Evaluation of an Emergency Medical Retrieval Service in the West of Scotland
- Aug 27
- 2 min read
Imagine living in a remote community and facing a medical emergency—time and expertise are everything. That’s where Scotland’s Emergency Medical Retrieval Service (EMRS) comes in. This physician-led, air-based service, responding by helicopters and airplanes, was designed to bring advanced medical care to critically ill or injured patients in rural and remote areas, ensuring they get the right care, fast. This service was built upon and operated as a complement to the existing paramedic-delivered air ambulance system. EMRS teams are staffed with a consultant physician and a critical care practitioner who come from either nursing or paramedic backgrounds. Between 2008 and 2009, the Scottish Government evaluated a pilot EMRS program in the West of Scotland. The findings were pretty impressive.
Over the pilot program that year, EMRS completed 222 retrievals - mostly transferring patients from rural facilities to urban hospitals. Clinical outcomes were strong, with estimated Quality Adjusted Life Years (QALYs) gained per patient ranging from 0.47 to 3.5. Even under conservative estimates, the cost per QALY was reported to be well below the upper limit threshold for good value in healthcare.
Plus, both health professionals and patient representatives were overwhelmingly positive when surveyed on the service. EMRS was seen as a lifeline—improving outcomes, easing pressure on local staff, and reducing the need for rural clinicians to leave their communities to accompany patients on long transfers.
British Columbia faces similar challenges in delivering emergency care to remote and rural communities—from the Gulf Islands to the northern interior. Like Scotland, BC has vast geography and limited access to specialist care in many areas. Scotland’s EMRS model shows that bringing care to the patient, rather than always moving the patient to care, can improve outcomes and offer good value for money. It’s a compelling case for investing in mobile, consultant-led retrieval services—especially as BC continues to rethink rural health delivery.
