Due to the critical medical nature of HEMS missions, the NWAA fleet has special permissions from the Civil Aviation Authority to fly in worse weather conditions than other aircraft.

[4] The NWAA helicopter fleet include: Although the aircraft have their allocated counties, they will often cross into each other's areas should operational needs require it.

[4] As the helicopters can only fly in daylight, in February 2018, a £65,000 BMW X5 (X5 Xdrive25d Se Auto) road vehicle was added to the fleet.

As a rapid response vehicle, it enables doctors and paramedics to carry out some of their work during the hours of darkness (6pm–2am),[14] poor weather or when an aircraft requires maintenance.

The medical interventions provided at the scene are of a hospital standard, and were historically only done in critical care settings,[18] including blood transfusion,[9] emergency anaesthetics, Rapid Sequence Intubation (RSI; 136 performed in the financial year 2021-22, and 125 in the year before)[19][20] and chest surgery to make the critically injured patient stable enough to be transported to hospital.

[21] They have provided interventions such as thoracostomy (chest incission to remove excess fluid or air) and ultrasound to check for internal bleeding.

In addition to the paramedics, on one helicopter from Manchester Barton base (Helimed 72) there is a pre-hospital emergency medicine trained doctor.