Moving medical supplies via drone was once a farfetched idea, but there are now multiple projects working to make it a reality. Kathy Oxtoby considers five case studies from the UK and the Netherlands to determine the benefits for clinicians, patients and healthcare systems, as well as the remaining challenges and future potential of drone transportation within the healthcare landscape.
With rising waiting lists, ongoing staff shortages and mounting pressure on hospital teams, it is increasingly vital that care is delivered faster and more efficiently to patients. Greener, more sustainable care is also a priority, with the drive to achieve a net zero NHS by 2040.
One approach that has the benefits of both faster delivery and sustainability is the use of drones – also known as unmanned arial vehicles or UAVS. Drones are already transporting medicines to remote areas in such countries as Rwanda, the United States, Australia and India.
In recent years, the NHS has been trialling the use of drones for a variety of purposes, including delivering medical supplies of blood packs and chemotherapy, transporting lab specimens, and more.
For Professor Claire Anderson, Royal Pharmaceutical Society president, the Covid-19 pandemic and recent advancements in technology have made the drone transportation of medical supplies eminently possible, and the benefits are clear.
‘Drones offer timely access to medicines, especially in remote areas, and the pandemic highlighted their potential for safe, contactless delivery of essential supplies,’ she says.
‘It can reduce costs and travel time, improve access to healthcare for patients in rural or hard to reach areas, and free up staff time for direct patient care. Drones are also more environmentally sustainable, emitting less carbon dioxide than cars or trucks.’
For patients with chronic conditions, using drones to deliver critical medicines can ‘help reduce waiting times and ensure more consistent access to healthcare’ and ‘alleviate some of the pressures caused by long waiting lists’, she adds.
However, in their current form, there are some inevitable drawbacks. Drones can only carry light items – typically around two to four kilograms – which limits their use for transporting a wide range of items. Additionally, they have limited range and battery life, which affects the numbers of deliveries that can be made on one flight.
In addition, some medicines need to be stored in specific conditions, such as controlled temperatures and multilayer packaging, which must also be taken into consideration. ‘Regulations require these conditions to be met throughout transport to ensure the product is safe to use,’ says Professor Anderson.
As the need and momentum for the use of drones in healthcare builds, the list of projects assessing the benefits, challenges and future potential of drone transportation is growing.
So what projects are currently underway, and what insights are they giving into this innovative movement of medical supplies?
Open Skies Cornwall project
The weather and geography of Cornwall, southwest England, present unique challenges when it comes to the collection and delivery of pathology samples and time-critical medicines, particularly on the Isles of Scilly – 28 miles off the coast.
Poor weather conditions mean flights to and from the islands can be grounded for two to three days, delaying transit of crucial items.
The Open Skies Cornwall project is a consortium of technology providers and end users. It includes exploring conceptual use cases involving the transport of pathology samples and blood products, point of care equipment and consumables, and Royal Cornwall Hospital Pharmacy service provision via drones.
‘We wanted to level up the provision of care and build a reliable and robust service for the island community,’ says Jo Walsh, pathology optimisation project lead at Royal Cornwall Hospitals NHS Trust.
Samples can be adversely affected by the time it takes to transport them, and often repeat testing is required as a result. ‘We’re looking to prevent any repeated testing and provide timely and accurate results for clinicians, that are not adversely affected by transport delays,’ says Ms Walsh.
‘We also want to enable patients to receive treatment at home, rather than having to travel to the main hospital – a journey that is especially problematic for those living off the mainland, as they have to travel by plane.’
As well as focusing on island healthcare connectivity, the Open Skies Cornwall project also involves working with Falmouth Harbour to integrate autonomous drone solutions and enable infrastructure for ship-to-shore delivery, remote healthcare, telemedicine and flying defibrillator applications to support residents and maritime visitors.
Lisa Vipond, pathology services manager at the Trust says that the team sees ‘this project as a complimentary element to our courier system, assisting their challenges.’
A key part of the project is looking at maintaining the validity of samples, and the impact of environmental factors, such as heat, cold, pressure and vibrations on samples transported by drone.
There are plans to do testing flights at the end of this year, but ‘we need to ensure the regulatory and legislative requirements are all in place ahead of this’, says Ms Vipond.
Ms Walsh believes many other areas of the NHS could benefit from drones, including emergency care.
‘Working in the NHS, patient care is at the centre of what you do,’ says Ms Walsh. ‘When you see a solution to gaps in service provision due to elements beyond your control – such as geographical and weather limitations – you want to push that solution forward.
‘We can’t just use this project as a “proof of concept”. We need to embed drone transport within our infrastructure long-term.’
Project CAELUS
Project CAELUS (Care & Equity – Healthcare Logistics UAS Scotland), aims to develop and trial the UK’s first national distribution network using drones to transport essential medicines, blood, organs and other medical supplies throughout Scotland to eliminate land transport issues.
Led by AGS Airports, it brings together 16 partners, including NHS Scotland and is funded by the UK Research and Innovation Future Flight Challenge and other partners. The consortium has developed a virtual model, or digital twin, of the proposed delivery network, which connects hospitals, pathology laboratories, distribution centres and GP surgeries across the country.
A number of live flight trials are taking place across the country as part of the project. For example, this August, laboratory specimens were flown between NHS Lothian and NHS Borders by drone.
In October, drone technology was used to connect the island community of Arran with the mainland. Further trials are planned in the NHS Highland and NHS Grampian areas of Scotland later in the year.
And the Scottish Ambulance Service has also researched whether a drone could transport defibrillators to the location of a cardiac arrest faster than an ambulance.
Dr Jamie Hogg, clinical lead for Project CALEUS for the north of Scotland and a retired GP, says the team hopes that the use of drones to transport medicines, blood samples and equipment will enable patients living in more rural areas to be ‘treated closer to home and more quickly’.
Requesting quick deliveries of medicines for patients via a drone network would have significant benefit, he says, however, a change in regulations to allow the move from the currently segregated to integrated airspace will be key.
The project ends in December, and then there will be ‘a period of reflection to take in everything that’s been done and decide on next steps’, Dr Hogg explains.
NHS Blood and Transplant: flying blood via drone
Blood packs have been successfully flown by drone in a series of ‘beyond visual line of sight’ flights, for the first time in the UK.
In a research study to check the viability of flying blood via drone, run jointly by NHS Blood and Transplant (NHSBT) and the medical logistics company Apian, 10 units of packed blood cells were transported on a 68km journey across Northumbria’s skies, while an identical 10 packs were transported concurrently by road.
After assessment, results showed both sets remained viable, with no significant difference in the biochemical or haematological profiles of the blood, which determine if it has maintained quality and can be used for clinical purposes.
‘We’re proud to drive innovation that could improve patient outcomes, and this trial could do exactly that,’ says Mike Wiltshire, component development laboratory manager at NHS Blood and Transplant.
‘Drone travel would be especially useful in transporting items – whether blood packs, blood samples or other – to more remote locations, or via routes that normally suffer from traffic congestion, meaning the products are available for patients faster than they would be by road and ensuring patients are treated as quickly as possible.’
If drones are able to deliver blood products faster, then ‘more patients will be able to be treated or receive results the same day’ than at present, which ‘may reduce patients having to return to the hospital at a different time, should the medicine or test results not be available same day’, Mr Wiltshire adds.
The UK has clear guidelines on the transport of blood components and maintenance of product temperature. ‘We needed to source a suitably sized and specified transport container, along with cool packs, to ensure the temperature of the blood was maintained as required,’ explains Mr Wiltshire.
The number of items and weight that can be transported at any one time is limited by the drone load capacity. Drone operators are therefore exploring different types of drone to determine the best one for the transportation of blood, which may in turn be dependent on the specific requirements of the transport route.
The flying of drones like those used in this study is currently ‘very tightly regulated’ meaning that drones cannot simply fly directly between any given two points – permission must be granted, which may not be guaranteed, depending on the locations in question. ‘Drone operators are looking to overcome this significant challenge for the use of drones for this and many other uses,’ he says.
NHSBT is currently in discussions around a similar trial for platelets, to understand how platelets for transfusion will react to drone transportation and whether their use will be viable in the NHS for this purpose.
Welsh Health Drone Innovation Partnership
The Welsh Blood Service (WBS) is interested in exploring what role drones might play in enabling efficient, sustainable transport of blood products between north and south Wales as well as faster, on-demand delivery of blood products and other medical supplies in rural Wales.
The organisations involved in the Welsh Health Drone Innovation Partnership are the WBS – part of Velindre University NHS Trust –the Welsh Ambulance Service University NHS Trust, Snowdonia Aerospace Centre and the technology company Slink-Tech.
Currently, the partnership is undertaking a foundation study for drone-based blood delivery service between WBS stock holding units at Talbot Green in the south and Wrexham in the north to establish its potential for supporting the Welsh NHS, including specific use cases for the WBS, and to test the basic premise with the Civil Aviation Authority.
‘Drone-based infrastructure has the benefit of not being tied to pre-existing infrastructure on land, which due to geographical constraints has often unintentionally left rural communities underserved,’ says a spokesperson for Velindre University NHS Trust.
‘Drone technology provides the opportunity to tackle inequalities by improving accessibility to communities and regions which may be left behind by traditional logistic infrastructure.’
The primary challenge is to establish ‘a robust business case for early deployment of drone technology to improve the quality and resilience of health and care services in Wales’, the spokesperson adds.
Alan Prosser, the director of the WBS, says: ‘Technology is advancing at pace in this area, and we acknowledge that drone capability still needs to mature in terms of carrying capacity and battery payload before this becomes a viable option for our service.’
Monoclonal antibody transportation
The UK isn’t the only country trialling the use of drones to transport medical supplies. In the Netherlands, researchers have investigated the impact of medical drone transport on the stability of monoclonal antibodies (mAbs).
The study findings revealed ‘no significant differences between car and drone transport’, indicating that the stability of mAbs in both vials and infusion bags was adequately maintained during transportation regardless of the mode.
As such, medical drones are ‘a viable and reliable means for the inter-hospital transport of mAbs, paving the way for more efficient and predictable logistics in healthcare delivery’, the authors say.
In fact, the researchers concluded that the integration of drone technology into healthcare logistics ‘has the potential to significantly enhance’ the crucial transport of this treatment type.
Drone transportation potential
With so many ongoing trials and success stories demonstrating the benefits of drone technology in healthcare, the future looks bright, and Professor Anderson says it really does have ‘the potential to ‘revolutionise the way we deliver medical supplies, especially in remote or hard-to-reach areas’.
She is keen to point out, however, that ‘as with any transport around medicines, safety and security must remain a priority’.
The use of drones will ‘undoubtedly increase over the next five to 10 years, for a variety of applications,’ according to Mr Wiltshire. ‘However, there are challenges to overcome – such as restrictions on airspace – before this use is widespread’.
In the meantime, Dr Hogg is encouraging healthcare professionals to ‘think about what they could do if they had drones available to them’ to support patients in accessing vital medical supplies.
‘We are getting to the point where drone transport for medical products could become a reality,’ he says. ‘In three- or four-years’ time, we could be saying to a [resident] doctor: “Can you “drone” this down to Aberdeen?”, and the answer will be: “Yes, sure.”’
A version of this story was first published on our sister title Hospital Pharmacy Europe.
