Changes at the CAA from 01/03/2016.

Closure of their clinic, sickness management and over reading of ECGs.

Dr Christopher King Head of The AMS London AeMC

Aviator Insider article 01 March 2017

This is, I hope, the first of many articles I have been asked to write for Aviation Insider to help with pilot understanding of aviation medical and related matters.

The views and opinions expressed in this article are my own interpretation of the changes at the CAA and in no way represent the views of the CAA or EASA.

The most pressing of these is to explain what has happened with the closure of the CAA Medical Clinic at Gatwick and the consequences of this closure, which was relatively sudden on 1st March 2016.

There had been a period of consultation prior to closure, the main issue being of a loss of £2.5 million per year to the CAA, and, EASA related issues from Cologne, but little information regarding the closure and consequences of this closure was communicated to the wider aviation industry

The medical facilities at the CAA closed from 1st March 2016 and with it most of the specialist clinics such as ophthalmology, cardiology and neurology etc. The only clinics remaining relate to psychiatry, drug and alcohol problems and diabetes and referrals to these clinics can only be made via the CAA medical officers via your Aviation Medical Examiner (AME).

The immediate consequences of closure to AMEs and pilots were the following:

  • No EASA initial class 1 or ATCO European class 3 medicals undertaken by CAA. They are now undertaken by one of the three Aeromedical Centres in the UK.
  • The CAA no longer speaks directly to pilots about medical issues, it is all done via the AME.
  • It is the responsibility of the AME to manage pilot sickness, make them unfit, obtain reports and assess when fit again. I will elaborate on this later.
  • It is the responsibility of the AME and pilot to arrange specialist aviation related medical reports from local specialists when required. This can no longer be done via the CAA specialists at Gatwick.
  • The CAA no longer over reads the ECGs, these have to be over read by a cardiologist of the AME’s choice. Any investigations required because of the over read have to be arranged by the AME, collated by the AME and forwarded onto the CAA.
  • The AME now makes pilots unfit on the CAA online system and must liaise with the CAA to make them fit again.
  • After the Germanwings incident, the CAA is very hot on pilots who do not disclose medical issues at the time of their medical or any issues that arise between medicals.

The effect of all the changes is to delegate most of the aviation related health management of pilots to the AME which was previously undertaken by the CAA and has resulted in a huge increase in workload for the AME.

Previously, most AMEs were able to manage any sickness issues without any charge to the pilot but now the time taken for medical assessment, administration and processing it is not possible from the AME business perspective to provide as a no cost option.

This has caused considerable consternation to the pilots which is understandable as they had no idea of the processes involved.

To give you an idea of the process to make a pilot unfit and fit again, I will go through the SOP we operate at Centreline Aviation Medical Services. Bear in mind that this was all undertaken previously by the staff at the CAA at Gatwick and contributed to their workload and budget deficit and now has to be undertaken by the AME as part of their additional workload and costs.

  • Pilot phones or emails us with medical issue.
  • Telephone consultation to discuss issue and decide whether needs to be made unfit.
  • If unfit, an entry is made by the AME on the CAA online medical records and then made unfit by the AME.
  • The AME then has to issue an unfit letter for the pilot to give to their employer.
  • At the same time, the pilot’s email address is taken and sent a template or algorithm by email to cover the processes required and reports required from medical specialists for the relevant condition before the pilot can be reviewed to be made fit.
  • The algorithms and report template need to be given to the specialist to provide the relevant investigations, treatment and reports to the AME before any further fitness assessment can be made.
  • Once the reports are available and the pilot is fit, an appointment is made for review by the AME.
  • The AME must check the regulations and guidance material on the CAA website to ascertain that all the conditions for fitness have been fulfilled.
  • At the appointment, the pilot is assessed and a clinical decision on fitness is made and further notes made on the AME online medical system and reports reviewed, if necessary forwarded onto the CAA for review by their medical officers.
  • If the pilot is deemed fit, the CAA has to be contacted by phone or email to be made fit.
  • The AME then issues a fit letter which can then be passed onto the employer.
  • This whole unfit fit process by the AME takes considerable time, effort and expertise. Given the numbers of pilots being dealt with daily, it now has a marked effect on the AME working day, administrative support and also has financial and business implications.

We at Centreline hope that the unfit/fit process management by the AME results in the pilot being unfit for a shorter period before returning to flying duties. This minimises the loss of pay or allowances by the pilot

I hope you now have a better understanding of the effect of the closure of the CAA clinic on pilots and AMEs and on the sickness management process.

Dr CJ King

Head of AeMC


For more information on anything Aviation medical related check out our pilot aviation medical page here: Pilot Medicals or check out Centreline Aviation Medical Services website where you can book an aviation pilot medical!


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