Disclosing confidential information

19. You may encounter situations where you consider a patient’s vision means they may not be fit to drive.
20. Below, we set out the requirements of the governing bodies of drivers and driving in the UK, the ways in which you should communicate with a patient when advising them they may not be fit to drive, and when you should disclose this information to someone other than the patient.

Driver and Vehicle Licensing Agency (DVLA) and Driver and Vehicle Agency (DVA)

21. The DVLA in England, Scotland and Wales and the DVA in Northern Ireland are the government agencies that register and issue licences to drivers in the UK. As part of their role in registering and licensing drivers, they are legally responsible for deciding if a person is medically fit to drive and retain their licence.
22. The DVLA issues guidance for healthcare professionals on assessing fitness to drive which includes the medical standards for driver licensing. There is specific guidance on sight testing as well as other health conditions you may encounter during a consultation.
23. The medical standards in the guidance are applicable to the whole of the UK, including Northern Ireland.

Driver’s responsibilities

24. Licensed drivers have a legal responsibility to notify the DVLA/DVA of any medical condition they have that may affect safe driving. A full list of conditions that are considered notifiable can be found here. 

Your responsibilities

25. You should inform the DVLA/DVA where:
    1. you have assessed that a patient may not be safe to drive; and
    2. you consider that they will not or cannot inform the DVLA/DVA themselves; and
    3. you have a concern for road safety in relation to the patient and/or the wider public.
26. In making an assessment of whether a patient is safe to drive, you should be aware of, and make reference to, the DVLA’s guidance, particularly the chapter on visual disorders, which outlines the legal sight standards that all licensed drivers must meet.
27. If a patient’s corrected vision would meet the minimum standards for driving, but their uncorrected vision would not, this may mean they are not safe to drive if they choose to drive without corrective lenses.
28. You should be aware that there are higher standards in place for bus and lorry drivers than for car drivers and motorcyclists, and details of these can be found in the DVLA guidance referenced above (listed as "group 2").
29. If you are unsure whether a patient meets the required standards you should consider seeking the advice of a professional colleague or your employer, or seeking the advice of the DVLA/DVA’s medical advisors.

What should I do if I think a patient is not safe to drive?

30. If, in your professional judgement, you think that a patient may not be safe to drive you should explain this clearly to the patient and your reasons for this. With the patient’s consent, you should discuss your concerns with their family and/or carer if appropriate (e.g. if they attend appointments with the patient, or if they live with the patient).
31. You should advise the patient to stop driving immediately.
32. You should advise the patient that they have a legal responsibility to notify the DVLA/DVA of any condition which may affect their ability to drive safely and provide them with further information on how to contact the DVLA/DVA.
33. You should advise the patient that you have a duty to notify the DVLA/DVA yourself if, in your professional judgement, a patient either will not or cannot do so, and there is any concern for the safety of the patient and/or the wider public. For more information on the steps you should take in such situations, see the section below on ‘disclosing to the DVLA/ DVA without consent’.
34. You should also consider whether you need to notify other healthcare professionals, such as the patient’s GP if possible and discuss with the patient why you think this is appropriate.
35. If driving is relevant to the patient’s occupation, you should advise them to inform their employer. ¹
36. You should put any advice in writing and keep a clear record of your actions including any correspondence, for example, with the patient, other healthcare professionals and other external agencies, as well as documenting if the patient advises that they will self-report to the DVLA/DVA. For further information, see standard on maintaining adequate patient records in the standards.
37. If you have followed all the steps above, but you consider that the patient will not or cannot inform the DVLA/DVA themselves, please see the section below for the steps you should take to disclose information to the DVLA/DVA.

Disclosing to the DVLA/DVA without consent

38. If the criteria in paragraph 25 apply, and you are not able to seek consent from your patient, you should notify the DVLA/DVA if you believe that a patient will continue to drive despite advice not to do so.
39. In disclosing information to the DVLA/DVA you should:
    1. first, inform the patient that you intend to notify the DVLA/ DVA and you have a duty to cooperate fully with the DVLA/DVA and provide all relevant information as requested;
    2. notify the DVLA/DVA (current contact details are set out below) and provide all relevant information that is requested;
    3. consider whether you need to notify other healthcare professionals, such as the patient’s GP, if possible; and

    4. keep a clear record of your actions and any advice given. For more information, please refer to Standard 8 (7).

40. The DVLA/DVA make the ultimate decision of whether to revoke a driving licence and may make further enquiries and/or require further assessments to establish whether the patient’s licence should be revoked.

Communicating effectively with patients

41. You should communicate clearly and effectively with your patients and give them information in a way that they can understand. Informing a patient that they may have to stop driving can be a sensitive and difficult subject to raise and you should communicate this with empathy and compassion. Providing patients with information about resources they can access for assistance, for example about alternative means of transport, could be helpful.
42. For more information on communicating effectively with patients, please refer to Standards 2 and 4 (annex 1).
43. A flowchart showing the process to be followed when making a decision is available.
44. Contact details for the DVLA (England, Scotland and Wales) and DVA (Northern Ireland) can be found on their websites. 

¹ Whilst this guidance is focused on road safety, the principles also apply to drivers of other transport (including rail), seafarers and pilots. If you are concerned that a train driver, pilot or seafarer’s vision means they may not be able to do their job safely, you can contact the Office of Rail and Road, the UK Civil Aviation Authority or the Maritime and Coastguard Agency respectively for advice.