If LAS is anything like YAS then the crew have the discretion to take a patient to the nearest receiving A&E or they can bypass it if the patient's needs are better served at a different hospital. Near us we have a fantastic burns unit, so it makes sense to take a patient with burns ther (if they are stable) rather than take them to the possibly more local A&E and then have to transfer them to the self same burns unit later. The same goes for Neuro, we have a good neuro unit at one of the local hospitals so if we get a bad head injury (coomon round here at this time of year with all the bikers who throw themselves off their machines) then we are OK to take the patient to there and bypass a lesser more local unit.