Occupations and Terms of Reference › Medevac operations director
Universal terms of reference · POS-246 · version 1.0 · status: draft · next review 2027-10-27
Medevac operations director
To run medical evacuation operations, so that aircraft, crews and patients are ready, safe and matched to the need of every case.
Each part of this page links to the related trainings, competencies and policies. The links are the same for every facility, so an organisation can see at a glance what a role requires and what it is trained in.
Job description
Job summary. You lead medical evacuation. You run the aircraft and crew readiness, the operating plan, aviation safety, and clinical standards for flights, and you are accountable for every mission.
Reports to: Chief operating officer.
Leads or supervises: Flight physicians, flight nurses, dispatch, technicians, aviation safety, pilots and repatriation case managers.
What you do on a typical day
- Review readiness and roster each morning.
- Approve operating plans and aircraft changes.
- Review aviation safety reports weekly.
- Lead the response to serious missions and incidents.
- Report medevac performance to the board monthly.
Working conditions and demands
- On call around the clock.
- Works across borders and regulators.
- High-risk operations.
What good looks like
- Every mission is safe and within standard.
- Aircraft and crews are ready.
- Aviation safety reports are acted on.
Place in the organogram
Reporting line, from the top: see the organogram on the Occupations page. The lines above and below this role are listed in section 3.
1. Golden rules
These rules apply in every setting.
- The right patient gets to the right care, at the right place, without avoidable delay.
- Patient safety comes before speed, cost or convenience.
- Clinical handover is complete and recorded every time.
- Vehicles, aircraft and equipment are checked and fit before every journey.
- Crews work within their scope of practice and call for help when out of their depth.
- Every incident and near miss is reported, and learning is shared.
- Staff and patients are protected from violence and harm during transport.
- Confidential patient information is protected in every journey and record.
2. Identification
| Item | Detail |
|---|---|
| Position code | POS-246 |
| ISCO-08 | 1324 (skill level 4) |
| ESCO | to map |
| Department | Medical evacuation |
| Facility types | Hospital, Ambulatory, Transport, Medevac, Fitness, Aesthetic |
3. Reporting line and working relationships
Reports to: POS-004. Supervises: POS-247, POS-248, POS-250, POS-251, POS-252, POS-253, POS-254.
| Works with | Nature of the relationship |
|---|---|
| Chief operating officer | Operating plan and budget. |
| Chief medical officer | Clinical standards for flights. |
| Chief quality and safety officer | Aviation safety and incidents. |
4. Key accountabilities
| Domain | Accountability | Evidence of delivery | Checked | Linked competencies | Linked trainings | Linked policies | Standards |
|---|---|---|---|---|---|---|---|
| Operations | Makes sure every mission is planned, ready and safe. | Mission readiness 100%; mission reviews completed | Monthly | C-01 | T-07 | POL-SAFEG | 2 |
| Aviation safety | Leads aviation safety management and acts on reports. | Safety reports reviewed within 72 hours | Monthly | C-02 | T-07 | POL-INC · POL-SAFEG | 2 |
| Clinical standards | Sets and assures clinical standards for flights. | Flight clinical audits at standard | Quarterly | C-03 | T-05 · T-07 | POL-INC | 2 |
| Team | Leads and develops the medevac team. | Team appraisals completed on time | Annually | C-04 | T-08 | POL-EQUAL · POL-WHISTLE | 2 |
5. Decision rights
| The post holder decides | Consults or escalates |
|---|---|
| Mission acceptance within the operating rules | Serious aviation incidents (CEO, CQO and regulators) |
| Aircraft and crew roster within limits | Missions that cannot be safely completed (CMO and CEO) |
6. Qualifications and experience
| ID | Qualification | Mandatory | Validity |
|---|---|---|---|
| Q-01 | Medical or nursing licence, current, or aviation licence where relevant | Yes | per regulator |
| Q-02 | Aviation medicine or air ambulance management certificate | Yes | Lifetime |
| ID | Experience | Minimum years | Mandatory |
|---|---|---|---|
| E-01 | Air ambulance or aviation operations leadership | 8 | Yes |
7. Training requirements
Recommended common practice. Each facility adapts the list to its national law. Essential items apply in every setting; recommended items apply where resources allow.
| ID | Training | Tier | When | Validity | Linked policies | Linked competencies |
|---|---|---|---|---|---|---|
| T-01 | Facility induction | essential | at_entry | Once | POL-WHISTLE · POL-EQUAL · POL-DATA | – |
| T-02 | Safeguarding adults | essential | periodic | Every 3 year(s) | POL-SAFEG | – |
| T-03 | Safeguarding children | essential | periodic | Every 3 year(s) | POL-SAFEG | – |
| T-04 | Data protection and confidentiality | essential | annual | Every 1 year(s) | POL-DATA | – |
| T-05 | Incident reporting and open disclosure | essential | periodic | Every 2 year(s) | POL-INC | C-03 |
| T-06 | Governance, accountability and assurance | recommended | periodic | Every 3 year(s) | – | – |
| T-07 | Emergency and major incident command | essential | annual | Every 1 year(s) | POL-INC | C-01 · C-02 · C-03 |
| T-08 | Speaking up, inclusion and equality leadership | essential | periodic | Every 2 year(s) | POL-WHISTLE · POL-EQUAL | C-04 |
8. Health, fitness and language
| ID | Requirement | Frequency | Tier | Minimum in low-resource settings |
|---|---|---|---|---|
| H-01 | Immunity to vaccine-preventable diseases relevant to the setting, documented at entry | At entry or as set | essential | Documented hepatitis B status at entry |
| H-02 | Tuberculosis screening at entry, then as the national rule requires | At entry or as set | essential | Symptom screening at entry and after exposure |
| H-03 | Fitness-to-work assessment at entry and after serious illness or injury | Every 12 months | recommended | Fitness check at entry |
| Language | Level | Mandatory |
|---|---|---|
| Official language of the country of practice | professional | Yes |
| English | working | Yes |
9. Competencies by level
| ID | Competency | Foundation | Practitioner | Expert | Assessed by | Revalidate | Linked trainings |
|---|---|---|---|---|---|---|---|
| C-01 | Operations planning and readiness | Follows operating procedures | Plans missions | Designs operating plans | Operations audit | Every 12 months | T-07 |
| C-02 | Aviation safety management | Reports safety issues | Leads safety reviews | Designs aviation safety systems | Safety audit | Every 12 months | T-07 |
| C-03 | Clinical standards for flights | Follows flight standards | Leads flight clinical reviews | Designs flight clinical standards | Clinical audit | Every 12 months | T-05 · T-07 |
| C-04 | Leading multi-disciplinary aviation teams | Works in a team | Leads a team | Leads medevac change | 360 feedback | Every 24 months | T-08 |
10. Performance evaluation
- Probation: 6 months, with a sign-off review (recommended value).
- Appraisal: every 12 months against the competencies and indicators below.
| ID | Indicator | Target | Data source | Frequency |
|---|---|---|---|---|
| PI-01 | Mission readiness | 100% | readiness log | Daily |
| PI-02 | Safety reports reviewed in 72 hours | 100% | safety register | Monthly |
| PI-03 | Flight clinical audits at standard | 100% | audit results | Quarterly |
| PI-04 | Team appraisals completed | 100% | HR records | Annually |
11. Career ladder and promotion
| Level | Role | Minimum experience to move on | Qualifications | Competency minimums | Trainings required | Assessment |
|---|---|---|---|---|---|---|
| Executive | Medevac operations director | 8 years (recommended) | Q-01, Q-02 | C-01 expert, C-02 practitioner | T-07 | Executive appointment and performance review |
12. Policies the post holder follows
Each policy is a standard template that the facility adopts and adapts. Templates are maintained centrally, so every facility works from the same version.
POL-SAFEG · Safeguarding adults and children
Purpose: Protect patients from abuse, neglect and harm, and make sure every concern is recognised and acted on.
Scope: All staff, volunteers and contractors.
Key rules:
Scope: All staff, volunteers and contractors.
Key rules:
- Recognise signs of abuse and neglect and record them factually.
- Report every concern to the designated safeguarding lead the same shift.
- Do not investigate alone.
- Share information only as the safeguarding procedure allows.
POL-DATA · Data protection and confidentiality
Purpose: Keep patient and staff information private, secure and used only for care and legal purposes.
Scope: All staff who access records or systems.
Key rules:
Scope: All staff who access records or systems.
Key rules:
- Access only the records needed for your work.
- Keep records secure; do not leave screens or paper unattended.
- Do not share information without a lawful basis.
- Report any breach to the data protection officer within 24 hours.
Linked trainings: T-10 · Review every 12 months · Template 0.1 (draft)
POL-WHISTLE · Speaking up (whistleblowing)
Purpose: Let staff raise patient safety or conduct concerns without fear of reprisal.
Scope: All staff.
Key rules:
Scope: All staff.
Key rules:
- Raise a concern with your line manager or the named speaking-up officer.
- If that route fails, escalate to the board or the national regulator.
- Retaliation against anyone who speaks up is a disciplinary offence.
- Concerns are recorded, investigated and the outcome given to the person raising them.
Linked trainings: T-01 · Review every 12 months · Template 0.1 (draft)
POL-EQUAL · Equality, diversity and inclusion
Purpose: Give every patient and colleague fair access, respectful treatment and reasonable adjustments.
Scope: All staff and patients.
Key rules:
Scope: All staff and patients.
Key rules:
- Treat every person with dignity regardless of background.
- Make reasonable adjustments, including interpreters, for language and disability.
- Report discrimination through the speaking-up route.
- Monitor access and outcomes by group.
Linked trainings: T-01 · Review every 24 months · Template 0.1 (draft)
POL-INC · Incident reporting and open disclosure
Purpose: Report and learn from incidents and near misses, and tell patients honestly when things go wrong.
Scope: All staff.
Key rules:
Scope: All staff.
Key rules:
- Report every incident and near miss the same shift.
- Give the patient and family an honest account and an apology where appropriate (open disclosure).
- Take immediate action to protect others.
- Learn: contribute to the review and follow the agreed actions.
13. Standards that name this role
14. Record history
| Date | Change | Approved by |
|---|---|---|
| 2026-10-27 | Draft record, batch 1 of the position build | Awaiting approval |