This section is for Approved Medical Examiners of Divers (AMEDs) and doctors interested in becoming an AMED.
AMEDs are medical examiners approved by HSE to perform statutory medical examinations/assessments for the Diving at Work Regulations 1997. Under these regulations, all divers at work must have a valid certificate of medical fitness to dive issued annually by an AMED.
In order to undertake such medical examinations/assessments, the doctor must have a valid ‘Certificate of Approval’ issued by HSE. This authorises the AMED to conduct medical examinations under the regulations for a stated period.
AMEDs must have knowledge of different types of diving, diving work environments and diving medicine (see Training). In addition, they must seek to maintain and improve their standards by continuing professional development. In conducting medical examinations, the AMED has a duty of care that is the same as that in any clinical situation and based on the General Medical Council’s (GMC’s) principles of Good Medical Practice. The standards for conducting the medical examinations/assessments are set out in: The medical examination and assessment of divers (MA1).
Although approved by HSE, AMEDs are not employed by HSE. Divers requiring the medical examination, or their employers, are responsible for agreeing payments with the AMED.
AMEDs are accountable to HSE for the work they carry out. They work under the supervision of the HSE Senior Medical Inspector who issues the Certificate of Approval.
As an AMED, you are responsible for achieving and maintaining your own competence as required by the GMC. In 2009, the GMC introduced a licence to practise. This is the first step towards introduction of a revalidation system to ensure doctors are fit to practise.
It is important for HSE to have appropriate governance arrangements to monitor your competence for the specific role of an AMED. This is reflected in the procedures detailed below for new applicants and review of existing AMEDs.
As part of the approval process, you must demonstrate access to appropriate facilities and equipment for conducting medical examinations. Accommodation should provide: a safe environment which protects the privacy of those being examined, appropriate equipment and furnishings, acceptable levels of hygiene, adequate heating and ventilation and hand washing facilities.
You will need to be able to perform or obtain electrocardiography, audiometry, spirometry and fitness testing. All equipment must be suitably calibrated and maintained. You must have adequate emergency provision and training for dealing with cardiopulmonary incidents. There may also be a need for access to local haematology and radiology services. Where technical procedures or measurements are delegated to others, the AMED is responsible for ensuring the competence of such staff through appropriate training and supervision.
If a diver or employer requires the services of an AMED, initially they should consider using a doctor already approved by HSE. If an AMED is not available, circumstances may require assistance from another doctor who will need to apply to HSE for approval.
To apply for approval, you should complete application form AMED02 and provide HSE with the following information:
The application form and information requested above should be sent to: Corporate Medical Unit, Health and Safety Executive, Redgrave Court, Merton Road, Bootle, Merseyside, L20 7HS.
On receipt of a full package of information, an HSE Medical Inspector will assess your application. You will be contacted if further information is required. If successful, HSE will issue you with a Certificate of Approval, normally for one year in the first instance. It is not transferable and you are responsible for ensuring you do not work beyond the expiry date on it unless issued with a new certificate.
To ensure your ongoing competency for the role of AMED, your approval will normally be reviewed before your certificate is due to expire. The standards against which you will be assessed during a review are based on those detailed in The medical examination and assessment of divers (MA1).
When HSE notifies you that your review is due, you must submit the following information:
On receipt of a full package of information, an HSE Medical Inspector will conduct a review. You will be contacted if further information is required. If appropriate, HSE will issue you with a new Certificate of Approval for 1-5 years.
Under certain circumstances, an HSE Medical Inspector will conduct a face-to-face review visit with the AMED. You will be contacted in advance if a visit is deemed necessary. In considering the need for review visits, the following will be taken into account:
When conducting your review, the HSE Medical Inspector will record any issues of concern identified and inform you in writing. On receipt of the letter, you must respond within 10 working days confirming when and how you will address the areas of concern. The Medical Inspector will then decide what further action may be necessary. This could include:
If a Medical Inspector has serious concerns about your performance that require urgent action, they will initially contact you by telephone and subsequently follow the procedure outlined above.
Ultimately, the Senior Medical Inspector (who issued your Certificate of Approval) has the power to revoke your Certificate of Approval at any time, if your work as an AMED is unsatisfactory.
You may appeal against a decision:
If you wish to appeal, you should submit your request within three months of receiving formal notice of the decision. It should be accompanied by documentary evidence in support of the appeal. The request should be sent to:
Chief Medical Adviser
Corporate Science, Engineering and Analysis Directorate
Health and Safety Executive
Redgrave Court
Merton Road
Bootle
Merseyside
L20 7HS
If there is a verbal complaint made about your work as an AMED, HSE will request written confirmation. To investigate a formal, written complaint, you may be asked to provide written comments in response. Alternatively, an HSE Medical Inspector may visit you to gather evidence on which to base their judgement.
Enquiries about the approval process, completed MA2 forms or requests for blank MA2 forms should be sent to:
Corporate Medical Unit
Health and Safety Executive
Redgrave Court
Merton Road
Bootle
Merseyside
L20 7HS
e-mail: AMED@hse.gsi.gov.uk
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):
Diving Diseases Research Centre
Professional Services
Hyperbaric Medical Centre
Tamar Science Park
Plymouth
PL6 8BU
Tel: 01752 209999
Hyperbaric Medicine Unit
Aberdeen Royal Infirmary
Foresterhill
Aberdeen
AB25 2ZN
Tel: 01224 553264
Institute of Naval Medicine
Training Division
Crescent Road
Alverstoke
Gosport
Hampshire
PO12 2DL
Tel: 02392 768090
