Dedicated Sim for Flying Doctors

Twenty-four-hour emergency medical service to people spread over an area of 7.69 million square kilometres – that’s a very big waiting room! Keith Morgan reports on the new RFDS training facility in Dubbo.

An Australian icon, the Royal Flying Doctor Service (RFDS) first flew in 1928. The vision of founder (the Reverend) John Flynn was to create a “mantle of safety” for those in remote areas of outback Australia. Leased from Qantas for two shillings a mile, a de Havilland biplane made 50 flights and treated 225 people in that first year of RFDS operation.

The not-for-profit RFDS today is one of the largest and most comprehensive aeromedical organisations in the world. In the 2018-19 financial year, RFDS assisted 370,706 people through clinics, telehealth, aeromedical and non-emergency road transport. It conducted 21,323 nurses, GP and dental clinics and flew 27,286,414 million kilometres in a fleet of 77 aircraft.

An FTD of Their Own

In October, RFDS launched a new state-of-the-art training facility at their RFDS South Eastern Section base of Dubbo, Central Western New South Wales. The multi-purpose facility includes a visitor experience centre, medical and health training facilities and a training centre incorporating class and meeting rooms and featuring a TRU Simulation + Training Beechcraft King Air 200/350 Level 6 FTD fitted with Proline Fusion Avionics.

“Acquisition of the TRU device is a first for the Flying Doctors during its 91-year history,” said Glenn Todhunter, Head of Flight Training, Aviation Training Team, RFDS South East Section. “From outsourced to in-house simulator training not only allows us to tailor specific training programmes that reflect our single-pilot IFR operations, it will greatly enhance the value of our donor funding. Our own TRU FTD provides three times the training for every dollar compared to training provided by third-party vendors. This will also allow us to explore providing training to other regional King Air operators in an effort to reduce the cost of ownership and operation. It may also help contribute to the organisation’s bottom line.”

The management of training is in good hands with Todhunter, a retired Army Major and pilot with clear values and a strong desire to deliver quality-structured and evidence-based training that recognises the unique demands placed on the pilots and crews of the RFDS. These include short notice trips at any time, day or night, often to austere and basic airstrips. RFDS crews’ threat and error management is critical in what is an exceptional single-pilot IFR twin-turbine day/night operation in ever-changing circumstances of weather, patient acuity and treatment. Managing both fatigue and risk, often during back-of-the-clock operations, and coordination with the destination ground-based medical facilities and services all add to the demands on RFDS crews.

Pilot Shortage Challenges

The challenge of mission flying with the RFDS has, to now, been assisted with attraction and retention of a mature cohort of experienced and talented aviators; however, the global shortage of pilots and the steady bleed off to airlines is ever present. The South Eastern Section currently outsources about 400 training hours per year of initial and recurrent simulator training for the 60 line and management South Eastern Section pilots. Todhunter plans to increase his flying instructor numbers next year to facilitate growth to South East Section’s flight training needs, with possible increases to rate of effort due to increased pilot turnover whilst concurrently building a saleable capability.

Todhunter said the South Eastern Aviation Leadership Team continues to foster a strong working relationship with the TRU team from Florida, USA, who have been extremely supportive in establishing the FTD with a full suite of proprietary software that has fidelity and capability well in excess of the Level 6 requirements. The RFDS training team is also collaborating with the Australian regulator, CASA, to assist and play its part in transition to the full ICAO regulatory suite for assessment and qualification of FTDs and FFSs.

What is on the future agenda for RFDS South Eastern? “We plan to integrate trend data from our internal Quality & Safety Team who monitor our flight data analysis programme. Flagged events and trends can be used to inform part of a new evidence-based cyclic training programme to be run over three events per 12-month period. This plan is quite ambitious as it represents a new and transformational training philosophy that is dependent upon sufficient pilots to maintain roster coverage for core service delivery.

One of the three cyclic events will be an Operator Proficiency Check which, at this stage, will be completed in a third-party FFS. RFDS are working toward realising “all-of-crew” synthetic training events connected real time via distributed simulation. Connecting the FTD via video and audio feeds with a re-purposed King Air Fuselage Aeromedical Cabin Trainer will permit introduction of complex aeromedical and emergency training scenarios for pilots, flight nurses/doctors as well as offer training of staff from other RFDS bases,” according to Todhunter.

The leap forward to in-house training using the new TRU FTD is an Australian and RFDS first. It is supported by a clear vision to grow a sustainable, modern, technology-based and compliant training system engaging TRU, FlightSafety, Textron Aviation Training and CASA in meaningful partnerships to ensure success. “We are adopting a risk-based approach to developing our in-house training capability. This is to ensure quality of training delivery is maintained during a period of incremental and sustainable growth. It is vital that capability and expectations are clearly communicated to all internal and external stakeholders during this next crucial chapter for the RFDS”, Todhunter said.

A Unique Head of Training

Major Todhunter is the only bilateral amputee aviator to serve in the history of the Australian Defence Force. He lost both legs below the knee following a training aircraft accident in 1995. After an arduous eight-year journey to rebuild his life, he has flown both fixed- and rotary-wing military aircraft. He is an active member of amputee and disability support groups, and speaks regularly on school visits and at public events. Glenn is the only non-doctor to be awarded lifetime honorary membership to the Australasian Society of Aerospace Medicine.

RFDS King Air Set-up

Custom Cabin: Two stretcher beds and three seats in a variety of configurations. The standard passenger door is replaced with a large cargo door to facilitate patient loading and unloading.

Cockpit: The standard aircraft installation allows for two pilots; however, the RFDS typically operate in single-pilot configuration. In addition to the normal aircraft systems, the aircraft is fitted with an additional battery to provide medical power, a medical oxygen and suction system, and an intercommunication system between the cockpit and the medical staff in the cabin.

Staff: A Flight Nurse is usually on every flight and in cases where the patient is seriously ill, a Doctor is also present. Other passengers can include sitting patients, accompanying relatives or specialist medical staff.

Published in CAT issue 6/2019