Sitting atop Whitechapel's Royal London Hospital, in a base that rivals the villa of Tracy Island – or the penthouse of Avengers Tower – a group of the capital's unsung heroes a grabbing a well-earned rest.
Complete with helipad, world-class medics, cutting-edge equipment and some more than adequate tea-making facilities, this is the high-rise base of operations for London's Air Ambulance (LAA), the mobile emergency service for time-critical, life-threatening situations anywhere within the M25.
People in orange jumpsuits mill around waiting for the emergency siren. The atmosphere is calm and pleasant, but at any moment the crew will be despatched by helicopter to respond to one of the 3,500-plus 999 calls made in London each day, taking on the most urgent jobs in which a normal ambulance simply might not be fast enough.
So what sort of individual is able to work in such a demanding environment? One such person is the Duke of Cambridge, who began his new job at the East Anglian Air Ambulance, one of 18 UK services, last week. A former RAF search-and-rescue helicopter pilot, Prince William, 33, who will be based in Cambridge, will respond to the most urgent of the 1,500-plus calls the EAAA receives each year. Last week he flew his first EAAA mission after a man in his fifties suffered a heart attack in Felixstowe, Suffolk.
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Captain Neil Jeffers of the London Air Ambulance
In London, average flight times for the LAA are around six minutes, and usually no more than 15. A typical road ambulance journey takes around 40 minutes. In major trauma cases, those extra minutes count: in the UK, 3,000 people die each year because they do not receive the required medical facilities and treatment quickly enough.
The daily pressures and tragedy that unavoidably accompany such a job would take their toll on the majority of us, yet they are part of the appeal to members of London's Air Ambulance, which receives applicants from doctors all over the world.
The LAA's Chief Pilot, Captain Neil Jeffers, is all too aware responsibility and privilege of being part of the charity (the London Air Ambulance, founded in 1989, relies heavily on donations from the public).
The London Air Ambulance takes to the air near Tower Bridge
We walk past a whiteboard, upon which the last ten days' worth of missions are documented. Gunshot wounds, multiple stabbings, construction accidents and people under trains are just some of the incidents this team have attended in the last ten days. So this reinforces my curiosity: What does it take to do this every single day?
"There is a paradox in air ambulance pilots," explains Jeffers. "We know that if we’re tasked, then someone’s injured. But we want to be tasked. We see a lot of blood and guts – much more than most people would imagine – but I think we get desensitised to that."
However, ten years ago, when Jeffers began to fly for the Air Ambulance, it was not the physical injuries that took him by surprise. "I was not prepared for the emotional side – because that is something you do not expect. The bonds between mother and babies and children. There can be some pretty tricky events out there."
Jeffers is all too aware of the horrors and accidents that occur in the world on a daily basis, yet he is equally aware that without the Air Ambulance, there would be a lot less hope for those affected or injured.
Prince William now works for the East Anglian AirAmbulance (Photo: PA)
Despite the currently calm atmosphere, the Captain recounts tight situations that could have been lifted straight from a high-octane action film - powering into a thunderstorm to save a lightning-struck crane worker, flying near-blind through the city in thick falling snow, being forced to land on Piccadilly Circus at rush hour without ground support.
There are lighter moments too. "On the Queen’s birthday fairly recently," Jeffers chuckles, "the Red Arrows went through, and we were on a mission that we were tasked with just beforehand. The air traffic controller said to us 'would you like us to divert the Red Arrows?' - because we had priority. But we worked with them; we talked to them in flight."
Navigating the urban jungle was another facet of the job that appealed to Jeffers. Being city-based, landing can be an incredibly unpredictable task. "I think that the Air Ambulance role is unique in that we get to land effectively anywhere, within reason – whereas the police would not have that opportunity. The extra challenge of surveying and then landing where you like is a unique part of the job we do."
Captain Neil Jeffers atop the Royal London Hospital's helipad
So what does Jeffers look for when it's time to touch down? "Bridges, box junctions and multi-storey car parks are good. Hyde Park, St. James’ Park and sports pitches or fields." The Captain describes a moment several years ago when they landed on a deserted tennis court – only to find the compound locked up so tightly that even their bolt cutters couldn't get them out. "We had no choice but to go back to the helicopter."
The helicopter itself, a bright red flying hospital, is stocked with some of the most innovative and pioneering medical equipment on the planet. Despite the obvious challenges of operating a medical service as a charity, one benefit of the Air Ambulance's independence is its scope for spearheading new and ground-breaking techniques.
One of these procedures is REBOA(resuscitative endovascular balloon occlusion of the aorta), a pioneering new method of preventing trauma patients bleeding to death by inflating a small balloon inside their blood vessels. Just last year, London's Air Ambulance became the first team to administer a pre-hospital REBOA – and save a life as a result. Introducing new equipment and techniques in hospitals sounds daunting enough, but by the roadside?
"One of the first things I thought when I first came here was that it was all going to be super rushed. The patient comes first, everything has to be done super quickly – we’ll have to cut corners – it’s an emergency. When actually there’s none of that. It is extremely level-headed. In fact we have to manage our adrenalin. It’d be all too easy to know that there is a critically ill patient somewhere, and that their minute-to-minute is going badly and to rush into something that you shouldn’t do."
London' Air Ambulance on its Whitechapel helipad
Captain Neil Jeffers is a calming influence. Though he discusses the future of Air Ambulances with me – in 50 years' time he believes that medical drones may be saving the injured from battlefields and disasters – he gives the sense that he has simplified his work into a day-by-day, mission-by-mission responsibility.
The word "compartmentalisation" is bandied around, but for Air Ambulance workers it's truer than for most. Everybody has their own job to do, and everybody does it right.
London’s Air Ambulance is currently raising money for a second helicopter. Fifty-five days of necessary maintenance put the existing craft out of action last year. The team are conscious that lives could be lost during this time, so are fundraising with the hope to buy a second helicopter.
The emergency siren sounds and the team kicks into controlled action. Jeffers recites their mantra: "Slow down, we're trying to go fast". Up on the roof, the helicopter takes off and soars away into the sky, to save a life and to serve the city.
London's Air Ambulance is a charity currently fundraising for a second helicopter. Please donate at yourhelicopter.london or text HELICOPTER to 70800 to donate £5.