It began with a borrowed police helicopter one day a week.
Today, two state-of-the-art aircraft are on standby every single day to take to the skies on life-saving missions.
In between is a remarkable story of dedication, determination, and public support.
The East Anglian Air Ambulance service has just celebrated its 15th anniversary.
And when Prince William joins its ranks as a pilot this summer he will become part of one of the most sophisticated and highly skilled airborne emergency teams in the country.
Its distinctive yellow helicopters operate from bases at Norwich and Cambridge airports, ready to respond to the most urgent 999 calls over 5,000 square miles of Suffolk, Norfolk, Cambridgeshire, and Bedfordshire.
On board each flight is a doctor - often a senior consultant from a local hospital - and a specially-trained critical care paramedic.
The air ambulance is not only the fastest way of getting patients to the right hospital. It also brings skills and equipment once only found in accident and emergency departments.
In desperate situations delivering critical care to the scene of a car crash or medical crisis can make the difference between life and death for the victim.
At the very least it gives them the best possible chance of a good recovery.
Patrick Peal, now the service’s chief executive, was in at the start - one of two people who got the project off the ground.
The other was Gerry Hermer, who once led the RAF search and rescue unit at Coltishall in Norfolk and was awarded the Air Force Cross during his distinguished flying career. He is now the air ambulance’s aviation consultant.
But in the 1990s he was running a helicopter charter business based in Norwich. He and Patrick, then head of PR for Lotus Cars, became friends after Patrick hired his aircraft to transport VIPs.
“In the mid ‘90s the Norfolk search and rescue unit was relocated to Suffolk,” says Patrick, “Gerry said, this is awful, it will take longer for a helicopter to reach emergencies here. We should try to get an air ambulance going in Norfolk.
“I agreed to raise some money to run a trial. We borrowed the police helicopter and got permission to put a paramedic on it one day a week.
“We did some good work, and in 2000 the charity was set up. One small helicopter was all we could afford.
“In the first year we managed to increase to five days a week. At the start, the ambulance service loaned us paramedics.
“We doubled the size of the operation in 2006 by setting up a base at Cambridge airport and a year later we had two helicopters working seven days a week.
“The next really big step was changing from two paramedics on board, to a doctor plus a critical care paramedic who is trained to an even higher level than road ambulance crews.
“What we have now is a very rare and very capable team.”
The service took another huge step forward when it became the first Helicopter Emergency Medical Service in the UK to get clearance to fly at night.
Patrick has been EAAA chief executive for 18 months and has now given up his PR agency to devote himself to the role full time.
He was previously a trustee and deputy chairman.
The charity employs more than 50 people. It has a large fundraising department working tirelessly to raise the £10 million a year it costs to run.
“It’s a privilege to work with all our teams,” said Patrick. “They are all at the top of their game,
“We have absolute right of way over every other aircraft in the sky.
“It is amazing what small spaces they can get into when they land, pretty much the size of a tennis court - fields, back gardens, river banks, or on roads.”
Brand new Anglia Two is based at Cambridge. Anglia One, which flies from Norwich, is due to be replaced next year with a second H145 model giving them two of the most advanced air ambulances in the UK.
Dealing with the most severe emergencies and traumas means all crews face times when despite their efforts, the patient cannot be saved.
Crews work in shifts. The night shift flies until midnight then its paramedics stay on duty, using a car, until 1.30am.
They answer an average 140 calls every month, mostly cardiac arrests and road accidents.
Funding the service is a tough job, most of the cash has to be raised by the charity - and this is where the other indispensible element of the air ambulance service comes in. It is us, the public.
Without support - from buying lottery tickets to major fundraising efforts - the service would be grounded.
“We are extremely grateful for the support of the people we serve,” said Patrick. “Our lottery is a major part of our income.
“We also receive donations, and people leave us legacies, which is very thoughtful and kind.
“Our slogan, together we save lives, could not be more apt..”
For more information on the work of the East Anglian Air Ambulance, visit www.eaaa.org.uk or call 08450 669 999. You can follow them on Twitter at @EastAngliAirAmb.