Story ID: 131FrenchHEMS_AINJune16EditedByAY_NM.doc
French HEMS Operators Add Technical Crewmember
By: Thierry Dubois
Caption: Mixed feedback on safety while some concerned patient care might be diminished.
Word Count: 786

After four months of employing an extra crewmember to meet EASA rules, the French helicopter EMS (HEMS) industry continues to question the relevance of the addition. The so-called “technical crew member” (TCM) is supposed to help the pilot spot obstacles and traffic, but his or her presence raises costs and cuts useful load. Nonetheless, some operators view the requirement as an opportunity for future operational improvements.

Until January 1, HEMS companies in France were covered by a 2014 exemption to the EASA rule requiring two crewmembers in EMS helicopters. Therefore, a crew now consists of one pilot and one TCM (in the front seats), as well as a medical team (one physician and one nurse) in the cabin. The TCM’s weight–factored in at 180 pounds–either reduces endurance by 20 minutes or limits the number of accompanying people or medical personnel the helicopter can carry.

A TCM so far only helps the pilot see obstacles in the takeoff and landing phases, select a landing area and ensure “see and avoid” in cruise flight, according to Christophe Mauron, sales director of Babcock Mission Critical Services in France (formerly known as Inaer France). However, he suggested that in the future the TCM might perform more tasks–flight planning, radio communications and navigation–to the extent allowed by the EASA.

Most operators and physicians are challenging the alleged safety benefit of the newly enforced rule. French doctors using HEMS have their own lobbying association, AFHSH. “We were already doing ‘see and avoid,’ and the presence of a TCM opens a rift between the technical and medical teams, when the pilot cuts off the intercom to focus on teaching the TCM,” former AFHSH president Nicolas Letellier told AIN. In France, the operator hires the pilot and the TCM, while the medical crew is employed by a hospital. Most TCMs have no aviation background, according to Letellier.

He is concerned that the slimmer useful load of the smaller helicopters popular in French HEMS (the EC135 is the most common) might translate into issues, especially in summer, when temperatures also affect payload. For example, the helicopter might no longer accommodate the mother of an injured child. Even a heavy patient, one weighing more than 275 pounds, could become an issue. “What about the responsibility of the doctor who might have to choose between the patient and the TCM?” Letellier asked.

In terms of endurance, the difficulty is compounded by scarce fuel availability in some areas. At Paris’s heliport, no fuel is available on Sundays after 5 p.m., Letellier said.

Larger rotorcraft such as the Airbus H145 might be more suited to absorbing the weight of the TCM, but they carry significantly higher acquisition and operational costs. Belgium-based NHV, which has contracts with some hospitals in the North of France, operates MD Helicopters MD902s. “It is an old type but it is roomy and powerful; NHV tells us everything is fine with the TCM,” Letellier noted.

The helicopter operators’ lobbying association, the UFH, is also challenging the hoped-for safety benefit of the move. “How could this improve safety, since we, the French HEMS industry, have not recorded an accident for 17 years?” an official asked. Although he acknowledged that a skilled and experienced TCM could cut the pilot’s workload, he asserted that the TCM could also elevate workload by requiring that the pilot monitor him, a spokesman said.

So what about having a three-member crew that includes a paramedic able to assist the pilot? “Hospitals in France are not organized for the physician and nurse to be supplied by the operator,” the UFH spokesman answered, pointing out that the European Union says France’s problems with HEMS crews stem from the country’s own organization.

But Babcock’s Mauron holds a more positive view on the change under way. His company employs 80 TCMs, the same as the number of pilots on its payroll. “Two pairs of eyes working together enable better risk control,” Mauron believes.

Acknowledging the challenges of access and profitability, Babcock is seeking solutions. The company might ask the EASA to reduce weather minimums, thus enhancing helicopter mission availability. “We are talking to our customers to find a way for the TCM to assist the medical crew,” Mauron added.

Finally, he said the recent enlargement of the area covered by a tender has made more refueling points available, to the point that one operator he talked with does not see endurance as a problem.

At the national scale, the annual extra cost of employing TCMs is estimated at €6 million ($6.8 million), which is passed on to hospitals.