Assessing fitness to drive

You have responsibilities to a patient if their condition or treatment affects their ability or fitness to drive.

  • 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, sometimes without the patient's consent.

Doctors have a key role in road safety. It is important for doctors to be familiar with the DVLA's guidance for healthcare professionals on assessing patients' fitness to drive, which provides general information about licensing and detailed guidance about which conditions and treatments impact fitness to drive and must be reported. DVLA guidance is usually updated every six months.

In addition, the DVLA's medical advisers are available by phone and email (details below) for advice on fitness to drive.

The GMC's guidance Confidentiality: patients' fitness to drive and reporting concerns to the DVLA or DVA (2017) reminds doctors of their duty of confidentiality to patients and wider duty to protect the wider public, and explains the steps doctors should take if a patient who may not be fit to drive endangers public safety.

These are the steps to follow.

  • When you believe a patient's condition or treatment may impair their fitness to drive, you should explain this to the patient, tell them of their legal duty to inform the DVLA/DVA and tell the patient that, if they continue to drive when they are 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) you should inform the DVLA/DVA as soon as possible.
  • If a patient can understand but does not accept what you are 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.
  • But if you cannot persuade a patient to stop driving or you discover that they are continuing to drive against your advice, exposing others to serious risk, 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 try to discuss with the patient and, once you have made a disclosure, you should tell the patient in writing. Keep a careful note on the records of what you have disclosed, to whom and when, and your reasons.

How to contact the DVLA/DVA

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

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 that it will be up to you 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 unsure what action to take, our medico-legal advisers are always on hand to help.

This guidance was correct at publication 06/11/2018. It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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