Most delayed missions are not delayed by weather or aircraft. They are delayed by a missing signature. Here is the checklist we work from.
Over the course of a year, the majority of medical missions that slip do so on paperwork, not on operations. The aircraft is available, the crew is rested, the weather is fine — and the patient cannot leave because one document has not been signed. The list below is what we ask for at the start of every case.
From the sending hospital
A current medical report, ideally no more than 48 hours old, in English or with a translation. It must state the diagnosis, the current medications and doses, the ventilation or oxygen requirements, and any infection status or isolation requirement.
A fitness-to-fly statement from the treating physician. Airlines require this for commercial escorts; for a charter it protects everyone involved by documenting that the treating team considers the transfer appropriate.
A discharge summary prepared for the transfer date, plus imaging on a disc or via a transfer link.
From the receiving hospital
Written acceptance naming the admitting department and, ideally, the admitting physician. Without this, a mission can arrive with no bed assigned.
A bed confirmation with a date and time window. Acceptance in principle is not the same as a bed available on Thursday morning.
From the patient or the family
Passport or travel document, and any visa required for the destination and for technical stop countries where relevant.
Consent for the transfer and for the processing of medical data, signed by the patient or their legal representative.
Insurance policy details and, where the insurer is paying, the guarantee of payment. This is the single most common cause of delay: the guarantee arrives late and the mission cannot be confirmed.
What we handle
Overflight and landing permits, slot requests, ground handling, ambulance bookings at both ends, and the customs and immigration notifications for a medical arrival. These we manage in parallel with the clinical documentation, so the moment the last signature arrives the flight plan can be filed.
A practical suggestion
Start collecting the insurance guarantee and the receiving hospital's acceptance first — they take the longest and depend on other people. The medical report and passport are usually available within the hour. Working in that order routinely saves a full day.