Communication
CPSA · Communication · Consent & shared decision
Fitness to drive and the DVLA
The duty to notify is the patient’s. Yours is to tell them clearly, document it, and act if they will not — a station that is really about confidentiality and its limits.
The framework
Know the rule
- Common triggers: first unprovoked seizure (6 months off, car), epilepsy, syncope with injury or recurrence, TIA or stroke (1 month), MI, arrhythmia, insulin-treated diabetes with impaired awareness of hypoglycaemia, significant visual field loss, dementia.
- Group 2 (bus/lorry) rules are much stricter. Check the DVLA guide rather than trusting memory.
Tell the patient clearly
- They must inform the DVLA and their insurer. Say it plainly, confirm they understood, and record that you said it.
- Explain the consequences of not doing so — legal and insurance.
If they will not
- Explore why — work, income, independence, care responsibilities. Offer practical alternatives.
- Explain that if they continue to drive you have a duty to inform the DVLA, and that you would tell them before doing so.
- Involve a senior. Disclosure in the public interest is permitted and, if they continue driving, expected.
Document
- What you advised, that they understood, their response, and any disclosure and its justification.
Phrases that work
- “I am afraid this means you must not drive, and you need to tell the DVLA yourself. Can I check you are clear on that?”
- “I understand this is a huge thing — can we talk about what it means for your work?”
- “If you keep driving, I would have a duty to let the DVLA know. I would tell you before I did it.”
- “Your insurance would not cover you, which could matter far more than the licence.”
Pitfalls that lose marks
- Telling the patient you will inform the DVLA for them — the duty is theirs first.
- Being vague, so they leave thinking it is a suggestion.
- Not documenting the advice, which leaves you indefensible.
- Disclosing without first telling the patient you intend to.
- Forgetting the insurer, and forgetting Group 2 rules are different.