The Ultimate Guide to Fit-to-Fly Certificates

Why are Fit-to-Fly Certificates Important?

If you’re looking to travel but are concerned about the complications that might come with travelling with a medical condition, then you aren’t alone. With the help of Medical Travel Compared and their medical travel insurance policies, they can take the worry out of travelling. Alongside travel insurance, there are other things you should consider before flying to make the process as easy and straightforward as possible, such as organising fit-to-fly certificates.

Fit-to-fly certificates are important because they serve as official medical documentation confirming you are medically stable and able to fly safely. For people with certain illnesses, flying can serve as a threat, especially for those who may have had recent surgery, infectious diseases or chronic illnesses. Fit-to-fly certificates also offer peace of mind to other passengers and flight staff.

General Restrictions on Flying

Certain long-term medical conditions can flare up from time to time, especially under the effects flying can cause on the body. As well as making you feel generally unwell, a flare-up of some conditions (including asthma, COPD, Crohn’s disease and ulcerative colitis) can make travelling riskier.

There are other medical conditions where the severity of symptoms varies widely. For instance, many people with Parkinson’s disease have only mild issues with mobility, and many people with multiple sclerosis feel entirely well between attacks. But others may need major modifications to their travel plans or have very limited mobility.

So, if you have a long-term medical condition, you should always check with your travel agent or airline whether you’ll need a fit-to-fly certificate or medical letter confirming you’re currently fit to fly.

When Do You Need a Fit-To-Fly Certificate?

A fit-to-fly certificate is needed to obtain medical clearance from your airline. If your condition is stable, it’s very unlikely that you will be asked for medical clearance - but a fit-to-fly certificate may still be required if: 

• You’ve recently been discharged from the hospital
• You’re in recovery from an operation
• You’re more than 28 weeks pregnant
• You’re actually travelling for medical reasons (i.e. you’re going for some treatment)

Of course, whether you need a fit-to-fly certificate is at the discretion of your chosen airline, so you should always carefully check their individual guidelines to find out their specific requirements.

Flying when Pregnant        

Most airlines require a fit-to-fly certificate after 28 weeks. Most airlines do not allow air travel after 36 weeks (or 32 weeks for multiple pregnancies and some long-haul trips).

Flying While Recovering from Surgery   

Varies based on the severity of the surgery. Contact your airline and your GP to find out whether you’re fit to fly.

Flying with a Heart Condition       

According to the British Cardiovascular Society guidelines, most people with a heart condition can fly safely, but this varies based on the severity of the condition. Contact your airline and your GP or specialist about establishing whether you’re fit to fly.

Flying with Angina 

Provided symptoms are under control by medication, angina should not be a problem on board an aircraft. However, if you get chest pain while at rest (so-called unstable angina), you may not be able to fly. Contact your airline and your GP about establishing whether you’re fit to fly.

Flying after a Heart Attack              

You may be able to travel after 7 to 10 days, provided there are no complications. Always check with your specialist before booking a flight.

Flying after Heart Failure   

Provided symptoms are under control, heart failure should not be a problem in flight. However, if you have chest pain while at rest, you may not be able to fly. Contact your airline and your GP to find out whether you’re fit to fly.

Flying with a Pacemaker 

It should not cause problems for air travel. However, pacemakers can sometimes set off airport security alarms, so be prepared with a letter from your doctor.

Flying after Heart Surgery

Advisable not to fly for at least 10-14 days after bypass grafting or other heart or chest surgery and until you are able to manage normal day-to-day activities. However, if you've had an angioplasty (or other procedure which doesn't involve open surgery), you may be fit to fly from 3 days after the procedure, if your specialist gives the okay.

Flying with High Blood Pressure 

High blood pressure should not be affected by air travel, but it is advisable to travel only when your blood pressure is controlled. Find out more from our article on travelling with high blood pressure.

Flying with Asthma               

Those with asthma should not have issues with flying, though it is advisable to always carry any medication, such as an inhaler, in your hand luggage. You can find out more about travelling with asthma from our article.

Flying with a Broken Bone              

Because of the risk of swelling inside a cast, many airlines choose to restrict flying during the first 24-48 hours after a cast has been fitted. If you do decide to travel before that time period has elapsed, you can expect the airline to require your cast to be split along the full length to prevent any pressure build-up impacting your circulation. Having a letter containing the date & time the cast was fitted will be helpful.

Flying with Diabetes             

Air travel should not pose significant problems for travellers with well-controlled diabetes. However, it's important to check in advance what other precautions you need to take.

Flying with a Disability       

Most people with mobility problems have found it possible to travel by air, especially with legislation which was passed in 2008. If there are other medical issues, you should check with your GP that these are taken into account.

How to Get a Fit-To-Fly Certificate

Suppose you are seeking a fit-to-fly certificate. In that case, the first thing to do is ensure you are required to carry one with you whilst travelling, because, as mentioned above, there are only certain instances that would require you to have a fit-to-fly certificate.

Providing a fit-to-fly certificate has never been part of an NHS GP’s work. That means they would always charge for providing this service. However, GPs are not trained in aviation medicine, which is the specialised branch of medicine related to flying. Therefore, the British Medical Association has issued guidance advising doctors that they may not be professionally insured to provide an opinion on fitness to fly.

As a result, more and more GPs are saying they cannot provide fit-to-fly certificates, and they cannot say that a patient will be fit to fly in the future (for instance, by the end of their holiday). If they do provide information:

• They may provide purely factual information based on what is in their medical records and may not give any opinion on whether you are actually fit to fly.  
• If they do give an opinion, they may limit it to saying  "Based on information available in the medical notes, the patient appears to be fit to travel."

The Civil Aviation Authority advises that most people with long-term medical conditions should not need a letter if their condition is stable. If you are asked to provide information, your hospital team may be able to provide this.

However, some private online medical services will offer fit-to-fly certificates. This is usually obtained by completing a brief online form, followed by a short video call with a registered GP who will ask you some questions about your condition. Alternatively, private GPs or travel clinics can also help you obtain this document, too.

Travelling with Medicines or Medical Equipment

Travelling with Medication

You’ll often need a letter from your doctor if you need to take medication abroad. In addition, some countries have restrictions on certain medicines (and even ban them), including some available in the UK without prescription, such as codeine-containing medicines.

You can find out exactly what you need to do to avoid any issues with your medication from my article on taking medication abroad.

Travelling with Oxygen

One of the major issues in relation to fitness to fly is the fact that the oxygen pressure in a plane is lower than on the ground. That means conditions affecting your heart and lungs, which can reduce your body's ability to carry oxygen around your body, can lead to new or worsening symptoms during flight.

In some situations, you may be able to fly if you have access to oxygen on the plane – speak to your doctor about arranging this if needed. You will definitely need a letter from your doctor detailing:

• All your medical conditions.
• Why you need to travel with oxygen.
• That your condition is stable and that you are fit to fly with oxygen.

Remember that all airlines have different rules about travelling on a plane with oxygen: some provide it on board for free, while others charge for it. You’ll need to contact your airline well in advance to make arrangements. You’ll also need to make arrangements to access oxygen at your destination. You can find out more details in my COPD travel guide.

Flying with a Pacemaker or Implantable Defibrillator (ICD)

Having a pacemaker shouldn’t cause problems for air travel, but you will need your device identification card. It’s a sensible precaution to get a doctor’s letter, too.

Recent research suggests it’s usually safe to go through airport scanners with a pacemaker or ICD. But you can ask for a hand-held metal detector check instead – see my guide to travelling with a heart condition for more details.

Travelling with a Plaster Cast

Because of the risk of swelling inside a cast, many airlines choose to restrict flying during the first 24-48 hours after a cast has been fitted. If you do decide to travel before that period has elapsed, you can expect the airline to require your cast to be split along the full length. This will prevent any pressure build-up from impacting your circulation. Having a letter containing the date and time the cast was fitted will be helpful.

How Much Does it Cost to get a Fit-To-Fly Certificate?

This depends on how much your GP surgery charges, but typically this cost ranges from £20-£40. 

You can find a list of suggested fees from the British Medical Association if you want a more comprehensive idea of the different costs and fees you might expect.

When Will My Fit-To-Fly Certificate Expire?

Again, there is no clear-cut answer to this. But at the very least, your certificate should indicate that you’re fit to fly at the exact time of your trip. 

So, if you have a letter from months ago, it’s unlikely to be suitable for your airline today. 

If you have a recurring or more permanent medical issue, you should probably speak to your doctor or specialist nurse about getting a fit-to-fly certificate every time you travel, just to be on the safe side.

If you’re travelling with a medical condition or are looking to get travel insurance, annual multi-trip or single trip policies, then it is important to check if you need a fit-to-fly certificate. Hopefully, this guide has given you some insight and tips on how to ensure you are travelling with the right documentation.