Travel information

Important Patient Notice: Fit-to-Fly, Sports Fitness Letters & Flying Medication

To ensure safe and consistent care, our GPs do not provide the following:

Fit-to-Fly Certificates

We are unable to issue letters confirming that a patient is “fit to fly.” Airlines have their own medical forms and procedures, and they are best placed to assess what is required for travel.

Fitness Letters for Extreme or High-Risk Sports

Our clinicians cannot provide letters stating you are medically fit to undertake activities such as:

  • scuba diving

  • skydiving

  • marathon or endurance events

  • other extreme or high-risk sports

Specialist assessments are usually required for these activities, and providers often have their own medical processes.

Benzodiazepines for Flying

We no longer prescribe benzodiazepines (such as diazepam, lorazepam, or similar medications) for use during flights. This is due to safety concerns, including:

  • increased risk of blood clots on long flights

  • reduced awareness during emergencies

  • breathing difficulties at high altitude

  • dependency and other side effects

Airlines recommend alternative strategies for managing flight anxiety, such as structured breathing techniques, psychological support, and fear-of-flying courses.

If you need documentation for travel or sports providers, please check their specific requirements and seek advice from the relevant PRIVATE specialist or organisation. Hathaway Medical Centre cannot advise you on these.

Fear of Flying and Sedative Medication

Many people find flying stressful or frightening. We understand how real and overwhelming this can feel. However, our practice does not prescribe benzodiazepines or other sedative medication (such as diazepam) for fear of flying or to help with sleep on flights.

This policy is in line with national prescribing guidance and is now common across many GP practices.

Below we explain why.

Why we don’t prescribe diazepam

Safety in an emergency

Sedative medicines slow down your thinking, reactions and coordination. If there is an in-flight emergency, you may not be able to:

  • Take in and follow safety instructions quickly
  • React appropriately to danger
  • Help yourself or others (including children or vulnerable people travelling with you)

In extreme cases, heavy sedation can leave you too drowsy to evacuate the aircraft promptly, which is a risk for you and everyone around you.

Higher risk of blood clots (DVT)

Sedatives may make you sleep for long periods in an unnatural, non-REM sleep. When you sleep like this, you move around less than you would in normal sleep. On a long flight this can:

  • Reduce circulation in your legs

  • Increase the risk of deep vein thrombosis or a blood clot travelling to the lungs (pulmonary embolism)

This risk is greater on flights over 4 hours, and can be higher still if combined with other risk factors (smoking, some medical conditions, limited mobility).

Unpredictable and disinhibiting effects

While most people become sleepy on benzodiazepines, a minority have the opposite reaction and become:

  • Agitated or restless

  • Disinhibited, saying or doing things they normally would not

  • Occasionally aggressive or difficult to manage

On a plane, this can cause problems for other passengers and crew and may have legal consequences. These effects are more likely and more severe if alcohol is also consumed.

Short- and long-term health risks

Benzodiazepines:

  • Can impair concentration, memory and balance in the short term

  • Are addictive, with withdrawal causing symptoms such as agitation, confusion, hallucinations or even seizures

  • Have been linked to longer-term problems with memory and balance, and some studies suggest a possible association with dementia later in life

They are also widely misused, which is one reason their prescribing is now tightly controlled.

Not recommended for phobias or mild anxiety

National prescribing guidance (the British National Formulary – BNF) and NICE guidelines state that:

  • Diazepam is not recommended for treating phobic conditions, such as fear of flying

  • Benzodiazepines and sedating medicines should not be used for mild or self-limiting anxiety

  • They are only licensed short-term for crises in generalised anxiety disorders

If your anxiety is severe enough to require this type of medication, the safest course is usually to delay flying and seek proper assessment and ongoing treatment for your mental health, rather than masking symptoms for a flight.

Legal and travel complications

Benzodiazepines are controlled drugs in the UK and are illegal to carry into some countries, including parts of the Middle East. This means:

  • Your medication may be confiscated at the border

  • You could face questioning or legal difficulties

  • You may be left without medication for the journey home or later flights

Diazepam can also remain detectable in your system for some time. If your job involves random drug testing, taking it for a flight could cause you to fail a test.

Not part of core NHS GP services

Fear of flying on its own is not covered by the core General Medical Services (GMS) contract for GPs, and there is no obligation for practices to prescribe sedatives for this purpose.

Patients who still want medication specifically for flying may choose to discuss this with a private GP or travel clinic, but we would still strongly recommend considering the safer approaches below.

Better ways to manage fear of flying

Although we do not prescribe sedatives, we absolutely recognise that fear of flying is real and distressing. Fortunately, there are safer and more effective ways to address it.

Airline fear-of-flying courses

Airlines run specialised programmes designed by aviation experts and psychologists to help you understand and manage flight anxiety. These courses typically include:

  • Clear explanations of how planes fly and how safety systems work

  • Sessions with pilots and cabin crew

  • Techniques for managing panic and anxiety during flights

  • A supported “practice flight” in many cases

Examples include:

Psychological support

If your anxiety is part of a wider pattern (you feel anxious in many situations, or it is affecting work, study or relationships), it may help to:

  • Speak to your GP about talking therapies such as cognitive behavioural therapy (CBT)

  • Explore NHS-approved mental health resources and apps

  • Learn breathing, relaxation and grounding techniques that you can use before and during flights

These approaches tackle the underlying cause of your anxiety and are more effective in the long term than a one-off sedative tablet.

Practical steps for flying

Some people find the following tips helpful:

  • Plan your journey to the airport so you are not rushed

  • Choose seats where you feel more comfortable (aisle seats)

  • Avoid alcohol and caffeine before and during the flight

  • Use distraction: music, podcasts, films, puzzles or reading

  • Practise relaxation or breathing exercises while boarding and during take-off/landing

Travel insurance and medication

Whatever approach you use, please declare all medical conditions and medicines to your travel insurer. Failure to do so may invalidate your policy.

If you need further help

  • If you are unsure whether your anxiety is part of a wider mental health problem, please book an appointment with a GP to discuss it.

  • If you have a history of blood clots, serious mental health issues or other complex health problems, always seek medical advice before flying.

We hope this explains clearly why we do not prescribe diazepam or similar sedatives for flying, and points you towards safer, more effective ways to manage fear of flying.