What should you do if a patient with a condition that could affect their ability to drive refuses to notify the DVLA? Dr Wyn Parry, the DVLA’s Senior Medical Adviser, outlines the agency’s expectations of doctors to discuss driving during consultations with patients.

**This post was updated on 25 April 2017 to include references to the GMC’s most recent guidance on confidentiality**

There are currently almost 46 million driving licence holders in Great Britain and last year DVLA received just shy of 610,000 notifications of medical conditions.

The UK currently has a self-notification system for all driving licence holders as well as licence applicants. This means people have a legal duty to notify DVLA if they develop a relevant medical condition that might prevent them from driving.

Guidance for patients on whether their condition is relevant or not has to come from their doctors.

Guidance for patients on whether their condition is relevant or not has to come from their doctors. So, it is crucial to consider driving during any consultation with a patient.

DVLA guidance

DVLA’s guidance for medical practitioners on the current medical standards of fitness to drive is available online [PDF].

The guidance offers information on both medical conditions and restrictions on licensing periods when the condition dictates these. It is worth emphasising here that the majority of drivers with a medical condition are able to retain a licence, even if it is subject to periodic review.

However, an important minority are barred from driving because their condition has caused significant impairment of their visual, cognitive or motor/sensory function (which cannot be overcome by vehicle adaptations). Alternatively, the condition might put them at high risk of sudden and disabling events that render them unsafe to drive.

Notifications to the DVLA

Unfortunately there are instances where patients do not notify DVLA and we instead receive notifications from others – friends, family members or the police, for example. A significant number also come from doctors, either because a patient won’t follow their advice to inform DVLA or else in the interests of wider public safety. All such notifications are treated in confidence and the source is strictly protected.

All notifications made by doctors are treated in confidence and the source is strictly protected.

Managing difficult conversations with patients

Deciding how to manage what can be a difficult conversation around stopping driving because of a medical condition and contacting DVLA can be challenging – even more so if the patient resists or refuses your advice to notify DVLA.

While you have a duty of care and confidentiality to the individual, it is equally important to consider the wider public interest and even possible medicolegal implications for a doctor who does not notify DVLA.

To help with this, DVLA and the GMC have collaborated over the years to provide support and advice to doctors in these situations. The GMC publishes guidance for doctors on Confidentiality: patients’ fitness to drive and reporting concerns to the DVLA or DVA [link updated 25 April 2017].

Key takeaways:

  • Always consider driving in the context of consultations with your patients who are licence holders or applicants and if they have a relevant medical condition
  • Emphasise your patient’s legal responsibility to notify DVLA of their condition and also consider whether you should advise your patient to stop driving in the interest of safety
  • If you know, or consider it likely, that DVLA have not been notified by your patient, review the GMC’s advice on this and consider notifying DVLA yourself

Doctors can discuss cases in confidence with a medical adviser by phone (DVLA: 01792 782337, DVA: 028 703 41369) or seek advice by email (DVLA only: medadviser@dvla.gsi.gov.uk).

Dr Wyn Parry, Senior Medical Adviser, DVLA

 

Dr Wyn Parry is the Senior Medical Adviser at the Driver and Vehicle Licensing Agency (DVLA).