Fitness to Drive Summary

Legal Responsibilities

  • DVLA/DVA decides medical unfitness to drive
  • Patients must self-report relevant conditions
  • Doctors must advise patients of their duty

Doctor's Role

  • Assess fitness to drive during consultations
  • Advise patients on reporting requirements
  • Consider disclosure if public risk exists

Key Conditions

  • Epilepsy: 12 months seizure-free (Group 1)
  • Stroke: 1 month driving cessation
  • TIA: 1 month driving cessation
  • Syncope: Varies by type and circumstance

Reporting Process

  • Advise patient of legal duty
  • Document advice in medical records
  • Consider disclosure if patient continues driving
  • Inform patient before breaching confidentiality

Assessing Fitness To Drive

Medical guidelines for evaluating driving capability and legal responsibilities

Doctors' and Patients' Responsibilities

The Driver and Vehicle Licensing Agency (DVLA) in England, Scotland and Wales and the Driver and Vehicle Agency (DVA) in Northern Ireland are legally responsible for deciding if a person is medically unfit to drive. This means they need to know if a person holding a driving licence has a condition or is undergoing treatment that may now, or in the future, affect their safety as a driver.

Patient Responsibilities

The driver is legally responsible for telling the DVLA or DVA about any condition or treatment that might affect their ability to drive safely.

Doctor Responsibilities

Doctors should alert patients to conditions and treatments that might affect their ability to drive and remind them of their duty to tell the appropriate agency.

Public Interest Disclosure

Doctors may need to disclose relevant information without consent to the DVLA or DVA in the public interest if a patient is unfit to drive but continues to do so.

Assessing a Patient's Fitness to Drive

Clinical Considerations

When diagnosing a patient's condition, or providing or arranging treatment, you should consider whether the condition or treatment may affect their ability to drive safely.

Refer to the DVLA's guidance Assessing fitness to drive – a guide for medical professionals, which includes information about disorders and conditions that can impair a patient's fitness to drive.
Seek the advice of an experienced colleague or the DVLA's or DVA's medical adviser if you are not sure whether a condition or treatment might affect a patient's fitness to drive.
Document your assessment and advice in the patient's medical record.

Key Medical Conditions and Driving Restrictions

Condition Group 1 (cars and motorcycles) Group 2 (lorries and buses)
Epilepsy or multiple unprovoked seizures Must not drive and must notify DVLA. Driving must cease for 12 months from the date of the most recent seizure, unless the seizure meets legal criteria to be considered as a permitted seizure Must not drive and must notify DVLA. The person with epilepsy must remain seizure-free for 10 years (without epilepsy medication) before licensing may be considered.
First unprovoked epileptic seizure/ isolated seizure Must not drive and must notify DVLA. Driving must cease 6 months from the date of the seizure, or for 12 months if there is an underlying causative factor that may increase risk. Must not drive and must notify DVLA. Driving must cease 5 years from the date of the seizure. If, after 5 years, a neurologist has made a recent assessment and clinical factors or investigation results indicate no annual risk greater than 2% of a further seizure, the licence may be restored.
Provoked seizures (except related to use of alcohol or illicit drugs) Must not drive and must notify DVLA. In most cases driving must cease for 6 months after the provoked seizure. Must not drive and must notify DVLA. Driving must cease for up to 5 years after the provoked seizure.
Stroke and cerebral venous thrombosis Must not drive but may not need to notify DVLA. Driving may resume after 1 month if there has been satisfactory clinical recovery. DVLA does not need to be notified unless there is residual neurological deficit 1 month after the episode. Must not drive and must notify DVLA. A licence will be refused or revoked for 1 year following a stroke or TIA. Relicensing after 1 year may be considered if there is no debarring residual impairment likely to affect safe driving and there are no other significant risk factors.
Single transient ischaemic attack Must not drive for 1 month but need not notify DVLA. Must not drive and must notify DVLA. A licence will be refused or revoked for 1 year following a stroke or TIA. Relicensing after 1 year may be considered if there is no debarring residual impairment likely to affect safe driving and there are no other significant risk factors.
Multiple transient ischaemic attack Must not drive and must notify DVLA. Multiple TIAs over a short period will require no driving for 3 months. Driving may resume after 3 months if there have been no further TIAs. Must not drive and must notify DVLA. A licence will be refused or revoked for 1 year following a stroke or TIA. Relicensing after 1 year may be considered if there is no debarring residual impairment likely to affect safe driving and there are no other significant risk factors.
Typical vasovagal syncope (solitary episode) While standing: May drive and need not notify DVLA. While sitting: May drive and need not notify DVLA if there is an avoidable trigger which will not occur whilst driving. Otherwise must not drive until annual risk of recurrence is assessed as below 20%. While standing: Must not drive and must notify DVLA. While sitting: Must not drive for 3 months and must notify DVLA. Will require investigation for identifiable and/or treatable cause.
Cardiovascular, excluding typical syncope (solitary episode) Must not drive and must notify DVLA. Driving may be allowed to resume after 4 weeks if the cause has been identified and treated. If no cause has been identified, the licence will be refused or revoked for 6 months. Must not drive and must notify DVLA. Driving may be allowed to resume after 3 months if the cause has been identified and treated. If no cause has been identified, the licence will be refused or revoked for 12 months.

Reporting Concerns to the DVLA or DVA

Dual Responsibility

Doctors owe a duty of confidentiality to their patients, but they also have a wider duty to protect and promote the health of patients and the public.

Step-by-Step Process

Initial Assessment - If a patient has a condition or is undergoing treatment that could impair their fitness to drive, explain this to the patient and tell them that they have a legal duty to inform the DVLA or DVA.
Documentation - Make a note of any advice you have given to a patient about their fitness to drive in their medical record.
Incapable Patients - If a patient is incapable of understanding this advice (e.g., because of dementia), you should inform the DVLA or DVA as soon as practicable.
Second Opinion - If a patient refuses to accept the diagnosis, suggest that they seek a second opinion, and help arrange for them to do so. Advise the patient not to drive in the meantime.
Persuasion Efforts - If you become aware that a patient is continuing to drive when they may not be fit to do so, make every reasonable effort to persuade them to stop.
Risk Assessment - If the patient continues to drive against your advice, consider whether this exposes others to a risk of death or serious harm.
Disclosure - If you believe there is significant risk, contact the DVLA or DVA promptly and disclose any relevant medical information, in confidence, to the medical adviser.
Notification - Before contacting the DVLA or DVA, try to inform the patient of your intention to disclose personal information. If you decide to contact them, tell your patient in writing once you have done so, and make a note on the patient's record.

Confidentiality Considerations

Disclosure of personal information without consent may be justified in the public interest where failure to disclose may expose others to risk of death or serious harm. Where possible, you should inform the patient about the disclosure beforehand.