1. Dr Wyn Parry Senior Medical Adviser DVLA
Fitness for Driving
Dr Wyn Parry
Senior Medical Adviser
DVLA

2. Driving-A Complex Task

4. Facts and Figures 1.2 million deaths per annum Worldwide in RTCs
35000 per annum in EU
1.5 million injured per annum in EU
seriously injured per annum in EU
Injury costs= 2% of EU GDP
Most RTCs are due to driver behaviour (phones/ speeding/fatigue/ drink and drugs)
Impact of medical conditions unclear

5. Background: UK Licensing and The UK Driving Population
In the UK there are two licensing groups
- Group 1 (car and motorcycle)
- Group 2 (bus/ lorry)
Currently in the UK there are approximately
- 45 million Group 1 licence holders
- 1.3 million Group 2 licence holders

6. The UK Driving Population and Medical Conditions
DVLA cases with a medical condition represent around 4.3% of licence holders in the UK. The UK has principally a self notification system and this figure is likely to under estimate the extent of medical conditions
all medical condition cases are considered by the Drivers’ Medical Group (DMG) within DVLA
DMG made 655,000 licensing decisions during or 2,660 medical licensing decisions each day

7. Medical Conditions and Driving: The Risks
Relative risk = accident risk with condition
accident risk without condition
Medical Conditions, Driving and Relative Risks
High relative risk (x 1.5-2)
diabetes mellitus/ alcohol use/neurological/ psychiatric conditions
Moderate relative risk (x 1-1.4)
cardiovascular/ locomotor conditions
Low(er) relative risk (<1)
deafness/ visual conditions
Sleep apnoea
3-4

8. Medical Standards
Galen (A.D )

9. History 1903 First Driving Licences
Parliamentary Committee: Physical impairment considered incompatible with road safety
Driving test for disabled drivers
Universal driving test including number
plate test
1930s Epilepsy: Legislation banning anyone with epilepsy from driving
Revision of epilepsy standards

10. Medical Standards
standards are required in the interests of road safety
all major countries have medical standards for driver licensing There are some differences in standards across these countries but very broadly the standards are comparable
medical standards for Group 2 drivers are higher due to
the size and weight of the vehicle and
the time the driver may spend at the wheel in the course of their employment
all Group 2 drivers must meet the Group 1 standards

11. Medical Standards

12. Current UK Medical Standards: The At a Glance Guide

16. Medical Standards

17. Development of the Medical Standards
The Legal Basis for the UK Medical Standards
The laws in relation to driver licensing currently are:
• The UK Road Traffic Act 1988
• The UK Motor Vehicles (Driving Licences) Regulations 1999 and subsequent amendments
European Legislation (Directive 2006/126/EC and subsequent amendments)

18. The Road Traffic Act
• requires drivers to notify DVLA of any medical condition
that may affect safe driving
• empowers DVLA:
 to investigate (in the presence of reasonable grounds)
 to issue or refuse/revoke licences
 to restrict licences in duration and form
• gives licence holders/applicants the right of appeal in
court (DVLA appointed barrister and medical advisor
attend final hearing)

19. Development of the Medical Standards
Although a number of contributions input to standard development, the legal basis and Panel advice are most significant
Domestic legislation
EEC legislation
EEC working parties
UK working parties
Panel advice

20. Honorary Medical Advisory Panels
the six advisory Panels are in
-vision
-diabetes mellitus
-neurology
-cardiology
-alcohol/ drug misuse
-psychiatry
Panel members are all practising clinicians with expertise in the relevant area of medicine and are appointed by the Secretary of State for Transport
Panels advise on the interpretation of the law in relation to fitness to drive and on compilation of the ‘At a Glance Guide to the Current Medical Standards of Fitness to Drive’
Panels meet bi-annually to advise on medical standards in line with latest clinical practice, research developments and traffic medicine
Panel will also consider complex/ contentious cases when requested by DVLA

21. Medical Conditions Requiring Notification
Broadly there are two groups of conditions
-those likely to cause sudden impairment or collapse at the wheel e.g.,
-epileptic events
-loss of consciousness/ loss of awareness
-hypoglycaemic events
-cardiac arrhythmias
-those likely to impair the safe handling of the vehicle e.g.,
-physical disabilities
-impaired vision
-cognitive problems
-psychiatric conditions
-alcohol and or drug misuse

22. How DMG works in practice
notification from driver or a reliable 3rd party
medical enquiry commenced with
information from driver’s GP, consultants (including ad hoc reports or sight of hospital letters)
or by independent examination with DVLA appointed doctors
licensing decision
statutory customer right of appeal through the local magistrates’ court

23. The Road Traffic Act
• requires drivers to notify DVLA of any medical condition
that may affect safe driving
• empowers DVLA:
 to investigate (in the presence of reasonable grounds)
 to issue or refuse/revoke licences
 to restrict licences in duration and form

24. Notifications of Medical Conditions 2014
• Licence holder , (86.5%)
• 3rd party , (9.9%)
(GPs/Consultants, family, neighbours or members of public)
Police (1.3%)
• Courts (0.0%)
• Driving Standards Agency (0.0%)
Non-notifiable conditions ,971 (2.3%) (medical conditions notified, but require no further action by DVLA)

25. The Medical Advisor’s Roles
to assess medical fitness to drive and make licensing
decisions on behalf of the Secretary of State
to represent the Secretary of State as expert witnesses
in Court at both appeal hearings and at Coroners’
Court
to provide medical input into policy and research
secretary to the expert Panels advising the Secretary of State
to provide lectures to interested parties
telephone and written advice to individual doctors

26. The Road Traffic Act
• requires drivers to notify DVLA of any medical condition
that may affect safe driving
• empowers DVLA:
 to investigate (in the presence of reasonable grounds)
 to issue or refuse/revoke licences
 to restrict licences in duration and form

27. GMC Guidance for Doctors (2017)

30. Glasgow and Its Implications
-DVLA
-new, clearer guidance
-the driving public
-notification awareness
-doctors
-crucial responsibilities in road safety

31. Further Information Telephone advice for doctors/ HCPs - 01792-782337
For patients –
(medical professionals only):
DVLA website:
“Assessing fitness to drive”- available as PDF on DVLA website:
data/file/526635/assessing-fitness-to-drive-a-guide-for-medical-professionals.pdf
Panel minutes are available as PDF on DVLA website:

32. Thank you and...

33. The Road Traffic Act Section 88