If you are unwell or have had recent surgery you need to get advice as to whether you can travel. You should also make sure you travel insurer is aware of pre-existing medical conditions. If you fall unwell abroad most insurers will contact your GP, with you consent to access you medical history. If you have failed to disclose information you should have, you may invalidate your travel insurance policy.

Travelling by commercial airline can be hard work. If your health is in question or you have had recent surgery you must get guidance from the airline. You may need a “Fit to Fly Letter” or need to gain medical clearance from the airline. Further more if you need special assistance this has to be booked at least 48 hours prior to flying. Special assistance will mean you will be supported through the airport and won’t have to walk, a buggy will usually take you directly to the plane. If you are unable to walk at all, a special wheelchair is used and you will be taken directly to your seat.

If you are ill abroad your doctor may have told you you cannot return home by plane. This can be confusing in repatriation terms. Generally, when a hospital advises you cannot fly, they refer to commercial flights. It is worth consulting with your insurance assistance company or a firm like MET Medical. It may be that you can still travel on a flight with a medical escort, such as a paramedic, nurse, or doctor. Specialist repatriation companies like MET provide fully equipped escorts that carry medical equipment and even oxygen. It may be, though, that the medical condition means you need to travel in a dedicated air ambulance. This can be costly, but there are very few situations where a patient is too ill for air ambulance.

Aeromedicine is a specialist subject, and those determining whether it is safe to fly require specialist knowledge. The aircraft environment places additional pressures on our bodies due to G-force, atmospheric pressure and oxygen availability. Air ambulances are able to pressurise the cabin to a lower height than commercial aircraft, and oxygen is available in flight. If a patient is on oxygen on the ground, their oxygen requirements will be greater at altitude. Equally, care has to be taken in relation to gases for example in relation to pneumothorax or any recent surgeries. These are all considerations that are beyond the knowledge and experience of most doctors on the ground. They may advise if you are in France and need to get to the UK that the only way is by ground transport, this is not always the case and an air ambulance flight can place less strain on the body and be generally more comfortable. Healthcare professionals can seek guidance from the Civil Aviation Authority website or from a specialist advisor.

What about pregnancy, can you fly? If you are more than 28 weeks pregnant, most airlines require a letter confirming the pregnancy is progressing ok, and there are no complications. Those over 36 weeks for single pregnancies or 32 weeks for multiple pregnancies are usually not permitted to fly.

As a rule very few patients are too sick to fly if they need to be repatriated, however, care and thought should be given prior to setting off following a recent surgery or following a serious illness. Whilst mobility is a key factor for determining how to travel its vital to gain advice due to the reduction in oxygen, pressure changes causing expansion, and forces.

Read the small print in relation to travel insurance. Getting caught without valid insurance can be hugely costly. Repatriation from the pacific could run into hundreds of thousands of pounds and a stay in intensive care could be over £3000 per day. Even a medical flight from Europe to the UK can cost in excess of £20,000.