Case study: Project CAELUS

More than a quarter of Scotland’s population lives in remote or rural areas spread across 69% of the land mass, leading to delivery challenges that ultimately contribute to incidences of medical treatment inequity. As a result, NHS (National Health Service) Scotland, which encompasses the Territorial Health Boards and Scottish Ambulance Service (SAS), is keen to investigate the potential of a drone-based distribution network, which would not only bring greater treatment equity, but would deliver substantial environmental improvements. And that’s where Project CAELUS comes in.

Friends in high places

Project CAELUS (Care & Equity – Healthcare Logistics UAS Scotland) is the work of a 16-organisation-strong consortium. It is not a coincidence that the stakeholders have engineered this acronym. Caelus, a Latin name, means ‘sky’ or ‘heavens’, and that is very much where their focus lies.

Led by AGS Airports – operators of Aberdeen, Glasgow and Southampton airports – the consortium is bidding to develop the UK’s first national distribution network to use drones to transport essential medicines, blood, organs, and other medical supplies across Scotland, which boasts some of the most remote communities in the UK, not least on its northern islands, where harsh weather can have a detrimental effect on more conventional deliveries.

The project has some impressive backing, in terms of financial, technical and industry clout. AGS Airports, a partnership between Ferrovial and Macquarie Infrastructure and Real Assets, is the consortium lead. It is joined in the project by fellow members such as ANRA Technologies, which provides end-to-end drone operations and traffic management solutions for unmanned aircraft systems (UAS) operators and airspace managers, and Skyports Drones Services, operator of the physical flight demonstration drones that will ultimately implement and operate end-to-end, middle and last-mile drone deliveries.

Academia is represented by the University of Strathclyde, while Cellnex will install cell tower infrastructure to provide a 5G network at an agreed airport-based network site. NATS, the UK’s main air navigation service provider is a member, as is consultancy and services specialist The Drone Office.

The UK Government’s involvement in Project CAELUS is driven by UK Research and Innovation (UKRI), a non-departmental public body that directs research and innovation funding, backed by the science budget of the Department for Science, Innovation and Technology. Also involved in CAELUS are the Future Flight Challenge, a UKRI division designed to deliver the third revolution in aviation, and the Industrial Strategy Challenge Fund, which aims to connect UK research with business to meet major industrial and societal challenges. It too is part of UKRI. Connected Places Catapult, the UK’s innovation accelerator, is also a member.

As the Project CAELUS team noted, “Covering UAV [unmanned aerial vehicle] manufacturers, UTM [unmanned aircraft system traffic management] and ATM [air traffic management] service providers, airport and UTM operators, ATM modernisation specialists, energy providers and infrastructure designers, medical packaging manufacturers, business, market and social analysts and experts in digital modelling and simulations, CAELUS has it all covered.

“The size and reputation of the organisations in CAELUS ensure credibility in its ambition and capability to deliver innovation.”

Early days

Since securing its first funding – £1.5m – in January 2020, the CAELUS consortium has designed drone landing stations for NHS sites across Scotland and developed a virtual model (digital twin) of the proposed delivery network which connects hospitals, pathology laboratories, distribution centres and GP surgeries across Scotland.

October 2023 saw a successful trial undertaken by Glasgow Airport and NHS Golden Jubilee Hospital in Clydebank. Live flight trials were operated by  Skyports Drone Services. While Skyports operates the flight trials with small electric vertical take-off and landing (eVTOL) drones of under 25kg, the project also includes a much larger uncrewed aircraft, Dronamics’ Black Swan, which can carry up to 350kg. Its flight between Orkney and the Shetlands will be assessed in a simulated environment.

Fiona Smith, AGS Airports group head of aerodrome strategy and CAELUS project director, said: “These flight trials are an important step towards the integration of drones into modern airspace and enabling the safe use of drones at scale within Scotland’s airspace.

“The input from all partners has resulted in a high-quality safety case for the flights undertaken in a busy airport environment which can be transposed for other sites in future.”

The Golden Jubilee trials inspired a further initiative, with Project CAELUS members Arup, The Drone Office and CommonPlace launching a remote listening test that enabled members of the public to experience drone sound in different environments – rural and urban, for instance – and provide feedback on how they sounded.

Testing the water

Drones have been subject to a degree of scaremongering in the mainstream media, with baseless stories leading to fears regarding their safety, operation and potential impact on privacy. As public sentiment, especially the acceptance of new technology, is essential to initiatives like Project CAELUS, the stakeholders have been careful to solicit public opinion as the work progresses. In addition to being asked what they thought of the use of drones for medical deliveries, local people were asked for their say on the proposed landing infrastructure for the CAELUS network.

A June 2024 Public Engagement Survey recorded 86% of participants as feeling positive about the use of drones for medical delivery in Scotland, a substantial improvement on the 70% seen in 2021. The top perceived benefits were better access to care for remote and rural communities, efficiency (including speed, availability and reliability), and cost savings for healthcare services. Reductions in CO2 emissions scored poorly, as did lower contamination risks.

More than three quarters (77%) of respondents felt positive about extending the use of drones beyond healthcare services. A high proportion (89%) were in favour of drones being used by the emergency services, or within the context of search and rescue. However, when there was no longer a health element to the scenario, 78% of respondents were still in favour of using drones for the inspection of rail tracks, powerlines, bridges, and so on.

The same survey asked about the acceptable level of noise for medical drone delivery. The most popular level – ‘like a regular car’ – received 37% of the votes. Perhaps surprisingly, slightly fewer respondents (35%) said that the lowest level of noise – ‘like a bicycle’ – was acceptable.

OHCA simulation

Medication and specimens are of course not the only valuable medical cargo that drones could soon be carrying across Scotland. August 2024 saw the Scottish Ambulance Service (SAS) carry out a simulation study as part of Project CAELUS. Designed to see how drones could be used in response to cardiac arrests, the simulation looked into the feasibility of delivering automated external defibrillators (AEDs) by drone and examined how bystanders might become involved.

During each simulated OHCA (out of hospital cardiac arrest) scenario, one group of participants was given instructions by telephone, while another received video-assisted guidance in retrieving a nearby drone-delivered AED. This study built on existing research, both in the UK and internationally, to better understand how drones could be used by an ambulance service.

SAS chief executive Michael Dickson said: “The entire health service, including here at SAS, is always looking at ways to innovate and find new ways of providing life-saving care. Drone delivery of AEDs to out of hospital cardiac arrests is being investigated in several parts of the world, in particular looking at how this could be used in remote and rural places, or areas of extreme urban congestion.

“This study will provide us with additional evidence to assess if drones could provide value to the Scottish Ambulance Service in the future.”

Results of the study were still pending when Vertiports went to press.

The latest trials

CAELUS recently took a big step forward, if ‘step’ is the right word for an airborne achievement. In what stakeholders described as ‘a ground-breaking first for Scotland’, in late August 2024, laboratory specimens were successfully transported by drone between NHS boards. Over the course of a three-week trial between NHS Lothian and NHS Borders, specimens were flown between Edinburgh BioQuarter (next to the Royal Infirmary of Edinburgh) and Borders General Hospital in Melrose.

At present, laboratory samples required for urgent clinical decision-making are transported by road and can take up to five hours between NHS Borders and NHS Lothian due to the requirement to make multiple pick-ups. Use of drones could cut the journey time to just 35 minutes, which could have enormous implications for both patients and staff.

“The NHS is reliant on van logistics that have provided valuable service for decades, however these can take time, travelling hundreds of road miles each day. In some parts of Scotland, patients who live in remote and rural locations are even dependent on ferry or airline availability.

“This project will enable the NHS to consider if drone technology is viable and able to contribute to improving the health and wellbeing of our population. This project will position the UK and NHS Scotland as a leader in healthcare and aviation industries,” said Hazel Dempsey, the CAELUS NHS Scotland programme lead.

Noting that this latest trial was one of the first UK demonstrations of beyond visual line of sight (BVLOS) medical drone operations transiting between controlled and uncontrolled airspace, Project CAELUS’s Fiona Smith said: “We are delighted we have been able to test this important use case for the NHS.

“Transporting laboratory specimens by drone could speed up the clinical decision-making, allowing same-day diagnosis and treatment.”

Throughout the trial, the consortium also tested how NHS staff might interact with the drones, both physically and digitally. This knowledge will help support the scale-up of services.

Next steps

As part of Project CAELUS, NATS has been working with a number of airports and other air navigation service providers to identify the operational requirements, and ensure the appropriate safety procedures are in place for BVLOS drone operations in controlled airspace. NATS will provide a robust safety submission to the regulator, in this case the UK’s Civil Aviation Authority (CAA).

The current phase of Project CAELUS is the second, and is backed by a further £7m of funding. In addition to demonstrating live flying of drones, it aims to remove any remaining barriers to safely using drones at scale within Scotland’s airspace.

Further flight tests will be carried out this year, between Ayrshire and Arran in the west of Scotland; further north between Aberdeen Royal Infirmary and Dr Gray’s Hospital in Elgin; and between Dr Gray’s Hospital and Inverness’s Raigmore Hospital.

According to its timeline, Project CAELUS will draw to a close in December 2024. The project is currently researching and testing use-cases supplied by the NHS across different parts of Scotland. 

Further reading: The packaging

Packaging is crucial to the project, given the delicacy and importance of the materials being transported. Supplied by Intelsius, a York, UK-headquartered producer of temperature-controlled packaging solutions, it has been designed for the payload areas of the drones used in Project CAELUS trials, weighing just 2-3kg. According to CAELUS, the packaging can be easily adapted and resized for different drones. In other words, as drone technology develops, and bigger and heavier payloads can be carried, the packaging within the network can increase in size, with low tooling costs and short lead times.

The packaging used in the trials has been validated at Intelsius’ International Safe Transit Association (ISTA) certified lab. Each product variant is supplied with testing reports to demonstrate suitability of the packaging for temperature control at 2°C to 8°C, 15°C to 25°C and -25°C to -15°C.

A logging device within the lid of the packages uses GPS to track their position, transmitting this information over mobile phone networks. It is possible to track the shipments through the Intelsius cloud platform, ORCA Cloud.

Given the sensitivity of the materials, the packaging needs to be tamper-proof. The logging device within the lid has a locking feature which will be locked at point of packaging preparation at the NHS facility. The CAELUS team is working with Intelsius to ensure that it can only be opened by authorised users. Evidence of the device being locked and unlocked will be recorded in ORCA Cloud and shown in the shipment report. Patient data will not be transported, and documentation in transit will be locked within the packaging.

Ultimately, drones will be seen as just another means of transport between NHS facilities. In the first instance, however, staff will require some training. This may include a Skyports course on safely interacting with the aircraft, or training on how to use the ANRA Delivery Management Software. The Intelsius packaging and portal access are supplied with easy-to-use guides. Intelsius will also provide reference documentation to add to standard operating procedures (SOPs) and quick guides to be displayed in areas where packaging will be prepared.

Further reading: The landing pad

The ground-based infrastructure to support the CAELUS network is being designed by AtkinsRéalis, with the initial concepts for the landing pads revealed late last year. According to the Montréal-based firm, the design is unique, ‘taking its cue from nature to create an origami-inspired structure made of strong, lightweight aluminium’.

The structure has been designed to operate off-grid, and will feature photo voltaic (PV) panels where possible, to generate the power required to operate its lid and re-charge the drone. The mobile, lightweight nature of the design means the unit will leave little or no trace on its surroundings.

Chris Crombie, AtkinsRéalis technical director for architecture, is leading on the design for the landing pods and ground-based infrastructure for the project. He said: “Project CAELUS has the potential to revolutionise how rural and remote communities receive vital supplies. The landing infrastructure is an important part of how the network can integrate with those communities.

“The pad has to be able to fit into a van or on a trailer, so it needs to be lightweight. But it needs to be secure from the elements and strong enough for the job it’s designed for.

“It has sustainability at its heart and, most importantly, will provide NHS Scotland with the infrastructure it needs to operate the drone network and make a real difference to people’s lives.”

The landing pads will be positioned at sites such as GP surgeries, medical centres and hospitals where the drones can land safely, and where the unit can be stored securely while supplies are delivered.

Crombie said: “The live flight trials are a crucial point to reach in the project, and bring this important drone network a step closer for the people living in Scotland who will benefit.

“It also demonstrates how we as a consortium are working together to achieve the common goal of lifting this great idea off the page, or laptop, and literally launching it into reality.”