Crew resource management in SAR and HEMS operations

UK Coastguard
CRM - how do you do yours?

Alex Pollitt considers the issue of the exact roles and responsibilities held by helicopter technical crew, asking, if you’re not flight crew, what are you?

Some of the Technical Crew (TC) that I have worked with are considerably more experienced aviators than the pilots that they fly with. In my mind, TC are flight crew, and as such they have much more in common with pilots than they do with airline cabin crew. In a SAR aircraft, authority might be vested in the Captain, but leadership moves around the aircraft in different phases of flight. The crew is a team in every sense of the word, and the safety of the aircraft in flight is both the key role and the responsibility of everybody on board. But technical crew are not flight crew. Not at least according to the EASA definition of flight crew, which does not include crew members outside of the cockpit.

So what are you? You’re crew, and you fly, but you’re not flight crew. You work in the cabin, but you’re not cabin crew. Even the competent authorities are not sure what you are. So we start with a problem. What is actually meant by helicopter TC? Because of the huge range of jobs carried out by helicopter rear crew the term can mean different things to different people, so it’s worth pinning this down.

UK Coastguard

© Nick Martin

Defining TC: task specialist or aviator?

EASA defines a technical crew member as, “A crew member in commercial air transport HEMS, HHO or NVIS operations other than a flight or cabin crew member, assigned by the operator to duties in the aircraft or on the ground for the purpose of assisting the pilot during HEMS, HHO or NVIS operations, which may require the operation of specialised onboard equipment.”

That definition distills into a few lines a bewildering array of roles and functions that are carried out by helicopter TC worldwide across the gamut of rotary wing operations. For the purposes of further delving into the work that they do, it is helpful to break that definition down further into three groups:

1) SAR TC

2) HEMS TC

3) Helicopter Hoist Operator (HHO) TC

Each of these functions is afforded their own definition as follows:

1) A SAR TC is a member of the SAR crew (e.g. winch operator, winchman) other than flight crew who is assigned to a helicopter SAR flight for the purpose of operating specific aircraft and role equipment, assisting the flight crew during the mission and attending to any person in need of medical assistance.

2) A HEMS TC is a crewmember who is assigned to a HEMS flight for the purpose of attending to any person in need of medical assistance carried in the helicopter and assisting the pilot during the mission.

3) An HHO TC is a technical crew member who performs assigned duties relating to the operation of a hoist.

All of these definitions focus first on the nature of the specialist role that the individual brings to the aircraft, (i.e. winch operator/winchman/medic) and only subsequently mentions their function as part of the flying crew, (couching this in terms of providing assistance to the pilot). Notice that the second definition doesn’t consider the example of a non-clinical TC in a HEMS operations, and the third definition doesn’t define the role of the TC as anything other than an operator of the attached hoist, suggesting they have no further role to play in the crew environment in flight. However, ask a technical crew member to explain what it is that defines them as technical crew, and the answer is likely to relate first to their role as part of the flight crew; that is to say, a professional, non-pilot member of the crew integral to the safe operation of the aircraft; and secondary to that, their specific function on board.

US Air Force Photo - Technical Sgt. Chris Hibben - (c) DVIDS

US Air Force Photo - Technical Sgt. Chris Hibben - (c) DVIDS

Regulation, standards, and standardisation

As we have seen, technical crew are not defined as flight crew, which has led to the regulating authorities forging a subset of regulation under the title ‘Technical Crew’. This protects the individual and the operator from the demands of having to meet some of the same standards as pilots, with all the associated expenses and licensing questions. However, the ongoing debate over how these professional aviators should fit in to the existing regulatory framework has meant that the area of regulation covering TC has languished underdeveloped for some time, with some critical questions about their role and status still to be answered.

An example of this is the question of medical standards for TC, where EASA regulations only require TC to meet loosely defined medical terms such as, ‘be in good health’, have ‘adequate’ hearing and visual acuity, and ‘normal’ ear, nose, throat, respiratory, and central nervous system function. This is at the same time an imprecise standard, and one which some pilots who hold a full Class 1 medical certificate might not themselves be able to meet! Some operators now require their TC to hold a Class 2 aviation medical to prove a recognised medical standard, although this is still not required by regulation.

In the training and checking environment too, regulation has, until recently, been thin on the ground, and the de facto act of how to go about training and checking has been largely left to the operators. Last year, EASA acknowledged this, noting: “Feedback from stakeholders shows that the HEMS crew member training and checking varies significantly among operators. Operators that provide the most advanced training programmes use line flying under supervision, while operators that provide the minimum training…barely comply with the objectives of the rules. Training is essential considering the variety of backgrounds of the HEMS crew members, some of which have no aviation knowledge when they are recruited.”

It went on, “Rules put emphasis on a crew cooperation concept that is currently not developed.”

cornwall air ambulance

(c) Nick Martin

The development of professional status

This admission was part of an EASA Notice of Proposed Amendment (NPA 2018-4) which proposed to completely restructure the training and checking of HEMS crew members Europe-wide. Unfortunately, the breadth and complexity of the proposals has slowed progress, and it may be some time yet before changes to the rules work their way through the system.

Just as there is a recognition of the need for regulation in HEMS to catch up with the evolution of the industry, in SAR as well there is a general acknowledgement that the TC profession has reached a level of maturity that requires the development of guidance on professional status, and training in particular. In the UK, a working group is currently discussing amendments to CAP 999 (The UK CAA publication governing national SAR operations) with respect to SAR Technical Crew. Key questions are being asked on training and medical standards, such as: ‘who’s going to define the standard?’, ‘What should it look like?’, and, ‘what do you have to do to achieve it?’ It is likely that the award of a formal recognised professional qualification in the shape of a Technical Crew ‘Attestation’, will be the result of this process. This would be issued by holders of a UK national Air Operator’s Certificate, accredited by the competent authority, and provided on request for the purpose of inspection or verification.

Part of the problem in tackling these questions, particularly on training standards, is the range of roles played by technical crew members, and the vastly differing levels of training that they have been subject to, which varies according to the demands of the different roles and the standards of the operator. The chart at Figure 1 (below) serves to illustrate some of the breadth of roles, levels of training, and aviation experience out there, and it by no means attempts to be exhaustive. Worldwide, there will be every mix and permutation of training and experience operating in helicopters up and down the scales.

Traditionally, employment and remuneration as a TC in the SAR role has been based on aviation experience, and not on clinical skills, whereas in HEMS it is largely the other way round. Whether this is slowly changing as a result of both a greater emphasis on the level of clinical skills required, coupled with a diminishing pool of highly trained aviators with previous military experience, is a hot topic in the industry at the moment. It boils down to one question: What is the primary role of a TC in SAR/HEMS? Is it patient care, or is it the specific set of aviation skills you need to deliver clinical care in the aviation environment?

The medical role of the TC, from first aider to clinician, is of significance in flight in terms of how much the impact of their workload as a medic once airborne will necessarily detract from their capacity to carry out other aviation and crew functions; sometimes completely

The medical role of the TC, from first aider to clinician, is of significance in flight in terms of how much the impact of their workload as a medic once airborne will necessarily detract from their capacity to carry out other aviation and crew functions; sometimes completely. The evolution of HEMS towards H24 operations in the UK in increasingly complex aircraft such as the AW169, and particularly the shift to NVIS equipped flying is likely to lead to the development of a role for non-clinical TCs. This is a reflection of both the safety critical role that the TC plays in NVIS equipped night flight, and the distraction from this task that mental preparation for the medical considerations of attending a HEMS incident could provoke.

US Coast Guard - Petty Officer 1st Class Patrick Kelley (c) DVIDS

US Coast Guard - Petty Officer 1st Class Patrick Kelley (c) DVIDS

Aviator: the common thread

The common thread that links all TC is not their specialist function in the aircraft, but their contribution to the team that make up the flying crew. What are these other functions? I am referring to team behaviours and understanding the compartmentalisation of responsibilities. These include:

  • Understanding how and when to share your workload, and offload workload from others.
  • Contributing to mission planning and collaborative decisionmaking.

Pointing out of mistakes, and questioning. Being conscious of the way information and thought processes are shared and communicated within the aircraft. Awareness of ETAs, and of fuel planning and management.

Intuitively understanding the correct time to feed information forward to the pilot(s). Monitoring the actions and behaviour of the aircraft and the rest of the crew.

All of these things can be summed up in one term. Crew Resource Management (CRM).

Definition matters

So, is your CRM what defines you as a TC member?

I would argue that it is. My philosophy is that CRM is a kind of catch-all term for all the myriad skillsets that define what makes us aviators. A pilot is not a good pilot if they only have exceptional hands-and-feet flying skills. In the same manner, what makes a TC a truly good TC, is not their ability to operate a hoist or voice-marshal an aircraft. In actual fact, it is all about the other 90 percent. That is to say, your CRM behaviours. Get that part right, then in my mind you are Flight Crew.

Helicopter Technical Crew Roles and Training