The DVLA (in England, Scotland and Wales) and DVA (in Northern Ireland) are legally responsible for deciding if someone is medically unfit to drive.
Doctors are responsible for considering whether a patient's condition or treatment may affect the patient's ability to drive safely.
Doctors should alert patients when a condition or treatment may affect their driving and remind them of their legal duty to tell the appropriate agency.
Drivers are legally responsible for telling these organisations about any conditions or treatment that might affect their driving.
There are circumstances where you might need to tell the DVLA/DVA directly - and sometimes without the patient's consent.

Assessing a patient's fitness to drive

Doctors have a key role in road safety, and it's important to be familiar with the DVLA's guidance for doctors and healthcare professionals on assessing patients' fitness to drive.

This offers general information about licensing, as well as detailed guidance about which conditions and treatments impact fitness to drive and must therefore be reported. DVLA guidance is usually updated every six months.

You can also contact the DVLA's medical advisers (details below) for advice on fitness to drive.

What does the GMC say?

The GMC's guidance reminds doctors of their duty of confidentiality to patients and wider duty to protect the wider public.

It also explains what doctors should do if a patient who may not be fit to drive endangers public safety, as outlined below.

When you believe a patient's condition or treatment may impair their fitness to drive, you should explain this to them and tell them of their legal duty to inform the DVLA/DVA. Tell the patient that if they continue to drive when they're not fit to do so, you may be obliged to disclose their information to the DVLA/DVA.
If the patient cannot understand (for example, because of dementia or other cognitive impairments), you should inform the DVLA/DVA as soon as practicable.
If a patient can understand but does not accept what you're saying, you can suggest a second opinion and, if the patient agrees, discuss with those close to them. You should advise the patient not to drive in the meantime.
If you can't persuade a patient to stop driving or discover that they are continuing to drive against your advice, you should consider whether their refusal to stop leaves others at risk of death or serious harm. If you believe it does, you should contact the DVLA/DVA promptly and disclose relevant medical information in confidence to the medical adviser.
Before contacting the DVLA/DVA, you should tell the patient of your intention to disclose personal information. If the patient objects to the disclosure, consider the reasons they give for objecting. If you do decide to contact the DVLA or DVA, you should tell the patient in writing when you have done so. Keep a careful note in the records of what you have disclosed, to whom and when, and your reasons.

How to contact the DVLA or DVA

If you need to, you can report your concerns about a patient to the DVLA/DVA in confidence. Contact details are as follows:

DVLA: fill in the medical notification form and send to medadviser@dvla.gov.uk
DVA: 0300 200 7861 / dva@infrastructure-ni.gov.uk (See the DVA website for full contact details.)

The advice referred to in this guide deals specifically with drivers, but the GMC states the same principles also apply to drivers and pilots of other kinds of regulated transport.

Remember, you have to justify any breach of confidentiality in the public interest if you're asked to do so. Make a record of your decisions and reasons.

If you're an MDU member and you're unsure what action to take, contact our medico-legal advisers for help.

Assessing fitness to drive

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