GM2 SPA.HEMS.130(g)(2) Crew requirements

(a) Considerations concerning confidentiality when reporting possible signs of cognitive performance deficits of a pilot to the licensing authority

EU and national personal data protection regulations should be observed in all cases involving processing of personal data, including transferring of personal data to competent authorities and medical professionals.

Medical confidentiality related to the aero-medical assessments is strictly protected by point MED.A.015 of Annex IV (Part-MED) to Regulation (EU) No 1178/2011. Regardless of the fact that the assessment of cognitive performance is not a medical examination and hence not covered by the provisions of point MED.A.015, the principles of confidentiality should be observed at all times.

Confidentiality of medical records is an important ethical and legal duty of all parties involved and can only be superseded by the requirement to address imminent and high risks of harm to involved or third parties. In the context of the application of point SPA.HEMS.130(g)(2), this means that, when processing information containing health-related data, examiners involved are subject to the requirements of EU and national personal data protection regulations. As a consequence, the information, that the examiner will report to medical assessor of the licensing authority of the pilot concerned, should be clearly described in a privacy notice provided to pilots prior to the proficiency check specified in point (b) of AMC1 SPA.HEM.130(g)(2). When examiners detect a cognitive performance deficit of pilots, the personal data of these pilots should be shared only with the medical assessor of the licensing authority of the pilot concerned. When such sharing of personal data is needed, the examiner should inform the pilot concerned.

(b) Additional considerations and examples

It is anticipated that in the context of recurrent checking tests examiners may not come in a position where they have to breach confidentiality related to observed signs of neurocognitive performance deficits.

Nevertheless, such situations may take place occasionally. Below we present several best practices to consider in various scenarios:

(1) If neurocognitive performance deficits (see the report ‘Extending age limits of HEMS pilots to 65 years – mental health and cognitive screening’) cause failure or partial failure of the proficiency check, the result of the check will be reported to the authority and the pilot will not be allowed to exercise the privileges of their licence/rating pending the results of a new evaluation. While the pilot is grounded, flight safety will not be imminently endangered; nevertheless, the examiner should report the situation to the medical assessor of the licensing authority of the pilot allowing for additional medical investigations. In such a case, the examiner should provide a report based on identifiable factual items explaining why the pilot’s performance did not meet the required standards. In case there are signs of a cognitive performance deficit, the medical assessor of the licensing authority may demand a neurophysiological assessment before a re-examination check is to be performed.

(2) If a result of a check is sufficient only by the narrowest margin and the examiner has found one or more possible sign(s) of cognitive performance deficit, the examiner should explain their concerns to the pilot and seek the consent of the pilot to share the concerns with the medical assessor of the licensing authority in order to discuss monitoring of possible cognitive decline by shortening the interval between the last and the next check and/or a neurophysiological assessment. In such cases, the examiner should describe their concerns in operational terms based on identifiable factual items explaining why the pilot’s performance is borderline to meet the required standards such as ‘situational assessment and decision-making on engine failures took longer time than commonly needed’ (which relates to the cognitive function of problem‑solving and decision making). Where the pilot refuses to give consent regarding the notification to the licensing authority, the examiner performing the proficiency check should consider taking appropriate measures to remove the respective pilot from flying duties in the interest of flight safety, while at the same time reporting the situation to the medical assessor of the licensing authority of the pilot. In that case, the examiner could consider paying special attention to signs of cognitive performance deficit(s) during a next check.

(3) In the case that a pilot has successfully passed the check, demonstrating that their performance is sufficient to exercise the privileges of the licence/rating, it can be considered that there is no evidence of any cognitive decline that would negatively impact flight safety in the interval before the next check and, consequently, no further measures are needed.