Updated Guidance For Doctors on Notifying Fitness to Drive
The General Medical Council’s new guidance on confidentiality comes into effect on 25 April 2017. In addition to revising the general guidance, the GMC has also updated the specific principles on a patient’s fitness to drive and reporting concerns to the DVLA or DVA.
The GMC clearly states the steps that a doctor should take if they believe a patient may pose a risk to others by continuing to drive.
Assess the patient’s fitness to drive against the required standard
Doctors need to be aware that a patient’s ability to drive can be affected by a condition or diagnosis, and also by a treatment that they may be receiving or about to receive. This could be an intervention or a medication. Additionally, different standards apply to professional drivers, such as HGV drivers and bus drivers, and this needs to be taken into consideration when coming to a decision.
Tell the patient to inform the DVLA
A doctor’s responsibility is to explain to the patient that they have a medical condition or will be receiving treatment that may affect their ability to drive and that they have a legal obligation to inform the DVLA or DVA, and to stop driving. It is the driver’s legal responsibility to inform the authorities of this advice and it is a criminal offence for the driver to fail to do so. However, a doctor should tell the patient that they may be obliged to disclose relevant medical information to the DVLA or DVA if they continue to drive against advice.
Try to persuade the patient to stop driving
The potential loss of independence or financial income can mean that some patients do not accept medical advice to stop driving and inform the DVLA or DVA. Doctors must give clear advice to the patient that they must stop driving. If they disagree with this and believe that they are fit to drive they should be guided to seek a second opinion. However, it should be made clear to the patient that they must refrain from driving while the second opinion is obtained. In the event that the patient does not have the capacity to understand the advice, for example because of dementia, DVLA or DVA should be informed straight away.
Consider the potential risk
If the patient continues to drive contrary to advice, consideration should be given as to whether their refusal to stop driving leaves others exposed to a risk of death or serious harm. If this is believed to be the case, the doctor should then contact the DVLA or DVA promptly. Only the minimum amount of information necessary needs to be disclosed, so that the DVLA or DVA can identify the patient.
Keep detailed records
It is not uncommon for patients to complain when a disclosure has been made, and having clear and comprehensive records about what was discussed with the patient before the disclosure, and whether they were warned prior to disclosing the information, can help provide a robust response and demonstrate that the proper process have been followed.
The full guidance can be found here