardo Helicopters has a strong share in-country in VIP and SAR segments, providing also the platforms for the UK SAR service. When necessary, the Leonardo UK built AW101s and AW159s also support emergency response operations in UK, as we’ve seen, for example, during the still ongoing pandemic.
Which are the most important models for HEMS within your portfolio?
We do have a large offering of products spanning from the smaller single engine (AW119 and the next to come innovative SH09) up to larger twin engine helicopters such as the AW139 and AW189. In the future the AW609 tiltrotor will introduce unique capabilities also for HEMS, leveraging its combination of airplane performance and rotorcraft versatility and a pressurized cabin suitable for better medical stabilization. Then the perfect size shall be chosen considering the specific requirements of each Country; in particular, considering the UK charity-led scenario, the NHS infrastructures available today and the typical mission profile, we do believe that the most appropriate solution combining the requirements of top-edge technology available on the market and cost effectiveness is provided by the AW109 Family and AW169.
Why these two models?
Our vision is to provide our customers with means to support people in an emergency situation by fulfilling the requested mission in the shortest possible time at the most reasonable trade-off between cost and capability. From a “platform” perspective, both models grant the shortest start-up time, most efficient CAT-A profiles and highest speeds in their own class, each granting the marginal gain that makes the difference to the patient in the medium and long term. The latest AW109 variants, GrandNew and Trekker, share the same design philosophy with a few differences mainly for materials (composite vs aluminium alloy), landing gear and avionics suite, that for the Trekker is modular to provide for Single/Dual Pilot, VFR/IFR configurations. Regarding the AW169, besides the advanced avionics with touchscreens and satellite navigation capabilities, the introduction of the APU mode allows power to run critical systems such as aeromedical tools, air conditioning and radios / internal comms while the rotors are stopped on the ground, a feature that is unique in its class. On the medical standpoint, both platforms can effectively meet UK requirements for primary and secondary missions, providing a real 360° patient body accessibility and the widest cabin volumes in each relevant class to accommodate any medical equipment, including those pertaining to specialised treatment such as ECMO (ExtraCorporeal Membrane Oxygenation – for cardiopulmonary support) and IABP (Intra-Aortic Balloon Pump – for cardiac perfusion). Furthermore, these two models are compliant to the latest safety standards, granting safe flight even in the harshest environments. Moreover, both platforms have been fully certified by the British Standard Institution (BSI) with regards to the EN13718-2:2015 “Medical vehicles and their equipment — Air ambulances” attesting their capability to fully satisfy and going beyond the current standards for what concerns HEMS operations.
You just mentioned safety. Can you go into a little more detail?
I’m referring to 360° safety, covering both passive and active aspects, aimed to lower the workload not only of the pilots, but also of the rear crew and let them focus only on the mission outcome. Starting from safety by design, the helicopter shall grant the highest level of safety in any emergency situation, be it One Engine Inoperative or in general the power margins in any conditions, dry-run capability etcetera. HEMS flights are rarely performed in controlled, comfortable environments and the helicopter should not be an additional variable into the equation, as there is already a life-threatening situation ongoing. The other side of safety includes all the additional equipment, aimed to increase the situational awareness and operational capability of the crew in complex airspace and harsh environmental conditions; among them, we can highlight HTAWS (Helicopter Terrain Awareness – or Avoidance – and Warning System), TCAS (Traffic Collision Avoidance System), EVS and SVS (Enhanced and Synthetic Vision System respectively). Considering typical HEMS operations, primary and secondary missions with their own peculiarities, all this equipment contributes to the overall safety of the helicopter helping the pilots to have a clear understanding of the surroundings. Our exclusive and proven Obstacle Proximity LiDAR System adds one more layer of safety for the crews, especially when operating at night and in confined areas that are common practice in HEMS missions. Furthermore, Leonardo Helicopters has recently signed an agreement with the Italian air navigation service provider, ENAV, to promote the usage of low-level instrument routes to grant connection between hospitals 24/7 no matter the weather conditions. Since technology is already available, the missing piece of the puzzle was to collaborate and provide Customers with a turn-key solution including route design, development and validation, plus dedicated training and evaluation of the applicable airspace concept. Our products are also showing these capabilities during demos in other nations (i.e. Life Flight of Maine’s AW109s in US). This dedicated network of rotary-wing routes impressively increases operational availability and enhance patient survivability and effectiveness of the healthcare system. Should any Operator/Charity be interested in this new feature, we are ready to support and lead them throughout the whole process. Finally yet importantly, for the AW169 we are working on certifying the Full Ice Protection System, a kit that once installed on the helicopter will grant the possibility to conduct safe flights also when icing condition may suddenly happen along the route. The AW169 will be the smallest helicopter in the market with this option, thanks to a very innovative system design, providing the same capability of our larger AW189 SAR operating for the UK Maritime Coastguard Agency to fly in such demanding icing conditions, commonly experienced during harsh winter months.
What about COVID-19, what has Leonardo learnt from this pandemic?
Firstly, we learned that cabin volume is key. The amount and size of the medical equipment demanded by this kind of emergency require adequate space and an agile cabin environment. Moreover, we focused our efforts towards proper protection of the crew by means of: A separation wall, to reduce as much as possible any contact between pilots and cabin crew; Biocontainment devices to properly safeguard cabin crew from confirmed COVID cases; iii. Cabin and cockpit sanitation procedures. Upon biocontainment we are working on AW169 and AW139 to certify a dedicated portable unit to be stored into the baggage compartment and ready to be used, without affecting the movements across the cabin. It can be fitted onto a series of aeronautical stretchers so no modifications are required. Similar activities are going to be launched with AW109 EMS Interiors STC holders aimed to receive an approved installation procedure. For cabin sanitization, we have achieved clearance for typical cleaning techniques with spray and wipes and through the usage of Ultra Violet devices. Last but not least, the AW139 and AW169 were the world’s first civil approved EMS helicopters capable of transporting bio-hazard systems in early spring 2020, starting in Italy and UK as well. We learned a lot from that unfortunate experience, confirming many of the design assessments and solutions we had developed for the segment with these models.
Great! This is today but looking towards the future, what do you see?
We are continuously monitoring the trends and the market requirements thanks also to some collaboration agreements we have in place with national and international medical associations operating within the HEMS sector. We do encourage an open discussion with our main stakeholders, UK Air Ambulance community included, to understand where the market is heading and the requirements for the future of HEMS. Just as an example: we are currently receiving requests upon the possibility to centralise wireless data coming from all medical equipment and send in real-time to the referral hospital for specialised support, as a core part of telemedicine development. Leonardo Helicopters has already certified on AW169 a cabin Wi-Fi router capable of collecting info and transmitting information from the helicopter directly to the operative room, whether it is located at the hospital or operator’s base. The question itself is how medical equipment will develop in the future, the amount of data required to be transferred, and the type to be transmitter, whether they are encrypted or not. The medical equipment world is moving faster than the aeronautical industry mainly due to certification reasons, meaning there will always be a gap between what is available on the market and what is available on the helicopter. Technology is going in a direction where medical equipment will be even more capable and compact, therefore it will be easier to implement on board technology that today could not fit due to its actual dimensions or complexity. This obviously applies as well to the cabin layout in general, as EMS interiors have remained the same over the last two decades. Any stakeholder involved in the industry, regardless of the extent of their contribution, must be aligned and fully aware of the near future requirements in order to be ready to provide the right solution as soon as needed.
You mentioned at the beginning that Leonardo Helicopters is covering from design up to training; can you please expand a little on this?
In this case, we are referring to thorough training, for both pilots and rear crew, whose offering ranges from web-based training tools up to the Level-D Full Flight Simulators. This has two benefits, it cancels the risks of potential emergencies in the helicopter still being credited as a real flight hour, plus reducing dramatically the footprint of the industry, letting Customers cover part of the training from a remote location. Leonardo is a strong advocate of a green philosophy. Furthermore, Leonardo is capable of providing specialised HEMS mission training for medical crew as well, thanks to the wide offering of different tools and the aforementioned agreements with medical associations with a specific training syllabus for medical practice on helicopters.
Considering what has been stated before, what is the role of the helicopter in the healthcare system?
Many Countries are modifying their own healthcare systems. The most common trend is the closing of small primary care centres and the concurrent strengthening of the tertiary or quaternary facilities, mainly for cost rationalisation. This reflects on helicopters as well, as they are now required to be more capable in terms of performances, range and cabin volume for medical practice. The “scoop and run” philosophy has been overcome by the “hub & spoke” one, and the helicopter is now some kind of long arm of the NHS; it must be able to provide a tangible value added to the system and be fully integrated into it. In this regard, platforms need to grant 360° accessibility to attend to the patient while in flight, and modern, broadband real-time connectivity to the referral hospital can make a terrific difference in the patient outcome and in the NHS economics as well, limiting the overall hospital stay and potential welfare subsidies. In mature markets like the UK and in absence of overlapping with SAR service requiring bigger helicopters and longer-range missions, a combination of modern, upper CS-27 class platforms like the AW109 and advanced Light Intermediate models like the AW169 are the best fit to grant a high-level HEMS service framed within the ever-growing hub & spoke system.