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Solent NHS drone trials

The Isle of Wight NHS Trust and Apian are using drones to optimise the speed of delivery and access to chemotherapy for cancer patients.

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Frequently Asked Questions

What are the challenges with the existing supply chain and how will drones solve them?

Cancer patients on the Isle of Wight are dependent on the mainland for an ever-expanding range of chemotherapy. Chemotherapy must be delivered by ground courier to Portsmouth, then ferry to the Isle of Wight, then taxi to St Mary’s Hospital. Disruptions to the ferry service, including cancellations, delays and changing timetables, complicate deliveries and distracts staff with additional workload. Given the short shelf life of chemotherapy, this can occasionally result in the drug being wasted. It takes up to 4 hours to transport chemotherapy from the nearest chemotherapy pharmacy manufacturing unit at Portsmouth Hospitals University NHS Trust. Reducing this to a reliable 30 minute flight is transformative, minimising wastage and treatment delays, whilst also saving staff time that can be used for direct patient care instead.

Today, chemotherapy is manufactured before the patient has been clinically assessed and confirmed to be physically able to receive treatment on the day it’s due. In some cases, the patient’s condition can cause the treatment to be delayed and the chemotherapy to be wasted. An on-demand drone delivery service will allow for a sequential process where manufacturing doesn’t start until after the patient’s assessment, enabling more flexibility for both the patients and clinicians.

What are we transporting?

The main focus of the trial is to transport chemotherapy medication. Other items may be delivered including pathology samples, blood packs, prescriptions and medical equipment.

How often will we fly?

As the project progresses, the drones will have permission to fly across the Solent on Monday to Thursday between 14:00 and 18:00 and on Fridays between 10:30 and 14:30. This schedule has been devised in partnership with the CAA (Civil Aviation Authority) to minimise impact to other aviation stakeholders.

What route will the drone take?

The CAA has approved a route between Portsmouth Queen Alexandra (QA) hospital’s helipad to Baker Barracks on Thorney Island to St Mary’s Hospital (SM) helipad on the Isle of Wight. The flightpath has been designed to minimise impact on other stakeholders within the region such as residents, Chichester Harbour’s Site of Special Scientific Interest (SSSI), maritime activity and other aviation. The drone is flown in a segment of airspace the upper limits of which are 850ft.

What are the flight distances and flight times between the sites?

The flight distance from QA to SM is 47km. The expected flight time is 30 minutes.

What are the characteristics of the drone?

We will be using fully electric, vertical take-off and landing (eVTOL) aircraft. It can take off and land vertically like a helicopter while being able to transition into horizontal flight like a plane by combining fixed wings with rotors. It has a flying time of up to 1.5 hours on a single charge with a maximum speed of 100mph. It weighs 100kg, has a wingspan of 5 metres and can carry up to 20kg of payload. The drones were designed and developed by Skylift, who were selected by Apian to be the project’s drone operators. Phase 3 introduces a second drone operator, Modini. They will be using a hybrid VTOL drone which has a width of 2.1 metres, a maximum speed of 70mph, weighs 15kg and can carry up to 9kg of payload.

Who will fly the drone?

The drones are autonomous, but will be continually monitored by up to three trained safety pilots who will oversee the flight of the drone along the route. One pilot will be based at the take-off location, one at the landing location and the other at our command and control centre under conditions approved by the CAA. These pilots are able to take full control of the drone at all times.

What permission do we have to fly?

The CAA, the UK’s aviation regulator, has granted us permission to fly in segregated airspace provided by a Temporary Danger Area (TDA). The goods will be transported in accordance with Air Navigation (Dangerous Goods) Regulations 2002.

Can the drone fly in bad weather?

As a general rule, we can fly in the same weather conditions as helicopters such as the Helicopter Emergency Medical Services (HEMS).

Has this ever been done before either in the UK or similarly overseas?

Deliveries of medical supplies are being successfully carried out by drone overseas in segregated airspace, for example in Rwanda. However, Beyond Visual Line of Sight (BVLOS) drone flying is only being carried out in the UK where operators can demonstrate a strong safety case to the CAA, for example in Argyll & Bute. In the Solent, trials occurred in 2020 with Windracers using a fixed-wing petrol drone taking off from Lee-On-Solent airfield and landing at Binstead Airfield.

The CAA guidance on BVLOS flying may be found here.

How safe are drones?

Aviation is safer than road transport. There have been no known collisions between small drones and manned aircraft in the UK. The CAA’s analysis indicates two incidents of proximity per million flight movements and, for this specific risk, the likelihood of an actual collision would be considerably less than this. The average fatality rate for passengers carried by UK operators is 1 in 287 million. In comparison, in the UK there is a 1 in 17,000 chance of being killed in a road accident and a 1 in 19 million chance of being killed by a lightning strike. With regards to the risks to other airspace users, the CAA’s CAP722 highlights three options for operating unmanned aircraft BVLOS: Prove that the intended operation poses no aviation threat Demonstrate a technical capability at least equivalent to ‘see and avoid’; Operate in airspace segregated from other users References:

What happens if something goes wrong?

As part of gaining approval to fly, we have worked through scenarios where things go wrong and documented Standard Operating Procedures. All events will be recorded and reported to the relevant authorities, including the NHS, governing bodies and the CAA. Apian has overarching responsibility for the trial and will be on-call 24/7 to address any problems. Our flight route, procedures and equipment has been selected and approved by the CAA with the assurance that we have taken all the appropriate measures to de-risk the operation as best we can.

What happens if a package is accidentally dropped, or the drone malfunctions?

Approval by the regulator (the CAA) is subject to the submission of a robust safety case. There is no risk of the package being dropped as it is in the hold of the drone. The drone is extremely safe and the drone's systems have passed CAA scrutiny. The drone has a deployable parachute that automatically inflates in the event of a malfunction and multiple redundancy systems onboard to remove single point of failures.'

How noisy is the drone?

During takeoff, landing and hovering drones are comparable in sound to a lawnmower. When cruising in forward flight under the power of the propeller, the noise is barely audible.

How are they currently getting medical supplies onto the Isle of Wight? Why not increase support for that?

The majority of medical supplies in and out of the Isle of Wight will continue to be carried by existing logistics operators, using the existing ferry services. Drones have an advantage in their speed of response and will provide a just-in-time (JiT) logistic option for carrying urgent and/or time dependent small-consignment medical supplies.

Is it safe to fly chemotherapy by drone?

Southampton University and King's College London have been researching the impact of drone flight (e.g. vibration and temperature) on redundant chemotherapy and found that the product remains stable throughout the drone flight. As a result, the NHS approved flying real medication destined for patients. Given guidance from the Medicines and Healthcare products Regulatory Agency (MHRA), we will only transport chemotherapy-related (non-UN1851) products that are not classed as Dangerous Goods on account of the low level of oral and dermal toxicity. The CAA has given permission for the carriage of dangerous goods in the form of human blood samples classified as UN3373. The goods will be transported in accordance with Air Navigation (Dangerous Goods) Regulations 2002.

Are there any specific packaging requirements for the drugs?

Yes, the packaging must meet the requirements of UN3373 and Packing Instruction P650. In order to do so, we have partnered with Versapak whose water tight insulated medical carriers adhere to the regulations governing the transportation of diagnostic specimens, providing infection protection and thermal insulation. The packaging selected has a higher specification than that used on current ground based logistics. Chemotherapy spillage kits are located at every site along the supply chain.

Does the drone have cameras?

Our drones are equipped with a camera for remote piloting purposes only. The camera provides an additional layer of safety and control for the operators to refer to live video footage when piloting the drone remotely. Captured data is used for quality improvements in both logistical efficiency and airspace routing, which will be stored securely for auditing purposes. No video content is retained.

Who is the team behind this trial?

This is a joint effort between Isle of Wight NHS Trust, Portsmouth Hospitals University NHS Trust, Solent Transport, University of Southampton, King's College London, Skylift, Modini, the Ministry of Defence, UKRI and Apian (the project leader).

Who is funding the trial?

Apian is privately funding the trial with support from UK Research and Innovation (Drone Solutions for COVID-19: Innovate UK Article 25 Strand) and Solent Transport. No NHS Trust funds are involved in this project.

Where is the base of operations?

Thanks to the generosity of the Ministry of the Defence, the drones will be based at the British Army’s Baker Barracks, home to the 12th and 16th Regiment Royal Artillery, located on Thorney Island.