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-   -   New medical rules for NPPL/PPL (https://www.pprune.org/private-flying/583994-new-medical-rules-nppl-ppl.html)

thing 13th Oct 2016 16:14

It's certainly a minefield. I've just had to get a LAPL medical certificate as the class II I went for this month (and passed including ECG) is not valid until I jump through several hoops at great cost because of a recent pacemaker implant which was for bradycardia (slower than normal heartbeat), which I've had for all of my sixty years. It was an hour's job under a local, hardly open heart surgery.

So, I am now fitter than last year when I renewed my class II with no problem and bradycardia. But now I don't have bradycardia I can only get a LAPL medical...I feel like I'm in the middle of a Lewis Carroll novel...

By the way my AME charges £100 for a class II including ECG and £60 for a LAPL.

m.Berger 13th Oct 2016 20:47

Hip Hooray! it has been fixed. If you are fit to drive, you are fit to fly 2000Kg.

WoofWoofwoof 14th Oct 2016 08:08


Originally Posted by Lodems (Post 9503110)
It would be easy to assume there is an AME agenda behind all this. Could one of them perhaps be persuaded to comment to dispel that terrible thought?

I am glad its getting sorted out and common sense prevails although we have all seen drivers who are clearly unfit drive and then crash.

Lodems
"It would be easy to assume there is an AME agenda behind all this. Could one of them perhaps be persuaded to comment to dispel that terrible thought"
So here goes
A lot of AME's are pilots too and try to help people fly.
You should understand that constantly changing criteria and rules make things difficult. Contrary to what you might think class1 medicals tend to be easier to perform, lapl's nppl"s can be extremely difficult but if you put a signature to something you can be held to account.
A mono-ocular 70yr old with multiple pathologies yet a lack of information rocking up for a simple signature was not easy. Guidance is limited and as has been pointed out varies depending on where you look. For this reason some AME's do not do LAPL medicals.
Please be sensible in your comments
The CAA is being decimated in general and that includes the medical department as you would have noticed. We all need to be constructive.
PS Enjoy your flying as this is what it is about!

DeltaV 14th Oct 2016 11:06


Originally Posted by m.Berger (Post 9540053)
Hip Hooray! it has been fixed. If you are fit to drive, you are fit to fly 2000Kg.

Not fully fixed. Non-EASA only.

flybymike 14th Oct 2016 12:05

Opinion elsewhere is that a Self declaration is ok with a uk national licence and EASA aircraft until April 2018
(LAPL privileges only, and within U.K. Only)

MrAverage 14th Oct 2016 12:29

......... but most Clubs/Rental outfits will not allow because of insurance concerns...........

PA28181 14th Oct 2016 14:18


but most Clubs/Rental outfits will not allow because of insurance concerns..........
Why should that be? Any details of clubs/renters you actually know who do that?

All this talk about what insurers will and won't let US do is very tiring:ugh:

flybymike 14th Oct 2016 14:25

As stated, I suspect this is largely hearsay.
Insurers have no business inventing their own legislation which does not exist in real life.
There is no significant causal link between accidents and medical incapacitation and indeed the CAA initiative is based on that very lack of evidence.

BEagle 14th Oct 2016 18:48


There is no significant causal link between accidents and medical incapacitation...
Perhaps that's because, until recently, all pilots had medicals of one form or another?

:rolleyes:

flybymike 15th Oct 2016 00:06

NPPL was a self declaration requiring no medical examination, and plenty of proven safe history behind it, and similarly AOPA America see fit to make the following observation;


With the implementation of the Sport Pilot/Light Sport Aircraft Rule, the FAA has the drivers license as a basic form of establishing medical fitness. The use of the driver's license medical for sport pilots has not negatively impacted safety. There have been no accidents in this community related to medical deficiency.
Oh and by the way.......

:rolleyes:

To you too.

Maoraigh1 15th Oct 2016 22:18

Is there a driver's licence medical in the UK, for non-commercial car drivers?
I've been driving for almost 57 years, and don't recall ever having had such a medical.
(All I have is a current EASA Class 2.)

abgd 15th Oct 2016 23:31

No routine medical as such, but there are medical requirements for car drivers and should there be ambiguity about whether or not you meet them... a medical.

Personally speaking I have mixed feelings about it. I suspect the medical is overkill for most, but then how else do you ensure a ready supply of medical professionals who understand aviation and can advise when required? I'm not sure that the risks are as low as all that.

1) psychiatric - suicide by light aircraft is not all that uncommon.
2) medical - an epileptic seizure or collapse in a car is more likely to hurt a bystander; in an aircraft it's likely to prove fatal to the pilot and any occupants.
3) sensory - good sight and vision are quite important
4) general wellbeing - the number 1 cause of accidents is stupidity. We're more likely to be stupid when we're under the weather.

Stereotypical incapacitation accidents are probably quite uncommon, but a 'medical' contribution to aviation incidents is probably much more widespread.

Skylark58 16th Oct 2016 09:55


Perhaps that's because, until recently, all pilots had medicals of one form or another?
Thousands of pilots have been flying without medicals on NPPL GP declarations for the last 10 years and gliders pilots always have.

Having had a heart attack 20 years ago, three weeks after my Class 2 with ECG, they are not infallible.

Pittsextra 16th Oct 2016 10:13


housands of pilots have been flying without medicals on NPPL GP declarations for the last 10 years and gliders pilots always have.

Having had a heart attack 20 years ago, three weeks after my Class 2 with ECG, they are not infallible.
Indeed although clearly had the heart attack occurred during flight you'd likely not be in a position to have posted. So its perhaps less an endorsement of greater freedoms and more a question over why the focus is on the ECG and, for example, no Lipid test.


Stereotypical incapacitation accidents are probably quite uncommon
Does anyone keep any data? Opinion is great but wouldn't be nice if we had actually captured data on these things. One issue that isn't helpful is that in a case when unwell pilot blogs impacts the ground the cause of death is often focused upon that impact because to dig deeper costs somebody some money and even if that money is spent the results are not necessarily 100% conclusive such that the initial cause is changed.

Skylark58 16th Oct 2016 10:29


I'm not sure that the risks are as low as all that.

1) psychiatric - suicide by light aircraft is not all that uncommon.
Really? do you have any statistical evidence of this?


4) general wellbeing - the number 1 cause of accidents is stupidity. We're more likely to be stupid when we're under the weather.
Whether you have a medical or not, if you feel you are not fit to fly due to "being under the weather" then you should not. I don't think stupidity was assessed by any AME I ever went to

Skylark58 16th Oct 2016 10:40

In the 1972 Trident crash, Captain Keys had a Class 1 medical. I assume an ECG would have been taken. I believe it to be the case that a resting ECG is a poor indicator of potential problems compared to an exercise ECG, but have exercise tests never been mandated for Class 1?

MaxR 16th Oct 2016 16:50


the number 1 cause of accidents is stupidity
Yet still people are alive to post things like you did.

In one post you have a "suspect"; a "not sure"; a "not all that uncommon"; a "more likely"; a "likely"; a "quite important"; another "more likely"; a "probably quite uncommon"; and a "probably" but not one fact.

m.Berger 16th Oct 2016 17:21

The number one cause of accidents, as far as I believe is mistakes.

That is not the same thing as stupidity.

abgd 17th Oct 2016 01:07

I don't know whether exercise tests have been mandated for class 1 medicals - not an AME. I gather they're falling out of favour in general medicine now that tests such as angiography and perfusion scanning are considered safer and more informative.

I have no expert knowledge regarding any of these issues. But a quick 'Google Scholar' will show up a number of links suggesting they're significant issues. I haven't digested the papers in sufficient detail to fully appraise them, and don't have the time to do so. On the other hand, it's not so hard to get some kind of an overview of the context in which aviation medicals are justified.

Going back to the headings I used:

1) Suicides - a difficult thing to assess for multiple reasons such as a frequent reluctance amongst coroners to recognise suicide where there is any doubt and the ultimate unknowability of what was going through somebody's mind prior to an accident. If they haven't written a note, it's hard to know for certain.

Analysis of NTSB Aircraft-Assisted Pilot Suicides: 1982?2014 - Politano - 2015 - Suicide and Life-Threatening Behavior - Wiley Online Library identifies 51 pilot suicides 1982 to 2014 but there are almost certainly likely to be a lot more.

https://www.ncbi.nlm.nih.gov/pubmed/25199127

Estimated the rate of pilot suicide at 0.33%. Again, I'd wager that the true rate will be considerably higher.

2) Sudden incapacitation

https://crashstats.nhtsa.dot.gov/Api...ication/811219

states that 84% of people in passenger vehicle crashes who were suddenly incapacitated (e.g. faints, hypoglycemia) had suffered previous episodes. That would imply that similar accidents are by and large preventable.

4) I could have worded this a lot better. I don't mean to call people who make mistakes stupid (I've survived a fair amount of my own stupidity, as I suspect we all have), but a lot of aviation accidents are the sort of lapses that in retrospect are going to seem dumb. I don't mean helicopter-towing-speedboat accidents, but regular everyday things like EFATO turnbacks or landing gear-up or proceeding into bad weather. They're going to be classed as 'pilot error' on any accident report but could there be a medical contribution?

The US emphasis on sleep apnoea (and its potential to be an issue with anyone with a high enough BMI) is the sort of thing I'm getting at. If you have significant sleep apnoea, your cognition and ability to make sensible decisions suffer, but because you may always be impaired, your insight into it is likely to be limited.

The full blood count you get as part of a medical will give information on anaemia (may cause reduced performance at moderate altitudes), alcoholism, vitamin deficiency (B12, Folate are important for cognition and deficiencies change the size of your blood cells). Your BMI is easy enough to measure.

It may be that these issues contribute to more accidents than the obvious all-or-nothing medical incapacitation events.

I've heard figures such as 5% of private pilot accidents being due to medical factors - obviously these are 'failures' of aviation medicals. The question is, how many 'successes' are there where people have not died because their AME either stopped them from flying or resulted in them being treated such that it no longer posed a risk to them (e.g. swapping Piriton for a non-sedating drug).

As I mentioned before, I'm on the fence. I think there's a strong argument for solo pilots to do pretty much what they want - perhaps anyone who flies in airspace should have a hearing test and you might have some caveats for some personality disorders and flying over cities. If an ex-WWII pilot with a dodgy heart wants to take a risk, I'm all for that. But for grandparents who want to give joy-rides to their grandkids I'm not certain. I can see that AMEs and aviation medicine really do have something to offer, even for PPLs.

It would be really interesting to see an AME argue the case for their continued existence, head to head with someone arguing for deregulation. Perhaps the editors of Pilot or Flyer could take note?

Skylark58 17th Oct 2016 06:48

As far as I am aware, a Class 2 medical does not include a full blood count.

BEagle 17th Oct 2016 07:28

The original NPPL Medical Declaration system did at least require the pilot to visit a GP to countersign the certificate. There were 2 grades, one which permitted flight with passengers and one which did not.

But the new brooms at the CAA have swept that level of prudence away and now anyone can simply lie like a cheap Changi watch and self-declare.

abgd 17th Oct 2016 07:58


As far as I am aware, a Class 2 medical does not include a full blood count.
I had one for my initial class 2.

Skylark58 17th Oct 2016 09:09


The original NPPL Medical Declaration system did at least require the pilot to visit an AME to countersign the certificate. There were 2 grades, one which permitted flight with passengers and one which did not.
Sorry Beagle but you are incorrect. The NPPL declaration was signed by your GP, who arguably had full access to your medical history. If you wanted to carry passengers you had to meet the standards for DVLA Group 2 (HGV/Bus/Taxi driver)

BEagle 17th Oct 2016 16:38

Oops -yes, sorry! I meant to write 'GP'! Post duly edited!!

That was one of the best aspects of the NPPL system - no need to see an AME. In fact an AME wasn't even allowed to sign the Medical Declaration unless he/she happened to be your GP.

Hants Eaglet 21st Oct 2016 15:28

So thanks to the good offices of the LAA/BGA et al in lobbying for common sense with the "clarification" there is now some meaning to the changes as we're OK up to 2000kg, still tough if you've got an especially large plane though. We can continue flying our LAA types anon and EASA types until 04/18. I've heard rumours that they're working on that, which would sensible as it will keep more money in the industry from those who currently only have access to them. As the US is going the same way with driver medical standards for PPLs it would be the icing on the cake if the CAA and the FAA could come to the sensible agreement to recognise each other's rules so we could then fly again over there if we wanted to. My declaration has been done, so my old style PPL is now valid again as well as the NPPL, it's nice to have it back! Maybe my FAA one will become usable again some day, fingers crossed.

hugh flung_dung 21st Oct 2016 15:40


Originally Posted by Hants Eaglet (Post 9548371)
... We can continue flying our LAA types anon and EASA types until 04/18. I've heard rumours that they're working on that ....

If you are referring to the recently published Opinion 09/2016 on the revision of Part MED: https://www.easa.europa.eu/document-...opinion-092016 (also see the draft Annex) then I believe it will be finalised by the end of the year.

HFD

divy600 23rd Oct 2016 14:18

So, does this really mean that you can ignore any disqualifying condition/s and self declare providing you do not fly an aircraft over 2000kg MTOW?

BillieBob 23rd Oct 2016 22:08

Provided that you are not taking medication for a psychiatric condition - yes.

flybymike 23rd Oct 2016 22:52


So, does this really mean that you can ignore any disqualifying condition/s and self declare providing you do not fly an aircraft over 2000kg MTOW?
No it doesn't mean that. You must also comply with the following.


A person must not act as the member of the flight crew of an aircraft registered in the UK if they know or suspect their physical or mental condition renders them temporarily or permanently unfit to perform such functions or to act in such capacity, including unfitness.

Withdrawal of Medical Fitness

If you no longer reasonably believe that you meet the medical requirements:
• • •
Of a DVLA Group 1 Ordinary Driving Licence, or
have been so advised by a medical practitioner, such as a GP, or
if you reasonably believe that you have developed one or more of the disqualifying medical conditions, as mentioned in ‘The
Medical Declaration’ section, appropriate to the declaration made, or as otherwise specified by the CAA.
you must withdraw your medical declaration by ticking the appropriate box and submitting a new self-declaration to the CAA. You should request advice from an AME if you subsequently wish to resume flying.

divy600 24th Oct 2016 09:37

That's as it should be, but the LAA statement, "if you're fit to drive to the airfield, you're fit to fly!", is to say the least a bit misleading.


The DVLA group 1 medical requirement is pretty lenient with most medical conditions, but group 2 does rightly impose much more stringent requirements.


Also, if my reading of the revised Medical Declaration is correct it also seems to allow for the carriage of passengers, not what the old NPPL countersigned Medical Declaration allowed for under Group 1.


- or am I just confused!

Maoraigh1 24th Oct 2016 19:52

If I ask my GP whether I should continue driving, and he says "Yes', then, providing I have concealed nothing from him, I can legally fly, within the UK National Boundaries, to the limits permitted by my licence, while carrying pax.
Correct??

flybymike 25th Oct 2016 00:29

AIUI there is no restriction on the carriage of passengers using the new self declaration, neither is there any need to ask your GP whether you are fit to fly.

For sub 2 tons you simply need to declare that you are not bonkers and to undertake not to fly, or to cease flying if you have any reason to suspect or know that you are not fit to do so.

m.Berger 25th Oct 2016 16:36

It is said that you have to be mad to own an aircraft in Britain so only hirers may take advantage of the new declaration :-)

Maoraigh1 25th Oct 2016 20:06

My post assumed I had just been diagnosed with some serious medical condition. As long as the GP says OK to driving, I can now fly. He may be thinking of me driving on the local roads to the shops, or to his surgery.

Heston 26th Oct 2016 07:34

https://www.gov.uk/government/public...-professionals

See this for the guidelines for your doctor. There is no way they are going to say "yes you can drive to the local shops, but dont go on any big scary roads". Either you meet the standards or you dont.

So yes, if you can drive, you can fly up to 2000kg on the national licence unless you are under medication for a mental illness. With passengers.

Lodems 26th Oct 2016 08:24

Self declaration Medical submission
 
Is there a clever workaround for making the CAA self declaration online form work via Google Chrome? Doesn't seem to submit.

MRP22 26th Oct 2016 22:29

Pilot Medical Declaration
 
On the Declaration Form you have to tick the box that confirms :-
a. I hereby declare that I reasonably believe I meet the medical requirements for a Group 1 Ordinary Driving Licence issued by the DVLA and am not subject to any disqualifying medical condition as defined in the ‘Pilot Medical Declaration Guidance Notes’.

From the ANO wording 'disqualifying medical condition' is quoted :-

6) For the purposes of this article, “disqualifying medical condition”means any physical or mental condition or illness, or any history of such a condition or illness, including—
(a) any alcohol or drug abuse, addiction or misuse;
(b) any neurological condition;
(c) any functional disability;
(d) any surgery or medical treatment;
(e)any collapse, fainting or loss of consciousness;
(f) any history of (a) to (e); or
(g) such other medical conditions as the CAA may specify,

that might impair the safe operation of normal flight controls or render the licence holder unfit at any time to perform any function for which the licence is granted.


If appropriate you then tick the 'Fly no greater than 2000kg' box.

So from the above, previous comments on this thread about only needing to meet the medical requirements for a Group 1 Driving Licence are incorrect, because you are declaring also that you are not subject to any of the disqualifying medical conditions.

Please tell me I am wrong but don't seem to be able interpret any other way.




colibripilot 27th Oct 2016 12:06

Pilot Medical Declaration
 
On the Declaration Form you have to tick the box that confirms :-
a. I hereby declare that I reasonably believe I meet the medical requirements for a Group 1 Ordinary Driving Licence issued by the DVLA and am not subject to any disqualifying medical condition as defined in the ‘Pilot Medical Declaration Guidance Notes’.

The ‘Pilot Medical Declaration Guidance Notes' are shown at the top of the SRG1210 form and make clear that, for sub-two-tonne aircraft, the only disqualifying condition is psychiatric.

The twelve disqualifying conditions listed further down on page 1 apparently only apply for aircraft between 2001 kgs and 5700 kgs.

Or perhaps it is I who have misunderstood. Clear as mud, eh?

BEagle 27th Oct 2016 12:18

You are wrong.

Read the second section 'To Only Fly an Aircraft of 2000kg MTOW or Less' (sic) of https://publicapps.caa.co.uk/modalap...e=form&id=7580 .

paulF99 27th Oct 2016 19:05

The trouble is that the group of aircraft categorised as 'any Aircraft up to 5700kg MTOW' also includes as a subset all those aircraft categorised as 'an Aircraft of 2000kg MTOW or Less'. Poorly worded & open to misinterpretation.


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