Disclosure to the DVLA

A 30 year-old patient has been recently diagnosed with epilepsy manifesting with grand mal seizures. I previously advised the young woman that she should not drive a car in line with the Driving and Vehicle Licensing Agency (DVLA) guidance Assessing Fitness to Drive: A Guide for Medical Professionals. At the subsequent review, it was apparent that she had continued to drive in order to take her children to and from school. I am concerned about the safety of her and her children, as well as other road users and pedestrians. What should I do?

While you have a duty of confidentiality to your patient, there are circumstances where it may be necessary to breach confidentiality to protect patients or others from harm. However, before you do so, the GMC advises that every effort should be made to persuade the patient to stop driving voluntarily. For more information, see the GMC's guidance on reporting concerns about patients to the DVLA or to the Driver and Vehicle Agency (DVA) (Northern Ireland) found in the supplementary guidance accompanying Confidentiality: good practice in handling patient information (2017).

If the patient disagrees with the diagnosis and advice to stop driving you may agree with the patient to seek a second opinion, but she should be advised not to drive in the meantime. If she continues to drive, having already ignored your advice about her legal duty to family and others, you may have no option but to contact the DVLA yourself. You will need to make this clear when you are trying to persuade the patient to stop driving. It may help if you can inform the patient's relatives of your concerns but you would only be able to do this if she agrees.

If the patient continues to drive despite your advice, the GMC recommends that you should contact the DVLA or DVA immediately and disclose any relevant medical information, in confidence to the medical advisor. You will need to try to inform the patient of your decision to disclose before you do so. Inform the patient in writing once you have contacted the DVLA or DVA. Any disclosure made should be the minimum necessary. Make a note in the patient's records setting out your actions and explaining your reasons behind your decision to disclose, as you may be asked to justify your actions if the patient makes a complaint.