True to type, the Royal Flying Doctor Service in WA has stepped up with the support of WA’s business community to invest in additional personnel, aircraft, equipment and technology to anticipate surges in demand as a result of COVID-19.
Fulfilling RFDS founder Rev John Flynn’s vision to provide a ‘mantle of safety’ for the people of the bush, the organisation’s commitment to regional and remote communities affected by COVID-19 has been a razor sharp focus over the past two years.
As the first aeromedical service in WA – the world’s largest health jurisdiction – able to transfer COVID-19 affected patients, the RFDS has taken significant steps to ensure the organisation is prepared to respond to outbreaks across the state.
To date, the RFDS has safely transferred 143 patients in regional WA with suspected or confirmed COVID-19. An additional layer of their co-ordinated response is an ongoing community-led COVID-19 vaccination program to isolated and remote communities across WA.
For instance, the RFDS remote COVID-19 vaccination team has travelled to the Ngaanyatjarra Lands in the far east of the Goldfields region several times over the past six months to administer vaccines, provide education in the community and assist local health services to provide vaccinations to some of the state’s most isolated Aboriginal communities.
“The RFDS has five bases which are strategically positioned across Western Australia. Each base is fully equipped and staffed with highly trained doctors, flight nurses and pilots who are ready to take to the sky at a moment’s notice to help people in need of our care,” said Rebecca Tomkinson, Chief Executive Officer, RFDS WA.
“Thanks to the ongoing support of government, our corporate partners and the generous WA community, we have been able to boost our workforce, aircraft fleet, equipment and technology to prepare for surges in demand as a result of COVID-19.”
The 20 per cent increase in workforce includes doctors, flight nurses, pilots and engineers. In 2021, 141 new doctors, nurses, engineers, co-ordinators and support staff were recruited.
The RFDS WA aircraft fleet is now the largest of its kind in Australia with 22 assets including four new aircraft added in the past year. The new aircraft include a new Pilatus PC-12 aeromedical aircraft supported by the Chamber of Minerals and Energy WA, a third Rio Tinto LifeFlight jet and the introduction of two EC-145 helicopters to form the new Fortescue Heli-Med Service – a first for the RFDS anywhere in Australia.
RFDS Team Members have banded together to respond to COVID-19
Alongside extra crew members and aircraft in the air, new technology has been introduced to enhance infection control for safe and efficient aeromedical transfers. The RFDS continues to evolve best practise clinical guidelines for COVID-19 transfers, based on the latest evidence and testing to meet the needs of aeromedicine in WA. All RFDS COVID-19 retrievals are conducted with the highest clinical governance, with the health and safety of crew and patients of the highest priority.
The ongoing work of the RFDS to retrieve patients in conjunction with its partners in health from across the state during periods of ongoing outbreaks requires very special procedures.
“Crew members don professionally-fitted masks, face shields, gowns, gloves and boots, often in hot conditions, multiple times per day,” said Ms Tomkinson. “There are strict guidelines on how this PPE is worn and taken off to avoid possible contamination. It is mandatory for all frontline crew to carry out regular infection control training, including rehearsing our complex donning and doffing procedures.
“The RFDS was the first aeromedical service in WA able to transfer COVID-19 patients and we stand prepared to support the health needs of regional WA communities throughout the pandemic and beyond.”
Plans to expand this unique offering go well beyond extra capacity in the air. Establishing a dedicated facility for all patients with infectious diseases, including COVID-19, at each of the RFDS bases is next on the agenda.
“A dedicated new facility will be attached to each existing RFDS base to enhance safety and streamline transfers of regional COVID-19 patients to definitive care,” said Ms Tomkinson. “There will be a purpose-built resuscitation area suited to treat patients with respiratory and infectious diseases, as well as crew facilities and equipment for doffing and disposing of contaminated PPE.”
“We have new UV light and fogging technology to decontaminate equipment and have implemented an airflow design to prevent contamination in adjacent aircraft hangars or clinical areas.”
Once a COVID-19 patient has been received on the ground, they will be cared for in a separate patient transfer area which is equipped with facilities to keep them comfortable and ensure direct access for safe ambulance handovers.
There is also appropriate storage and refrigeration for medicines, equipment and PPE – all designed just for this bespoke purpose.
“Our entire team has been busy preparing for this response over the past two years and I am incredibly proud of their dedication, hard work and innovation,” Ms Tomkinson said.
“Western Australia has done an excellent job in managing the pandemic so far, but there is still uncertainty about its trajectory.
RFDS immunisation nurse Amy Kerr and Kate Jones with pilot Ben Hadet in the remote community of Kiwirrkurra
“What we do know is that in a state where we are challenged by our unique geography, working in partnership with our community and organisations across the health system gives us the capability to adapt quickly to the evolving situation for the benefit of our patients.
“We will continue to prepare, plan and practice with our health service partners including Aboriginal Medical Services, the WA Country Health Service and the State Health Incident Coordination Centre to deliver the most effective and co-ordinated response to COVID-19 while also meeting the wider health needs of regional and remote WA.”
Lessons learned from other states’ responses to outbreaks has informed RFDS WA’s planning, with a focus on participating in scenario planning and exercises with health and emergency service partners to prepare as much as possible.
“We also recognise the uniqueness of each community, its population and resources and the importance of engaging with early and effective communication at the local, regional and state levels.”
Ensuring remote communities across WA continue to have access to vaccines to give them the best protection possible remains an important element of the RFDS’ role in managing future outbreaks, as well as looking after their own people and supporting their workforce as each eventuality unfolds.
“We will continue to transport and administer COVID-19 vaccines to remote and regional communities and support our regional hospitals by retrieving ill COVID-19 patients requiring higher levels of care,” said Ms Tomkinson.
When visiting and working in many varied Aboriginal communities – some of which are extremely remote – RFDS clinicians seek the advice and permission of Elders and are proud to have built trust and strong relationships.
“So far, our team has administered more than 10,000 vaccinations to people from all walks of life in remote locations. This includes people living on cattle stations, tourism and hospitality workers, mine site workers, remote Aboriginal communities, and remote area health care and emergency services personnel.
“We are totally committed to supporting people living in remote and rural Western Australia, just as they have been supporting the RFDS for more than 90 years.”