The charity works in partnership with the Northern Ireland Ambulance Service (NIAS), with AANI providing the aviation side of the service and funding the non-medical costs of HEMS,[3] with NIAS being commissioned to provide the clinical staff, equipment, clinical governance arrangements and operational tasking.

Independently, in late 2013, Dr John Hinds and other members of the Northern Ireland Regional Faculty of Prehospital care began discussing ways of encouraging the development of a fully-fledged HEMS at a time when the only air support for casualty evacuation was from either Coastguard or PSNI helicopters.

After a near fatal accident at the North West 200 motorcycle race in May 2015, Dr Hinds' views received widespread support and he began a public campaign for Northern Ireland to have its own air ambulance.

The doctors undertake the HEMS role on a part-time basis alongside their primary posts in order to maintain clinical and organisational skills on both fronts.

[11] Two of the trustees, Rodney Connor and Ray Foran produced a Business Plan which was then brought to the Chancellor of the Exchequer and, in March 2016, AANI were successful in applying to the Chancellor's Libor banking fines fund, and were awarded £3.5 million to establish and support the HEMS service in Northern Ireland.