Class 1 Medical first issue - why only London?

[biscuit74]

Hello all.

A question which has puzzled me for some time, which has popped up again because some friends are about to be taking the relevant tests. Why are all Class I medical first issue examinations done only in London? At first I had assumed that the testing would be done at the CAA's headquarters, which might be justifiable on the grounds of initial standardisation, using CAA employee specialists.

Further checking however shows that these tests are carried out by what appear to be perfectly normal aviation medical practices. All look very nice. I have no doubt they are very good, but do the CAA really consider that no practices outside London are of suitable standards?


Class1 renewals can be carried out by suitable qualified doctors all across the country, so why not initial issue? I'd have thought that renewals are the more critical point, since it is then that any changes or deterioration in medical condition is likely to be identifiable - hopefully for early treatment, or other consideration or evaluation for impact.

As an engineer I consider continuing inspection and maintenance of ageing structures a more demanding task that initial design and inspection, on balance. The logic for people should be similar, surely!

Is this 'London centric bias' yet again, or simply convenience for easy inspection and oversight etc? Seems very odd and certainly adds costs and stress for those from outside the big smoke.

[Twin Squirrels]

It is probably a matter of practicality; at the initial medical they take chest x-rays, ecg and various blood tests in addition to the urine test and physical examination etc. I am no expert, but I suspect that the authorities trust that the AME''s are experienced enough to carry out subsequent medicals and send people for further investigations /treatment as required.

[pug]

Having spoken to AME's about this, it seems it's a cost thing. It's believed that there isn't sufficient demand elsewhere to invest. One trip to Gatwick isn't such a problem in the bigger scheme of things, and any further investigations can typically be done locally to the applicant..

[Radgirl]

Really quite simple. A couple of people decided Gatwick's closure was their opportunity to cash in. They chose central London as one of the few areas where there is readily available private imaging, cardiologists and other specialties.

The actual facilities are nothing special. As for the ambiance, well I leave that to others, but I have seen far better.

My concern is my experience, the eye watering prices and the pressure to charge for everything. My impression is that the number of AMEs in Central London not in this cartel is rapidly diminishing. Time will tell whether the specialists they have tagged onto is as efficient / effective / helpful when needed as Gatwick's bank of experienced specialists.

The opportunity is there for well run centres across the UK providing a fantastic personal service, but to date I fail to see that happening....

[Homsap]

Biscuit74......

I thought it was possible do an initial Class One at NATS Prestwick, you need to check that.

An update, I've checked, the following comes from the NATS website:

"NATS is one of just three providers in the UK approved by the CAA to perform initial EASA medical examinations for those needing EASA Class 1 medical licences. These are carried out at our Aeromedical Centres at Swanwick in Hampshire and in Prestwick in Scotland. Renewals are available at other NATS sites, including Heathrow House, (BAA pass holders may be able to have their EASA medicals at Heathrow Control Tower).

I should add that that the CAA website mentions three initial class one medical centres, two in London and one in Horley near Gatwick. Radgirl is of course correct in that certain AMEs are cashing in, it is a disgrace that there are no regional centres as the CAA suggest. Also I smell a rat that the CAA website do not mention NATS Swanwick or Preswick.

My suggestion to you biscuit74 is to phone NATS to see if they can do an initial class one, if so please let us all know, and I will then ask the CAA to update their website.

Finally the CAA approved cardiologists ECG reading has always been a rip off. I once got a frend's father who was a eminent cardio thoracic surgeon to do me a free ECG, he and his consultant cardiologist signed me off with a perfectly normal and healthy ECG, but the CAA would not accept that as they were not CAA approved. This surgeon was an interesting,as he had been an expert witness in the Staines disaster enquiry, in which it was suggested that the captain had a heart attack, he disagreed. Anyway the surgeon was both offended and livid with the CAA that they didn't think either he or his cardiologist were competent. I feel sure he must have had words with the CAA, as the next day the CAA decided to accept my normal ECG reading with no additional charge. There is no reason why any NHS consultant can not sign of a normal ECG, obviously if it's not a normal ECG, I accept a CAA authorised cardiologist might be appropriate.

[Homsap]

Just to update, NATS have responded by email to the effect that they can no longer conduct initial class one medicals. This leaves the only option for an initial class one with one of three clinics in the London area. This raises the question why the three locations can not be spread across the UK, for example Edinburgh, Belfast, Manchester. I think the chief medical officer needs explain himself himself.

Does anyone know the Name of the CAA chief medical officer?

[olympus]

When I had my initial Class 1 many years ago (it was at a CAA building just off Kingsway IIRC before FCL and the Medical Branch moved to Gatwick), in addition to the various test already mentioned, I (and presumably everyone else) had to have an EEG. I remember this particularly as, some days after the medical, I received an urgent phone call summoning me back to have another EEG. Whatever the problem, the second EEG resolved it. I was told the CAA required a satisfactory initial EEG as a baseline in the event of subsequent brain injury.

Is it still a requirement to have an EEG at the initial Class One examination?

[Lordflasheart]

Homsap .... Does anyone know the name of the CAA chief medical officer? I was going to ask if they have one any longer ? Actually I see it's Dr Sally Evans - https://uk.linkedin.com/in/sally-evans-979ab729

Oly .... When I had my initial Class 1 many years ago (it was at a CAA building just off Kingsway IIRC And before that, initial civil medicals were done by the RAF at Kelvin House. Evil bunch, from my personal experience.

Homsap - I see the NATS website is still (March 2nd) showing them as Initial Class 1 authorised, exactly as you quoted - despite them telling you otherwise on 16th Feb - I wonder how long they've been dis-authorised ?

Organisations that can't be bothered to keep their websites up to date are a PITA. I will get onto it.

[Flyin'Dutch']

Some outdated and incorrect information.

The CAA closed its Aeromedical Centre - the bit where medicals were done, after a consultation. You can find the details on the CAA website under 'closed consultations'

There are currently 3 AeMCs in the UK where you can do your initial Class 1 Medical, one is in Gatwick, the other in London and the third is at Heathrow.

I don't know why there are none in Birmingham, Manchester or elsewhere in the UK but do know that the market for initial Class 1s, is limited and that a large number of initial Class 1s is for people who are not UK based and therefore being close to large transport hubs may be why these centres are based may be not a bad idea. Setting up an AeMC is not trivial, both in effort and costs.

EEGs and Chest X-rays have not been part of the initial Class 1 for many many years.

NATS has not been doing the initial Class 1 medicals for quite some years. That is not because they have been de-authorised (they still do initial EU Class 3 medicals for ATCOs which requires the same authorisation) but because they have a capacity issue - as I understand it.

[Lordflasheart]

F'Dutch' - Correct - I asked NATS today and they kindly told me they stopped doing Initial Class 1s and external work in Jan last year (2016) (as you rightly say) for capacity issues ie. AMEs leaving.

I was also told they will try to get their IT dept to make the necessary corrections to their website - ie to remove the incorrect statement that still says (as I type this) that they do Initial Class 1s. After a year of duff gen already, that sounded to me like 'don't hold your breath.' I will look again in a few weeks.