How an ICU lesson should guide F1's future engine path

The shockwaves of Honda's decision to quit Formula 1 are unlikely to dissipate for quite some time, as pressure mounts for the sport to fast track a new engine formula.

While Honda's reasons for quitting may be more about the Japanese manufacturer needing to cut costs to save its road car business from the challenges of electrification than about grand prix racing's hybrid regulations, it does not mean F1 is fully isolated from what has happened.

Indeed, Red Bull's push to secure an engine that it feels will be competitive enough to allow it to fight for world championship glory against the might of manufacturers has served to accelerate calls for change.

It seems inevitable then that when F1's incoming new CEO Stefano Domenicali gets his feet under the desk on 1 January, he will face some pressure to bring forward the original 2026 plan for a new engine formula. How soon that new engine should come in is only one part of the equation though, because the much bigger issue is exactly what that power unit should be.

In its basic terms, it will be a hybrid. A move to fully electric is off the table; going hydrogen seems a bit premature, while the return to a full-on normally-aspirated V8 or V10 makes no sense for the manufacturers.

So what should the hybrid concept be then? Ferrari, Renault and Mercedes would all agree that the new generation hybrids need to be much cheaper, less complex, more easily marketable and run on sustainable fuels. But after that, their preferences may diverge.

Should the internal combustion engine element continue to be a turbo? Should F1 ditch the MGU-H? Should the MGU-K element become more powerful? Should energy deployment use be down to the drivers only? Should F1 abandon the fuel economy rules and make the power units louder and more flat out?

At every step of the way though, one of the key drivers in determining where these elements go, especially in a series with manufacturers so central to it, is how they fit in with road relevance.

For in order to secure the huge R&D budgets that are needed to be competitive in F1, the big car manufacturer boards want to see a return on that investment. And that means technology transfer from the battleground of race tracks on a Sunday, into garage showrooms that consumers can buy into on the Monday.

But perhaps what has got a bit lost in the debate over what sort of engine F1 should have is exactly how direct or indirect such transfer from race track to road needs to be. For one of the big mistakes is to think that road cars need to be running with exactly the same type of engine technology and specifications as F1 machinery for knowledge to be transferable. That's not true at all.

What F1 needs is for the engineers involved in it to be pushed to the limit, to chase bold ideas and push the boundaries of technologies in ways that can help fast track developments in other industries.

As long as engineers are pushed, and the most brilliant brains are at play in driving whatever technology there is forward, then that is more than enough to keep F1 relevant to the needs of the wider world

Such a message was underlined last week when social media resurrected a story from more than 10 years ago of how lessons from Ferrari's pitstop processes had been implemented by Great Ormond Street Hospital to help save lives in its intensive care unit.

Back in the 1990s, hospitals in the UK had been alarmed about why there was such a high mortality rate for surgery in congenital heart disease, particularly when the patient was transferred from the operating room to the intensive care unit. The conclusion focused on there being too many complications in swapping over wires, equipment, staff and information as the patient was transferred, rather than any fault elsewhere in the system.

The analysis was shared by children's hospitals too, as the very young were equally vulnerable in situations where they too were transferred from surgery to intensive care. Finding ways to improve the processes of patient transfer was not too easy though. But at Great Ormond Street, two surgeons were just finishing a shift when they had a eureka moment as they watched a Formula 1 race.

In a case study published by the American Society for Quality, Martin Elliott, MD, FRCS, Professor of Cardiothoracic Surgery, University College London, and Chairman of Cardiothoracic Services, recalled: "I'd done a transplant, then an arterial switch in the morning and we were both pretty knackered [exhausted].

"Formula 1 came on TV just as we were sitting down... at the end of surgery, and we just realised that the pitstop where they changed tyres and topped up the fuel was pretty well identical in concept to what we do in handover. So we phoned them up."

GOSH's contact with Ferrari resulted in an effort from the Maranello team to help offer insight in how the pitstops worked from a personnel perspective and the processes that were gone through to reduce errors and improve quality.

Through both the sharing of videos (of Ferrari's pitstop and a typical handover in a surgery unit) and talks with staff, allied to visits to Ferrari, GOSH came to learn some of the key elements needed to better execute their jobs and deal with mistakes. Just as each member of the F1 pitcrew had a set task that they are fully focused on, so too the surgeons realised the hospital staff needed to adopt a similar process for those personnel on call.

Ferrari's mindset also highlighted how better prepared the pitcrew were for things that could potentially go wrong - whereas in hospitals the previous mindset had tended to be only reacting when something had gone wrong. Changes were implemented at GOSH, and the end result was a handover procedure where every member of staff knew their roles down to the smallest details and kept out of the way of others who had their own responsibilities.

Just as the 'wheel-off' man in the pitstop stays well clear of the 'wheel-on' man, so too did the medical staff position themselves in ways where they wouldn't trip over each other.

The role of the original pitstop lollipop man was also evaluated. Having someone in overall charge of the situation (in the case of the pitstop, the lollipop man held the final call on when the car could be released) was something lacking in the hospital situation. So it was decided that the anaesthetist would take overall responsibility for coordinating the team until the final sign off to the ICU.

Some of Ferrari's recommendations could not be implemented though. It emerged that one problem area was in the transfer of a child from being rigged up to equipment in the operating theatre to then being moved to separate machines in the ICU.

Ferrari suggested that a better solution would be to have one machine used for both the operating room and intensive care. While it would be a better step, machine manufacturers were not interested in producing such equipment, and the costs of introducing them would be huge because hospitals would in theory need to replace every bed...

But even without a new machine solution, the processes and knowledge of the pitstops were valuable: and show that knowledge transfer from F1 to the real world isn't just about moving direct technology over. So when it comes to F1's new engines, there shouldn't be a fear about going down a route that isn't so directly linked to what can be found in road cars.

As long as engineers are pushed, and the most brilliant brains are at play in driving whatever technology there is forward, then that is more than enough to keep F1 relevant to the needs of the wider world.