Medical Compliance at Sea: Why it Matters for Yachts, Cruises & Vessels

[By: ANP Pharma]

Medical supply company ANP Pharma is taking the lead in helping mariners stay on the right side of medical compliance through its in-house consultancy service.

“Failure to comply with medical regulations carries significant consequences,” says Ella Isiraojie, Business Development Manager at ANP Pharma. “Beyond financial penalties and reputational damage, in the most serious cases non-compliance can result in legal actions such as criminal prosecution and imprisonment of responsible individuals.”

For mariners, compliance covers almost every aspect of living and working on board a vessel. But when it comes to medical compliance, the requirements are complex and often misunderstood.

Ella explains: “Medical compliance is frequently overlooked due to the complexity of varying regulations and requirements across Flag States, the differing knowledge base and training of crew on board and the absence of medical personnel on many private and commercial vessels.

ANP Pharma’s consultative role is to fully understand the detailed legislation that applies to each type of vessel, enabling the worldwide medical equipment supplier to ensure ship operators always remain medically compliant.

She continues: “As one of the world-leading maritime suppliers of pharmaceuticals, surgical and medical equipment, medical consumables, first aid supplies and kits, our work includes ensuring that each vessel has on board the correct medical stores for its type, usage, its flag state and its route or itinerary.”

Cruise ships which often carry hundreds or even thousands of passengers and crew, must comply with Flag State regulations while also benchmarked against the American College of Emergency Physicians (ACEP) Cruise Ship Healthcare Guidelines. They are required to carry advanced diagnostic and lifesaving equipment, maintain a larger onboard pharmacy, and ensure the presence of medically trained personnel to safeguard life at sea. Depending on the vessel, the medical team may range from a single doctor to a full complement of doctors, nurses, and paramedics, all of whom must operate within their scope of practice. As itineraries vary, they must also prepare and stock their medical supplies accordingly.

Commercial vessels such as tankers and cargo vessels are governed by the IMO and Flag State requirements. As they carry a much smaller crew, often only 18-30 people, then there is no requirement to have a registered medical professional onboard. In this situation the responsibility falls to the Master of the vessel who can then designate responsibility to another member of the crew who holds the requisite STCW qualifications in Medical Care to manage the inventory.

Some of these vessels also carry hazardous cargo, in which case they are also subject to International Maritime Dangerous Goods Code regulations (IMDG), requiring a specialist first aid kit to deal with first aid emergencies associated with dangerous or hazardous cargo. Ella explains: “Yachts and leisure vessels often exist in a grey area when it comes to medical compliance, as this depends on several factors including crew size and sailing distance says Ella. Yachts generally follow simplified yacht codes developed by their flag states, which adapt IMO standards to suit recreational or limited charter use. While commercial vessels must fully comply with all applicable IMO conventions and undergo stricter flag state inspections and certification under merchant shipping regulations.

At ANP we work with the management team or owner to educate them of the importance of a structured and compliant medical response onboard which helps to minimize risk and prevent situations arising that could cause unnecessary diversions, or poor patient outcomes.”

She continues: “Every commercially operating vessel is advised to maintain a compliant medical chest, and medical chest certificate. This annual certification confirms that the onboard medical stores comply with IMO and ILO requirements established under the Maritime Labour Convention (MLC, 2006), as well as the flag state’s regulations, ensuring full alignment with international maritime standards. The process involves an inventory audit by competent personnel and a certification of compliance with international and Flag State standards. Ongoing responsibility is with the ship’s medical officer (or Master’s delegate) to maintain compliance through checks and records.

ANP Pharma provides guidance and support to its clients which ensures a seamless service is delivered to its clients by working with partners such as Red Square Medical in providing training and medical support services to shipping companies. Often it is found during the audit and crew training process that common issues such as poor management of controlled drugs is due to genuine lack of understanding and inadequate medical supplies resulting from misinterpretation of Flag State minimum requirements.

Liz Baugh, Lead Medical Consultant at Red Square agrees: “This leaves them open to potential issues with the Port State when their medical inventory is being checked. Plus, incomplete medical record keeping; if any medication is given to a person, then a medical record of that interaction must be opened and maintained. This is an important requirement.”

Medical compliance at sea is not optional - it is both a legal obligation and a critical safeguard for everyone on board, concludes Ella. “While cruise ships and commercial vessels face different operational challenges, the principle remains the same: maintaining compliance protects lives, reputations, and livelihoods.”