AMED approval and review process

This section explains the approval process for Approved Medical Examiners of Divers (AMEDs) and doctors interested in becoming an AMED.

To undertake medical examinations for the purposes of the Diving at Work Regulations 1997, the doctor must have a valid 'Certificate of Approval' issued by HSE. AMEDs are accountable to HSE for the work they carry out. As a condition of approval they undertake to adhere to standards set by HSE in the regulation-specific guidance for AMEDs.

Approval process

To gain HSE approval to become an AMED, you will need to meet the following requirements:

You must be registered with the General Medical Council (GMC) and hold a licence to practise and be fully engaged with GMC revalidation. As part of your revalidation, you should ensure your AMED work is considered during your annual appraisals.
You must:
- have a recognised qualification in occupational medicine (minimum of diploma)
- a knowledge of different types of diving, diving work environments and diving medicine gained through training
- maintain and improve your standards by continual professional development as required by the GMC
You must have a comprehensive understanding of:
- the AMED web pages
- The medical examination and assessment of commercial divers (MA1);
- the Approved Codes of Practice for Diving
- ebulletins for AMEDs sent out periodically by HSE
You need access to appropriate facilities and equipment for conducting medical examinations. This includes:
- a safe environment for conducting examinations
- an environment which safeguards the privacy of the worker during the examination
- adequate emergency provision and training for dealing with cardiopulmonary incidents
- appropriate equipment for conducting examinations which is maintained and calibrated in accordance with the manufacturers' instructions;
- suitable furnishings for conducting examinations
- acceptable levels of hygiene
- adequate heating and ventilation
- hand washing facilities

While you must retain overall responsibility for the statutory medical examination, some elements may be delegated to nurses or occupational health technicians. However, you must ensure that the nurse or occupational health technician is suitably trained and competent. You should examine the diver and assess their fitness to dive as guided by the diving regulations, relevant Approved Code of Practice and MA1.

It is a condition of approval that you respond promptly to requests from HSE for information on your activities as an AMED and you promptly inform HSE of any changes in contact details. If HSE is unable to contact you, your approval may be withdrawn. You should aim to perform at least five statutory medicals a year. If you do not perform any diving medicals over a 12-month period, your approval may be withdrawn.

The following statement is being published to meet the requirements of the Professional Qualifications Act 2022 (PQ Act). Under section 8 of the PQ Act regulators in the UK are required to publish certain information about requirements to practise the profession.

Any person wishing to practise the profession of Approved Medical Examiner of Divers must hold qualifications and experience that complies with the HSE Approval process. There is no application process within the scope of Sections 8(2)(b) or 8(2)(c).

Training

You must attend a course in basic underwater medicine although this in itself does not guarantee approval. The duration of these courses is up to five days and they cover all the material necessary to enable the doctor to assess fitness to dive for a variety of diving work.

To keep up to date with developments in diving medicine you will be expected to attend a suitable refresher course with the emphasis on diving physiology and fitness to dive. The refresher should be a minimum of two days duration and repeated at least once every five years. The following organisations can provide suitable courses (inclusion in the list does not imply HSE approval or accreditation):

DDRC Healthcare
Hyperbaric Medical Centre
Plymouth Science Park
Research Way
Plymouth
Devon
PL6 8BU
Tel: 01752 209999

Institute of Naval Medicine
Training Division
Crescent Road
Alverstoke
Gosport
Hampshire
PO12 2DL
Tel: 02392 768091

How to apply for approval

You should only apply for approval if you can fully meet the requirements AND there is a demand for your services, if approved.

To apply for approval, you should complete application form AMED02 and provide HSE with the following information:

documentary evidence of satisfactory completion of your last annual appraisal, containing your name as appraisee, name of appraiser, signature of appraiser (or electronic confirmation) and date of appraisal
a copy of the certificate of your highest recognised qualification in Occupational Medicine (minimum of Diploma)
a copy of your current training certificate that shows evidence of specialist diving medicine (training provides further information)

Incomplete applications will be rejected. For example if you do not provide a copy of your current training certificate.

The application form and the additional information requested should be sent by email to: [email protected] and marked New Applicant.

If satisfactory, HSE will issue you with a Certificate of Approval for one year in the first instance. The certificate is not transferable to another doctor. You are responsible for ensuring you do not undertake medicals beyond the expiry date on your certificate unless issued with a new certificate.

How to renew your certificate of approval

When HSE notifies you that your Certificate of Approval is due for renewal HSE will check you continue to be registered with the GMC and hold a licence to practise. You should complete the renewal form AMED02R and provide the following information:

documentary evidence of satisfactory completion of your last annual appraisal, containing your name as appraisee, name of appraiser, signature of appraiser (or electronic confirmation) and date of appraisal
a copy of your current training certificate that shows evidence of specialist diving medicine
a sample of medical records for at least three divers (copies only, do not send original documents). At least one should be for an initial medical examination and where available, one should be for a female diver. In each case, the medical record should be accompanied by the last MA2 issued and any additional clinical notes

If you do not provide all the requested information in support of your renewal (for example, you do not submit a valid diving medicine training certificate), HSE may not renew your approval. In these circumstances, once your approval has expired, you will no longer be approved by HSE. Therefore, you will not be able to undertake statutory diving medicals.

When submitting medical records, you should anonymise them by removing or redacting the employee's name and address but still retain their gender and date of birth. If you submit records by post, you should mark them 'Medical in Confidence'. HSE will destroy the records on completion of the review.

Reviewing performance

An HSE Medical Adviser will look at the medical records to review your performance against standards based on 'The medical examination and assessment of commercial divers' (MA1). Following the review, the HSE Medical Adviser will write to you, indicating whether the outcome was satisfactory or if minor or major improvements are required, setting out any remedial action considered necessary. In exceptional cases, remedial action may include face to face review, usually at an HSE office. Once you have addressed any remedial action that may be necessary, HSE will renew your Certificate of Approval, normally for five years. If serious compliance problems are identified, HSE may decide not to renew your certificate or to issue a certificate of short duration for no longer than one year.

The certificate is not transferable to another doctor and you are responsible for ensuring you do not undertake medicals beyond its expiry date unless issued with a new certificate.

How to appeal

You may appeal against a decision:

not to issue you with a Certificate of Approval;
to revoke your Certificate of Approval.

If you wish to appeal, you should submit your request within 28 days of receiving formal notice of the decision. You should provide documentary evidence in support of the appeal and send the request in an email to [email protected]. The email should be marked Appeal and cite your PIN Number.

The original decision made will remain in place until the outcome of any appeals process.

Ahead of an appeal you may wish to discuss the initial outcome with HSE's Principal Medical Adviser or a member of their team to understand the issues raised and any actions that need to be taken.

The appeal process

The appeal is a paper based review conducted by the panel. The review will consider the previous decision made and the evidence to support that decision. The panel will reject the appeal if it is without merit.

HSE will aim to convene the panel within 15 working days after receipt of the appeal request or as soon as reasonably practicable thereafter. The appellant will be informed of the date of the panel once it is set.
The documentary evidence provided by the appellant in support of the appeal will be provided to the panel.
If additional information is required from the appellant they will be informed by email and provided with a date by which the additional information must be submitted.

Appeal outcome

The appellant will then be notified of the outcome as soon as is reasonably practicable following the meeting and conclusion of the panel. The decision will contain the reasons for the outcome of the appeal.

Complaints

If there is a verbal complaint made about your work as an AMED, HSE will request written confirmation. To investigate a formal, written complaint, HSE will ask you to provide written comments in response. Alternatively, an HSE Medical Adviser may visit you to gather evidence on which to base their judgement.

Enquiries

Enquiries about the approval process, completed MA2 forms or requests for blank MA2 forms should be marked ENQUIRY and be emailed to: [email protected]