Interview: Francoise Lin of Europ Assistance on air ambulance commissioning

How has the commissioning process for air ambulances changed in the last 12 months, with regards to Covid-capable transportations? 

The Europ Assistance (EA) International Network of Air Ambulance suppliers is handled at Global level by a team composed of Senior Network Manager (Francoise Lin) and EA Chief Medical Officer for the medical aspect, Professor Thomas Lescot.

Thomas Lescot has already validated 16 suppliers based in several continents who are able to transport Covid-19 cases internationally. Since this process is still ongoing, this number will continue to rise gradually. As it pertains to ‘Covid-19-capable’ transportation, not all air ambulance crews are trained and equipped for transporting Covid-19 patients. We are continuously validating additional suppliers and the overall number of air ambulance suppliers able to transport these patients is increasing. 

EA has its own list of air ambulance partners – how frequently is this updated and reviewed? 

The international network of air ambulance suppliers is one of the solutions offered by the Medical and Travel Networks Team at Europ Assistance Global to the EA companies. EA companies can also rely on the international network of agents for its upscale logistic capabilities everywhere in the world. We have an ongoing quality process and a rigorous management of supplier’s performance. In addition, insurance packages are regularly and carefully monitored.

What do air ambulance companies need to meet in terms of general criteria in order to be on your list? 

EA has a proprietary tool allowing our companies to request international medical patient transportation quotations. It also gives our suppliers the opportunity to present solutions and quotes. We currently have 30 international air ambulance suppliers accredited into the EA tool.

Before being accredited as part of the network, air ambulance suppliers are audited by a team composed of the global network expert (managing the network) and one of Europ Assistance’s doctors. The audit protocol covers: the medical team and crews, medical equipment (and management of such), aircrafts, insurances and licenses etc.

How important are exterior accreditations to EA when it comes to considering applications from companies to be added to your network of providers?

Our selection criteria are very high. As an example, brokers are not accepted into the network, nor are one-aircraft-fleet companies or single-engine aircraft. We fully audit the premises of any air ambulance companies asking to become part of our networks, and we carefully check their accreditations and insurances. It happens that the companies meeting our expectations have often been granted exterior accreditations such as EURAMI and CAMTS, and our suppliers also often apply ISO standards to their processes. In a nutshell, accreditations are important, but will not replace our own in-depth selection criteria.

Are there ever situations where EA has had to use a provider that is not on their approved list? What due diligence can be done at the last minute to mitigate any risks of using a non-approved provider? 

For some local evacuations, the EA operations teams can count on the EA network of agents. Our EA agents are our local experts. Under the supervision of the EA medical and travel networks team, EA agents maintain their own network of suppliers, including local small air ambulance companies, as some evacuations may be part of routing flight plans. After their medical evacuations, patients are boarded on commercial flights for medical repatriations under the EA medical escort team’s care.

How was EA affected by the pandemic initially, and how has it weathered to storm of the past 12 months? 

In 2019, the EA Group performed 800 air ambulance flights. With worldwide travel drastically slowing down in 2020 due to the rise and spread of the Covid-19 pandemic, the number of air ambulance flights has subsequently dropped as well; which means the assistance space has been impacted. Thanks to our network of air ambulances suppliers and to our agents, EA was able to safely transport all types of patients during this time, Covid-19 positive or negative. The visible consequence of the constraints on our air ambulance flights includes operational challenges such as longer time to be ‘take off ready’ and important impact on costs (up to 30-per-cent increase for complex and long-haul flights transporting Covid19+ patients).

There are additional constraints and challenges to overcome with the ongoing pandemic. In addition to Covid-19 tests being systematically requested, regional airspace may close without notice, and sometimes may remain closed for a certain period of time. Some countries have closed borders to certain nationalities, therefore increasing the complexity for the crew and sometimes impacting the patient. Lastly, some airports have closed or shutdown operations altogether; other ones are solely dedicated to entry in the country; with sometimes a very limited number of airports – as low as two available airports per country. All these factors are contributing to a complex situation building any assistance flight plan.

In addition, our teams have to manage administrative regulations that are constantly changing, often without prior notice, as well as flight protocol authorisations that are becoming more comprehensive, including, at times, authorisations from the local health authorities and agreements from foreign affairs departments. Hospital admissions have also been impacted by the Covid-19 pandemic, as governments identify facilities to become Covid-19-dedicated, which can make the admission process more complex.

This unprecedented situation has emphasised that it is essential to rely on strong networks while prioritising access to key information. The EA medical and travel networks team is putting a tremendous amount of effort in gathering and sharing key information pertaining to local situations with all the EA subsidiaries of the Group.