Helicopter Emergency Medical Services (HEMS) are a useful means of reducing inequity of access to specialist emergency care. The study was written by Angharad  Jones, Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, UK.  Michael John Donald, Departments of Emergency and Retrieval Medicine, Ninewells Hospital, Dundee, UK and Jan O Jansen, Center for Injury Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA with the aim to evaluate the variations in HEMS provision across Europe, in order to inform the further development of emergency care systems.

A survey of primary HEMS in the 32 countries of the European Economic Area and Switzerland was carried out. Information was gathered through internet searches (May to September 2016), and by emailing service providers, requesting verification and completion of data (September 2016 to July 2017). HEMS provision was calculated as helicopters per million population and per 1000 km2 land area, by day and by night, and per US$10 billion of gross domestic product (GDP), for each country.

The interesting results showed that in 2016, the smallest and least prosperous countries had no dedicated HEMS provision. Luxembourg had the highest number of helicopters by area and population, day and night. Alpine countries had high daytime HEMS coverage and Scandinavia had good night-time coverage. Most helicopters carried a doctor. Funding of services varied from public to charitable and private. Most services performed both primary (from the scene) and secondary (interfacility) missions.

The report concluded that within Europe, there is a large variation in the number of helicopters available for emergency care, regardless of whether assessed with reference to population, land area or GDP. Funding of services varied, and did not seem to be clearly related to the availability of HEMS.