Initial Class 1 Medical

[chitty1989]

Just after other people’s experience etc.

Basically I did my initial Class 1 Medical on Monday and past all tests but because I had childhood Asthma 20+ years ago they said they have to automatically refer me for an exercise Spirometry test.

Now I have no problem doing the test but the cost of this is £345 plus £90 referral fee.

The CAA guidance indicates that this is only required if asthma is current or within the past 5 years.

I asked a local class 1 AME who said he would tend to agree with me and I also contacted one of the other AeMC and they said as long as I pass the Spirometry test on the day, which I did, I would not need a referral.

The AeMC i attended is adamant that I need to this or the case to be deferred to the CAA for review but then I also need to get all my GP notes which I am sure will not be easy.

Does anybody have any experience of this or advise on how to proceed without wasting money or too much time?

Thanks in advance.

[Radgirl]

The relevant guidance seems to be

Exercise spirometry testing (https://cms.caa.co.uk/WorkArea/DownloadAsset.aspx?id=4294973874) (PDF) is required if there is any of the following: 1. Abnormal lung function:
Class 1 : FEV1/FVC <70%
Class 2:Peak flow <80% predicted

2. History of asthma:
Class 1 current or within last 5yrs
Class 2 current or within last 2yrs
Asthma needing regular (> once per 3
months) use of any inhaler

3. Any other indication



I assume 2 does not apply and you are NOT prescribed an inhaler.......

You are entitled to ask your AME to show you the result of the spirometry you underwent.

If FEV1/FVC <70% you need an exercise spirometry and although I think the price is steep I suspect there is little you can do. If FEV1 / FVC was not less than 70% (and the printout will use these terms so all you need is a calculator, not a medical degree) you should ask the AME what the 'other indication' was ie item 3. He or she has to disclose this. If there isnt one, show them the page and say you will appeal.

The appeal will take time and you would probably prefer to pay for the test, but most doctors, if they have made an honest error, will correct their actions.

Let us know how you get on

[chitty1989]

Thanks.

I already forwarded to the AME the CAA guidance you copied but is still insistent that it’s any history of asthma, regardless of how long ago.

The result of the Spirometry was 87% so well within.

They said the only other option is to refer the case to the CAA to decide but for that I need to get all my GP records.

Nothing is ever easy, haha.

[rate1turn]

£435?! CAA totally ripping the mick there... Thats unbelievable for such a simple test.

[Radgirl]

I have sent you a PM

[31Pilot]

I was referred for Asthma in February which was last mentioned on my medical records 20+ years ago. Before I went I’d read that I may be asked to conduct an additional exercise test, I think it was a jog around the block, so I brought some clothes ready to change and go for a jog��

On the day they weren’t convinced my historic records were enough and I was told I had to get my GP to write a letter about my asthma. They didn’t really want to send me out around the block, and I didn’t see what my test results were on the day.

I was told the main issue was that my records don’t show if I had a repeat prescription for inhalers which I could have had since asthma was last mentioned. I was referrred and my GP had to write a letter on my case - I declined to read it, so I don’t know what he wrote.

I was charged £90 for referral and was told the CAA would send me my Class 1 once reviewed. A few days after the GP letter I got my Class 1 from the AeMC.

[chitty1989]

I was referred for Asthma in February which was last mentioned on my medical records 20+ years ago. Before I went I’d read that I may be asked to conduct an additional exercise test, I think it was a jog around the block, so I brought some clothes ready to change and go for a jog��

On the day they weren’t convinced my historic records were enough and I was told I had to get my GP to write a letter about my asthma. They didn’t really want to send me out around the block, and I didn’t see what my test results were on the day.

I was told the main issue was that my records don’t show if I had a repeat prescription for inhalers which I could have had since asthma was last mentioned. I was referrred and my GP had to write a letter on my case - I declined to read it, so I don’t know what he wrote.

I was charged £90 for referral and was told the CAA would send me my Class 1 once reviewed. A few days after the GP letter I got my Class 1 from the AeMC.

Sounds very similar to me.

I’ve had an ongoing conversation with the AeMC and the CAA were no help in the slightest.

Currently I have declined the exercise Spirometry test as I can’t afford to waste £345 in the event it won’t be required. I’d much rather have the CAA tell me instead. I will then have the case deferred to the CAA along with my GP notes and a letter confirming I no longer have asthma etc.

Out of interest how easy did you find it getting a letter and your GP records? My doctors are not making accessing my records easy at all.

[31Pilot]

I'm not sure why they didn't do the exercise on the day, the website of the AeMC I went to said I would have to do it on the day? The doctor even mentioned it on the day and I had brought trainers etc in my bag just incase. He seemed to discourage himself from letting me go out to run around the block for however long it was. It didn't seem like it would cost me extra. I guess it depends which AeMC you went to.

I got my records a month or two before my medical. It took around 2 weeks, the GPs office were quite helpful when I explained why I needed them. It was simply a case of filling in a form and they emailed me a secure PDF of the scanned records. There was no charge.

The AeMC examiner issued me a letter for my GP requesting details of my case and tests done etc. All I had to do was sign the letter which had a declaration about releasing information. The GP had their own separate form I also had to complete to allow them to discuss my information. Getting the GP report was fairly quick, although there was a £15 charge from the GP, and the report was issued within a week as I had my medical in around 2 weeks of my medical date.

Everything was done via scanned letters and email. I didn't visit the GP office and only spoke to them once when paying the fee for the report.

[chitty1989]

I'm not sure why they didn't do the exercise on the day, the website of the AeMC I went to said I would have to do it on the day? The doctor even mentioned it on the day and I had brought trainers etc in my bag just incase. He seemed to discourage himself from letting me go out to run around the block for however long it was. It didn't seem like it would cost me extra. I guess it depends which AeMC you went to.

I got my records a month or two before my medical. It took around 2 weeks, the GPs office were quite helpful when I explained why I needed them. It was simply a case of filling in a form and they emailed me a secure PDF of the scanned records. There was no charge.

The AeMC examiner issued me a letter for my GP requesting details of my case and tests done etc. All I had to do was sign the letter which had a declaration about releasing information. The GP had their own separate form I also had to complete to allow them to discuss my information. Getting the GP report was fairly quick, although there was a £15 charge from the GP, and the report was issued within a week as I had my medical in around 2 weeks of my medical date.

Everything was done via scanned letters and email. I didn't visit the GP office and only spoke to them once when paying the fee for the report.

I wish mine was going so smoothly.

No end of problems with the AeMC and the GP office don’t seem to willing to issue copies of my notes and I have also requested a letter but this seems to be getting ignored.

Sorry to badger you but was there any specifics the CAA wanted in the GP letter / report or is it simply that Mr J Bloggs has not had any reports of asthma or medication since xx date?

Unfortunately my AeMC are being as useless as a chocolate fire guard. They are telling me what I require but not what should be contained within. They will also not give me any kind of letter etc to give to the GP confirming what information they require.

[31Pilot]

Not sure why they’d be reluctant to issue copies of your records unless they’ve lost them.

The AeMC letter simply asked for details of the treatment, testing and investigations carried out and how extensive that was plus any follow ups. All this was to go back to the AeMC for the CAA. My records had the last recorded date of anything asthma related. I had the opportunity to read my GPs report but I just asked them to send it to the AeMC direct and I never saw what was in the report or how extensive it was.

I had my full medical record printed out and the examiner took copies of this on the day but he said he couldn’t reasonably send all that for the CAA to review, hence the letter.

I would definitely keep on at the GP office for a copy of your records explaining your situation. It was an office administrator and practice manager who dealt with everything for me.

If the AeMC examiner haven’t seen your records then I guess the examiner is just wanting to see how extensive your asthma was, even if it was historic. If you haven’t shown anything other than the MD160 application thing then all they have to go on is what you’ve written on there. I was told as far as my examiner was concerned I might have had a prescription for inhalers since I was a kid but he has no way of knowing other than what I’ve declared on my form.

If you’re clear of it you should have nothing to worry about, it’s just going to be frustrating getting all that paperwork. Unfortunately they stand in your way of a medical for now.

[chitty1989]

For those who may be interested.

I managed to get a GP letter confirming my history of childhood asthma and the last recorded prescription etc. They were still reluctant to issue me with my records so against the advice of the AeMC I asked for the medical to be deferred to the CAA with the GP letter alone and without doing the exercise Spirometry.

Within a week I had received a letter from the CAA and they have issued me with an unrestricted class 1 medical.

This therefore confirmed my suspicion that the test was not required so this saved me around £345, plus a day off work and a 400 mile round trip.

I will not name the AeMC because they believe they were following the correct guidelines set by the European Union but it goes to show that sometimes it’s worth questioning your AME if you believe something isn’t quite right.

[Radgirl]

Excellent - well done.

As has been mentioned before, in the UK all patients have a right to their full medical records, enshrined in law. The only exception is where the doctor reasonably believes release to the patient would cause the patient harm - some mental health issues and release whilst the patient is a child but little else. The doctor has to be given enough information to identify the patient (he / she may ask for photographic ID) and what notes are required and enough reasonable time to provide them and may require reimbursement of costs BUT any other failure is unlawful. Sadly it seems endemic in the NHS to consider that patients asking for their notes or reports are trouble makers or demanding something they have no right to. Mentioning the Information Commissioner and GMC normally speeds up delivery.

[Radgirl]

Sorry, but if yo read the thread you will see that a pulmonological report, whatever that is, is definitely not required. These guys are being turned over and their wallets emptied as it is. Asthma by its very nature is a reversible entity so when you dont have asthma the measurements are effectively normal. Hence the written requirements concentrating on the medical history. A report based on a single consultation with a consultant on a good day will find nothing wrong but is effectively worthless

[C152gal]

For those who may be interested.

I managed to get a GP letter confirming my history of childhood asthma and the last recorded prescription etc. They were still reluctant to issue me with my records so against the advice of the AeMC I asked for the medical to be deferred to the CAA with the GP letter alone and without doing the exercise Spirometry.

Within a week I had received a letter from the CAA and they have issued me with an unrestricted class 1 medical.

This therefore confirmed my suspicion that the test was not required so this saved me around £345, plus a day off work and a 400 mile round trip.

I will not name the AeMC because they believe they were following the correct guidelines set by the European Union but it goes to show that sometimes it’s worth questioning your AME if you believe something isn’t quite right.
What a crap AeMC to work against you in such a way that you have to seek advice on this Forum! His/her name deserves to be published.