A critical analysis of the UK Civil Aviation Authority’s medical appeals process: Assessing the need for an independent medical ombudsman

The aim of this research was to determine how an independent medical ombudsman set up to arbitrate UK Civil Aviation Authority (CAA) medical appeals would impact on the levels of perceived clarity, transparency, fairness, and logic of the overall CAA medical appeals process. 24 in-depth interviews carried out in 2021 with a mix of stakeholders including Pilots, Air Traffic Controllers (ATC), Cabin Crew, Aeromedical Examiners (AMEs) and Safety Specialists gathered qualitative evidence on the current CAA medical appeals process compared with published evidence on medical appeals processes overseen by other major aviation regulators, namely the Federal Aviation Administration (FAA - US), and the Civil Aviation Safety Authority (CASA - Australia). Stakeholders were then asked to give their views on the possible impact of creating an independent medical ombudsman to arbitrate the CAA medical appeals process. The results revealed compelling evidence that the current CAA process is not as clear, fair, or transparent as it could be with only 21% stating yes to all three elements, lower than views on the currently published CASA and FAA processes, with 83% and 75% supporting them as they are respectively. The easy-to-follow approach of CASA, and its many independent options along with the ability for individuals to make a Statement of Demonstrated Ability (SODA) as part of the FAA process were standout features of the international comparators. The idea of an independent medical ombudsman received high levels of support from respondents (91% in favour) due to its perceived impact on introducing more independence and transparency into the current UK CAA process. The findings of this study support the case for an independent arbitrator of the CAAs medical appeals process, which would align well with the organisation's critical work around Just Culture.