The cost of fuel means Midlands Air Ambulance is facing "a challenging time" as it marks 21 years since its first rescue.
The CALSTAR air ambulance company based at McClellan Park in North Highlands has added a large, high-flying patient transport plane to its fleet.
The Midlands Air Ambulance spent £6.026 million from April 2010 to April 2011. It received £5.32 million from charities, £640,000 from trading and other smaller sums.
