So today the press is full of Apian‘s achievements with regards flying pathology samples between Guys and St Thomas’ Hospital in London.
https://www.thetimes.com/business-money/technology/article/nhs-drones-fly-blood-samples-in-uk-skies-for-first-time-rjxqprk8s
It is great to see a BVLOS trial like this happening as it shows that the CAA’s Airspace Change process finally working to enable Temporary Restricted Airspace over central London.
The process from application to flying took 469 days, which we must applaud the CAA for, for at this rate, and with the Earth and Mars soon to be in opposition, SpaceX will have launched samples to Mars, before the CAA enable BVLOS flight as standard in the UK.
But if we look a little closer to what Apian are doing in central London, the “need” doesn’t really make sense to me.
Google tell us the cycle time is 14 minutes between the hospitals.
I’d moot that an Deliveroo cyclist could make the transfer from lab to lab in under 14 minutes, bearing in mind their blatant disregard for the red lights, and quicker than the time it takes for Wing to make the delivery, allowing for packaging for flight, porterage and handover.
Also bear in mind the wait time for the transport package to fill up with the patient samples, 20 per tube… Unless 20 patients are having their blood drawn simultaneously, then the improvement figures Apian quote, are in reality, somewhat suspect.
Last year Tom Cherrett from Southampton Uni, who probably knows the most about this subject published a paper “Multi-modal multi-echelon logistics optimisation planning for medical interchanges in the Solent region of the UK using drones, cargo bikes, and vans” which modelled and optimised an NHS network using vans, drones and bikes and concluded that:
“The number of vans needed to service GP surgeries/ local hospitals was reduced from 10 vans per day to a maximum of 4 vans, 2 drones and 19 cargo bikes per day”
And having worked on the Morecambe Bay network, I would concur that for around urban settings e-bikes make much more sense than drones, as they can make multiple pick ups from GP’s CDC’s etc and not require any infrastructure, staff training etc.
In fact the only times to use the drone, we found, was when:
the mode of transport changed – i.e. you had to cross water
when road transport, preferably electric, was unavailable, such as the A590 around Morecambe Bay being closed.
But the key issue I have with Apian‘s operations is that the business model just doesn’t work.
These are my top 5 reasons behind this thinking:
The NHS is not a National Health Service, it’s a postcode lottery illness service. Pathology is an area that is meant to be regionally optimised but in reality, is run by individual hospital trusts, some outsourcing some types of testing to commercial operators, some outsourcing other types of testing to other labs at other Hospital Trusts. So what may work for Guys and St Thomas’ will not work elsewhere. There is no standard business pathology format across NHS England. I evidence this by the lack of progress on the NHS Pathology Networks programme.
Human accountability – with Deliveroo, there would be a human travelling with the samples, who can evidence what happened to them if there is a crash. This is really key as if a patient’s blood samples are lost through drone transit, the impact on the patient is huge, the duplication of the patient and phlebotomist time and the negative perception is huge. This is why drone delivery works for Manna in Ireland, if they misplace a customer order for a burrito, they can dispatch another and no one has a problem.
Effort v Reward – Other than we should always look to improve efficiencies of services is there any real benefit to getting a blood sample tested in 10 minutes as opposed to 30 minutes, the only real benefit we could find to speeding up sample transfer times was for pharma samples travelling on a Monday morning to release bed blocking patients that had been there all weekend.
Weather – and this is IMHO the biggest hindrance, we live in a cold, wet country! We’ve had an anticyclonic gloom holding over the UK for the last few weeks, are Wing cleared to fly BVLOS IFR? I genuinely don’t know, but I suspect not. On Morecambe Bay, mining the last 10 years METAR’s we concluded that our service level availability was actually only around 80%, with 20% of the time the drone not able to fly owing to reduced visibility, high wind and torrential rain. (admittedly this was for 20km fixed wing VTOL Cross Bay flights and not 2.2km Multirotor flights across town) For those 20% of the journeys the van would have to take up the slack.
Cost – is the cost of installing and operating a drone service, such that Apian promote, really cheaper than just equipping the labs at both hospitals with enough equipment to process all samples on site? or by sending samples by courier? What is the cost of the Wing operation compared to sending an e-bike courier? This was one aspect of the NHS we found on Morecambe Bay, where the transport need was generated by a previous pathology network optimisation process, which distributed the pathology labs abilities to process all samples across multiple hospitals…
In summary, the business model behind the @Apian use case being flown here in London just doesn’t add up to me.
It’s great to see the CAA justifying Airspace Regulations existence with TRA’s and it should move the UK closer to BVLOS, but you only have to look at @Bobby Healy’s Manna in Ireland flying in Geographic Zones to realise that we’re using business cases that don’t make commercial sense to struggle our way through the regulatory hurdles to mass BVLOS adoption and we’re still years behind Europe.
But Hey, having Wing fly in the UK must be cool right?
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