In terms of acceptable risk the medical standards applied for the LAPL are similar to those of professional drivers i.e. Group 2 DVLA level of acceptable risk for unrestricted certification. Where pilots only meet Group 1 DVLA level of acceptable risk (private vehicle driving), an OPL (No Passenger Limitation) or OSL (Safety Pilot Limitation) would be applied. However the aviation environment is very different to driving a lorry or bus and there are medical conditions which may be assessed differently to those set down by DVLA for drivers.
An ECG is not necessary for LAPL unless clinically indicated. Those pilots who value having a periodic ECG will be offered one at reduced rate.
A LAPL medical can be undertaken by an AME, or alternatively a GP in your own practice who has access to your medical records at the time and is happy to take responsibility for issuing an aviation medical certificate.