PatientPlus articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use, so you may find the language more technical than the condition leaflets.
The 'At a glance guide' is produced by the Driver and Vehicle Licensing Agency (DLVA) and is a guide for medical professionals to help them with enquiries from the public about driving with various conditions.
At a glance booklet
The applicant or licence holder must notify DVLA unless stated otherwise in the text.
This publication summarises the national medical guidelines of fitness to drive and is available to doctors and health care professionals. It is publicly available on the DVLA website at Gov.uk. Hard copies of the booklet are available on request for a fee of £4.50 (cheques made payable to DVLA Swansea) from Drivers Medical Group, DMDG, DVLA, Swansea SA99 1DF. Telephone 01792 782336 (answer machine for Medical Professionals only) or email EFTD@dvla.gis.gov.uk.
The information in the booklet is intended to assist doctors in advising their patients whether or not they should inform DVLA of their medical condition and what the outcome of medical enquiries is likely to be.
In the interests of road safety, those who suffer from a medical condition likely to cause a sudden disabling event at the wheel or who are unable to safely control their vehicle from any other cause, should not drive.
Compilation of the Guidelines
These guidelines represent the interpretation and application of the law in relation to fitness to drive following advice from the Secretary of State's Honorary Medical Advisory Panels. The Panels consist of doctors eminent in the respective fields of Cardiology, Neurology, Diabetes, Vision, Alcohol/Substance Abuse and Psychiatry together with lay members.
The Panels meet twice yearly and the standards are reviewed and updated where indicated. This booklet is, therefore, only accurate at the time of publication. Please see the DVLA website for the most up-to-date information www.gov.uk/government/organisations/driver-and-vehicle-licensing-agency.
It is also emphasised that this booklet is for use as guidance only. Whilst it provides some idea of the anticipated outcome of a medical enquiry, the specific medical factors of each case will be considered before an individual licensing decision is reached.
The legal basis for the medical standards
The Secretary of State for Transport acting through the DVLA, has the responsibility to ensure that all licence holders are fit to drive.
The legal basis of fitness to drive lies in the 3rd EC Directive on driving licences (91/439/EEC), which came into effect in the UK in January 1997, the Road Traffic Act 1988 and the Motor Vehicles (Driving Licences) Regulations 1999. The 2nd Driving Licence Directive was amended by Directive 2009/112/EC with effect from 15.9.09 and these amendments came into force on 15.9.2010.
Section 92 of the Road Traffic Act 1988 refers to prescribed, relevant and prospective disabilities. For the purposes of this guide, a disqualifying condition refers to either a prescribed disability or a relevant disability.
- A prescribed disability is one that is a legal bar to the holding of the licence. Certain statutory conditions, defined in regulation, may need to be met. An example is epilepsy.
- A relevant disability is any medical condition that is likely to render the person a source of danger while driving. An example is a visual field defect.
- A prospective disability is any medical condition, which, because of its progressive or intermittent nature may develop into a prescribed or relevant disability in the course of time. Examples are Parkinson's disease and dementia. A driver with a prospective disability may normally only hold a driving licence subject to medical review in one, two or three years.
Sections 92 and 93 of The Road Traffic Act 1988 also cover drivers with physical disabilities who require adaptations to their vehicle to ensure its safe control. The adaptations required are now coded and entered on the licence. (See Appendix 1 and Appendix 2.)
The medical standards refer to Group 1 and Group 2 licence holders.
Group 1 includes motor cars and motor cycles.
Group 2 includes large lorries (category C) and buses (category D). The medical standards for Group 2 drivers are very much higher than those for Group 1 because of the size and weight of the vehicle. This also reflects the higher risk caused by the length of time the driver may spend at the wheel in the course of his/her occupation.
All drivers who obtained entitlement to Group 1, category B (motor car) before 1 January 1997 have additional entitlement to category C1 and D1. C1 is a medium size lorry of weight between 3.5 and 7.5 tonne. D1 is a minibus of between 9 and 16 seats, not for hire or reward.
Holders of C1 and D1 entitlement retain the entitlement until their licence expires or it is medically revoked. On subsequent renewal the higher medical standards applicable to Group 2 will apply.
Under certain circumstances volunteer drivers can drive a minibus of up to 16 seats without having to obtain category D1 entitlement. Individuals should consult DVLA for a detailed fact sheet.
Group1: Licences are normally issued valid until age 70 years (Till 70 licence) unless restricted to a shorter duration for medical reasons as indicated above. There is no upper limit but after age 70 renewal is necessary every 3 years. All licence applications require a medical self declaration by the applicant.
A person in receipt of the higher rate of the Mobility Component of Disability Living Allowance may apply for a licence (Group 1 category B) from age 16 years, instead of the usual lower age limit of 17 years.
Group 2: Excepting in the armed forces and certain PCV licences, Group 2 licences, lorries (category C) or buses (category D) are normally issued at age 21 years and are valid till age 45 years but may be issued from age 18 where the licence holder has obtained or is undertaking a Certificate of Professional Competence (CPC) initial qualification. Group 2 licences are renewable thereafter every five years to age 65 years unless restricted to a shorter period for medical reasons.
From age 65 years Group 2 licences are renewable annually without upper age limit. All Group 2 licence applications must be accompanied by a completed medical application form D4.
Police, Ambulance and Health Service Vehicle Driver Licensing*
Responsibility for determining the standards, including medical requirements, to be applied to police, ambulance and health service vehicle drivers, over and above the driver licensing requirements rests with the individual Police Force, with the NHS Trust, Primary Care Trust or Health Service body in each area. The Secretary of State's Honorary Medical Advisory Panel on Diabetes and Driving has issued advice regarding insulin treated diabetes and the driving of emergency vehicles, which can be found in the Appendix at the end of Chapter 3.
The House of Commons Transport Select Committee on Taxis and Private Hire Vehicles recommended in February 1995 that taxi licence applicants should pass a medical examination before such a licence could be granted.
Responsibility for determining the standards, including medical requirements, to be applied to taxi drivers, over and above the driver licensing requirements, rests with the Transport for London in the Metropolitan area and the Local Authority in all others areas. Current best practice advice is contained in the booklet "Fitness to Drive": A Guide for Health Professionals published on behalf of the Department by The Royal Society of Medicine Press Limited (RSM) in 2006. This recommended that the Group 2 medical standards applied by DVLA in relation to bus and lorry drivers, should also be applied by local authorities to taxi drivers.
*Caveat: The advice of the Panels on the interpretation of EC and UK legislation, and its appropriate application, is made within the context of driver licensing and the DVLA process. It is for others to decide whether or how those recommendations should be interpreted for their own areas of interest, in the knowledge of their specific circumstances.
There is overwhelming evidence to show that seatbelts prevent death and serious injury in road traffic accidents. For this reason, the law makes it compulsory for car occupants to wear seatbelts, where fitted. One exception allowed by legislation is if the car occupant has a valid exemption certificate, which confirms it is inadvisable on medical grounds to wear a seatbelt. The certificates are issued by medical practitioners, who will need to consider very carefully the reasons for exemption, in view of the weight of evidence in favour of seatbelts. Medical practitioners can obtain supplies of Certificate of Exemption from Compulsory Seat Belt Wearing (product Ref PPU4272) and the guidance leaflet Medical Exemption from Compulsory Seat Belt Wearing by phoning 0300 123 1102. The certificates come in booklets of five. Further enquiries should be made to: Department for Transport, Road Safety Division 1, Zone 3/21, Great Minster House, 33 Horseferry Road, London SW1P 4DR; Tel: 020 7944 2027, Email: Hong.San@dft.gsi.gov.uk.
Impairment due to Medication
It is an offence to drive or attempt to drive whilst unfit through drugs; the law does not distinguish between illegal drugs and prescribed medication. Some prescription drugs and over the counter medicines can affect the skills needed to drive safely because they may cause drowsiness, impaired judgement or other adverse effects. Health professionals prescribing or dispensing medication should consider the risk associated with that medicine, or combination of medicines, and driving and take the opportunity to appropriately advise their patients.
Impairment Secondary to Multiple Medical Conditions
In some cases, a combination of multiple medical conditions, each insufficient in itself to disqualify from driving, may produce an annual risk of incapacitation unacceptable for either a Group 1 or a Group 2 licence, or render a person a likely source of danger.
When such a combination of risk factors is felt to be present, the patient should be advised not to drive. The health professional may seek clarification from the DVLA.
Notification to DVLA
It is the duty of the licence holder or licence applicant to notify DVLA of any medical condition, which may affect safe driving. On occasions however, there are circumstances in which the licence holder cannot, or will not do so.
The GMC has issued clear guidelines* applicable to such circumstances, which state:
- The driver is legally responsible for informing the DVLA about such a condition or treatment. However, if a patient has such a condition, you should explain to the patient:
(a) that the condition may affect their ability to drive (if the patient is incapable of understanding this advice, for example, because of dementia, you should inform the DVLA immediately), and
(b) that they have a legal duty to inform the DVLA about the condition.
- If a patient refuses to accept the diagnosis, or the effect of the condition on their ability to drive, you can suggest that they seek a second opinion, and help arrange for them to do so. You should advise the patient not to drive in the meantime.
- If a patient continues to drive when they may not be fit to do so, you should make every reasonable effort to persuade them to stop. As long as the patient agrees, you may discuss your concerns with their relatives, friends or carers.
- If you do not manage to persuade the patient to stop driving, or you discover that they are continuing to drive against your advice, you should contact the DVLA immediately and disclose any relevant medical information, in confidence, to the medical adviser.
- Before contacting the DVLA you should try to inform the patient of your decision to disclose personal information. You should then also inform the patient in writing once you have done so.
(*Reproduced with kind permission of the General Medical Council) - Full information on GMC guidelines can be viewed on www.gmc-uk.org.
Guidance for Optometrists in “The Code of Ethics and Guidance for Professional Conduct” is published by the College of Optometrists and states –
“A2.10 If in the practitioner’s judgement a patient is engaging in an activity where he or she constitutes a very real risk of danger to the public or him/herself, the optometrist may be justified in the public interest in bringing the matter to the attention of the appropriate authority. However, the practitioner should, in the first instance, advise the patient that s/he is unfit to engage in the activity in question and give the reasons. The patient should also be advised to tell the appropriate authority. This advice should be put in writing to the patient and a copy held on the patient’s record. As in the case of any patient whose sight the practitioner is unable to correct to a satisfactory standard, the practitioner may decide that it is appropriate to notify the patient’s General Medical Practitioner (GMP).
A2.11 There may be exceptional circumstances when these actions may be unlikely to achieve the desired effect or will take too long to do so. The optometrist then has to consider whether the public interest outweighs the duty of confidentiality. If the optometrist concludes that it does, s/he should notify the appropriate authority, preferably in writing, providing evidence of clinical finding. The patient’s GMP, and if appropriate the patient, should be notified of the action being taken. Where, for example, the patient is in the view of his/her GMP, mentally ill or is involved in the commission of a crime, it might not be in the patient’s or the public’s interest for the patient to be notified. The optometrist must be guided by his/her professional judgement and responsibility to the public at large, although any practitioner who decides to disclose confidential information about a patient must be prepared to explain and justify that decision, whatever the circumstances of the disclosure.”
In order to aid this notification process DVLA has devised a form (see below) which can be printed then completed and returned to DVLA at the following address:-
Medical Business Change
Or you can fax to 01792 761104
Application of the Medical Standards
Once the licence holder has informed DVLA of their condition and provided consent, medical enquiries will be made, as required. The Secretary of State, in practice DVLA, is unable to make a licensing decision until all the available relevant medical information has been considered. It may therefore be a relatively lengthy process to obtain all necessary reports and, during this period, the licence holder normally retains legal entitlement to drive under Section 88 of the Road Traffic Act 1988.
However, by reference to this booklet, the doctor in charge of their care should be able to advise the driver whether or not it is appropriate for them to continue to drive during this period. Patients may be reminded that if they choose to ignore medical advice to cease driving, there could be consequences with respect to their insurance cover. Doctors are advised to document formally and clearly in the notes the advice that has been given.
Where the licence has been revoked previously for medical reasons then Section 88 of the Road Traffic Act 1988 entitlement does not apply.
On receipt of all the required medical evidence,DVLA will decide whether or not the driver or applicant can satisfy the national medical guidelines and the requirements of the law. A licence is accordingly issued or revoked/refused.
Any doctor who is asked for an opinion about a patient's fitness to drive should explain the likely outcome by reference to this booklet but refer the licence holder/applicant to Drivers Medical Group, DVLA for a decision.
Throughout the publication reference is made to notification not being required where specified. For these conditions and others not mentioned in the text this is generally the case but very rarely, the conditions may be associated with continuing symptoms that may affect consciousness, attention or the physical ability to control the vehicle. In addition, regular ongoing therapeutic use of medication which causes relevant impairment(s) may be incompatible with driving. In these rare instances, the driver should be advised to report the condition and symptoms of concern to DVLA.
Driving after surgery
Drivers do not need to notify DVLA unless the medical conditions likely to affect safe driving persist for longer than 3 months after the date of surgery (but please see Neurological and Cardiovascular Disorders Sections for exceptions).
Therefore, licence holders wishing to drive after surgery should establish with their own doctors when it is safe to do so.
Any decision regarding returning to driving must take into account several issues. These include recovery from the surgical procedure, recovery from anaesthesia the, distracting effect of pain, impairment due to analgesia (sedation and cognitive impairment), as well as any physical restrictions due to the surgery, underlying condition, or other co-morbid conditions.
It is the responsibility of the driver to ensure that he/she is in control of the vehicle at all times and to be able to demonstrate that is so, if stopped by the police. Drivers should check their insurance policy before returning to drive after surgery.
Further advice on fitness to drive
Doctors or other health-care professionals may enquire in writing, or may speak to one of the medical advisers during the hours of 10:30am – 1pm, to seek advice about a particular driver (identified by a unique reference number) or about fitness to drive in general.
In addition, DVLA's topic specific medical enquiry forms are available on the website and may be downloaded in pdf format. These may be used by drivers/applicants to notify DVLA of their condition, to support an application and to provide consent for medical enquiry. Currently, the completed forms must be forwarded to the Agency by post.
|Address for enquiries in England, Scotland and Wales|
The Medical Adviser
Drivers Medical Group
Tel: 01792 782337 (Medical Professionals Only)
Email: firstname.lastname@example.org (Medical Professionals Only)
Address for enquiries in N. Ireland
© Crown copyright - DVLA 1993-2013
This document may be cited in part or in whole for the specific guidance of doctors and patients. However the document must not be reproduced in part or in whole for commercial purposes.
This booklet is published by the Department for Transport. It describes the law relating to medical aspects of driver licensing. In particular, it advises members of the medical profession on the medical standards which need to be met by individuals to hold licences to drive various categories of vehicle. The Department has prepared the document on the advice of its Advisory Panels of medical specialists.
The document provides the basis on which members of the medical profession advise individuals on whether any particular condition could affect their driving entitlement. It is the responsibility of the individual to report the condition to the DVLA in Swansea. DVLA will then conduct an assessment to see if the individual's driving entitlement may continue or whether it should be changed in any way. (For example, entitlement could be permitted for a shorter period only, typically three years, after which a further medical assessment would be carried out by DVLA).
Please fill in all parts of this medical notification in relation to the medical condition of your patient.
Part (A) – Please fill in all fields regarding your patients details.
Parts (B) – Please fill in all fields regarding your details, remembering to provide a signature and date which will act as a declaration that all details are correct to the best of your knowledge.
Part (C) – Please fill in all fields providing as much detail as possible regarding your patients medical condition. You may send clinic letters with this notification to help provide details of your patients medical condition or if you think they will aid a licensing decision.
Please note your patient can request copies of any medical documents which are held at DVLA unless is specified in writing that releasing this information could cause serious harm to your patient.
DVLA cannot be responsible for payment of any fee for this notification.
Where to send this notification
Please return this medical notification by post to:-
Medical Business Change
or you may fax to 01792 761104
© Crown copyright. Reproduced under the terms of the Open Government Licence.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
© Crown copyright. Reproduced under the terms of the Open Government Licence.