JULES Blackham, 37, is a registrar in emergency medicine at Gloucester Royal Hospital.

He has been involved with the air ambulance since the initial selection of paramedics in spring 2007 and was out with the cars before the helicopter launched. He helped on a University of the West of England training course.

Jules can see the benefit of the air ambulance from his work in A&E. "Patients will turn up in the department and paramedics have used the skills to their levels of ability," he said.

"But you think, 'this person could be better if more had been done early on'."

Jules has been involved with pre-hospital care for almost 15 years, working with St John Ambulance and providing medical cover for the Commonwealth Games, the Millennium Stadium, Glastonbury Festival and Castle Combe motorcycle team.

"It's different challenges. I am working with different people and it is more challenging to get out to people and using hospital skills in a different environment," he said.

"I like my day job and I like this job and they complement each other. We come away from jobs and think that our being there makes a difference."