Ambulance Paramedics and SES personel treat and prepare to move a spear fisherman at Storm bay.

Ambulance Paramedics and SES personel treat and prepare to move a spear fisherman at Storm bay. Photo: David Hall - Kiama Independant

The Snowy Hydro SouthCare rescue helicopter faces a shake-up of its role in the NSW aeromedical service under the recommendations of a new report.

The Canberra-based service could find itself flying all the missions for a new "super region" covering the vast southern half of the state or could lose its contract altogether as new deals are sought by the state with helicopter providers.

Snowy Hydro Southcare is a non-government service provider, one of several that flies under contract to the NSW government. The ACT-based flyers carry out about two-thirds of the missions flown in the state's southern and Murrumbidgee health districts.

Ambulance Paramedics treat a spear fisherman who got into difficulties in the water  in Storm bay at Kiama on Tuesday, January, 2.

Ambulance Paramedics treat a spear fisherman who got into difficulties in the water in Storm bay at Kiama on Tuesday, January, 2. Photo: David Hall - Kiama Independant

But under the recommendations of the review to the NSW health ministry by accounting firm Ernst & Young, Southcare may have to bid for a contract to service the entire southern half of the state, with no guarantee of success.

The long-awaited report has found there will be a 23 per cent increase in demand for the state's medical helicopter fleet over the next decade and unless changes are made, mission response times will significantly deteriorate in Sydney, Wollongong, Newcastle and central and northern NSW.

Major proposed changes include:

Ambulance Paramedics treat a spear fisherman who got into difficulties in the water  in Storm bay at Kiama on Tuesday, January 2, 2012.

Ambulance Paramedics treat a spear fisherman who got into difficulties in the water in Storm bay at Kiama on Tuesday, January 2, 2012. Photo: David Hall - Kiama Independant

■ Ceasing winching operations out of Wollongong and Tamworth and restricting them to just four bases: Sydney, Canberra, Newcastle and Lismore.

■ Investigate moving the Wollongong service to a planned mega-base in Sydney.

■ Review the future of the Lismore service once a new Gold Coast retrieval service is established.

■ Increase operating hours and staffing levels at Orange, Tamworth and Newcastle bases from 2014.

■ Slash the number of dedicated aeromedical regions from five to two.

The NSW helicopter fleet is deployed to serious emergencies and flies rural and regional residents to large hospitals when their condition worsens or a local hospital cannot provide specialist treatment. It flew more than 3300 missions in 2011.

The proposed changes may spark a backlash from many regional communities already concerned they are not adequately serviced by aeromedical services. Ernst & Young claims restricting winching to just four bases would add another eight minutes to the maximum time it would take to reach any NSW emergency scene.

NSW is serviced by five different types of helicopters. The state's fleet totals 15. The review recommends two models of identically configured helicopters.

"It is estimated that this strategy, combined with changes to the number of existing regions and helicopter operators could result in reducing the fleet from 15 to 12 helicopters and the number of back-up helicopters from six to three with the potential to deliver a recurrent annual saving of around $6.7 million," the report found.

Taking into account the potential savings and cost of implementing the other recommendations in full, the cash-strapped NSW government will need to find another $7.3 million a year by 2020 to pay for medical helicopters.

A NSW Health spokeswoman said the report had been sent to about 150 stakeholders for comment. They include the Ambulance Service of NSW, clinicians, a critical care taskforce, hospitals, unions and MPs.

The government says it will release its response to the review once the formal submission period closes in February.