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The Role of Drivers Medical Group

The role of the Drivers Medical Group in DVLA is to promote road safety by establishing whether drivers who have medical conditions are able to satisfy the medical standards required for safe driving. To undertake this task, DVLA employs its own fully qualified Medical Advisers who are supported by administrative staff. The Drivers Medical Group processes approximately 434,000 cases every year.

The national medical standards of fitness to drive are summarised in the At a Glance Guide to the Current Medical Standards of Fitness to Drive, which are available on the DVLA web site and certain secure GP medical information systems.

For further information please click here


Research


In common with many other areas of medicine, DVLA’s medical group is being increasingly challenged to demonstrate the evidence base for the medical standards and their relevance for road safety. In 2000, the Department for Transport set up a new research programme into “Medical Fitness to Drive”, appointing a Research Manager with a background in clinical medicine and psychology. A number of important studies are now underway including those on insulin treated diabetes, on visual fields, and on the attitudes of health professionals towards giving advice on fitness to drive. Several detailed literature searches are also being undertaken. An Expert workshop in sleep disorders (July 2002) was organised and ones on cardiology and on visual disorders are being planned. DVLA is itself developing a more active research facility and is currently working to establish database analysis and literature review services. For more information click here

 
     
 

New Issues

 
     
 
Topic 1  

(February 2009)

Abnormal liver function in Renal Transplant patients

It is not uncommon for Renal Transplant patients to have abnormal liver function, Hepatitis C being the most common cause in those patients who underwent dialysis before 1989. A less known cause of liver function abnormality in transplant recipients is Nodular Regenerative Hyperplasia (NRH), a condition caused by Azathioprine toxicity. As this medication has seen its importance declining within more recent immunosuppressant treatments, NRH usually affects the earliest cohorts of kidney transplant recipients. It may give rise to marked portal hypertension, to the extent that NRH patients often present with variceal bleeding.

DVLA’s Franchise Doctors are reminded that when abnormal liver function (especially significantly elevated AST) is noticed in blood tests of transplant recipients referred for examination by DVLA such information should be conveyed promptly to the driver’s own GP. Franchise doctors are also reminded of the need to advise a patient’s own GP urgently when any serious abnormality is identified at examination or on blood testing.

Topic 2  

(February 2009)

February 2009 - At a Glance Guide

The February 2009 edition of the “At a Glance Guide to the Current Medical Standards of Fitness to Drive” will be available shortly and can be downloaded at www.dvla.gov.uk/medical/ataglance.aspx

Practice Managers/Medical Secretaries may wish to print off copies for their own doctors to use or alternatively, hard copies are available on request for £4.50 (cheques made payable to DVLA Swansea) from Drivers Medical Group, DMSDG, DVLA, Swansea SA99 1DF (answer machine for AAG requests) Tel: 01792 782336.

A reminder that the publication “At a Glance Guide to the Current Medical Standards of Fitness to Drive” is revised and updated twice yearly in Spring and Autumn. The booklet represents the recommendations of the Secretary of State’s six expert Honorary Medical Advisory Panels on the medical standards for licensing as applied throughout Great Britain by DVLA’s medical advisers.

The standards aim to reflect current clinical practice including advances in technology, coupled with an understanding of relevant risk factors for safe driving.

Medical advice given to patients by their doctors based on out of date medical licensing standards may disadvantage patients and could jeopardise public road safety.

 
 

Recent Issues

Topic 1  

(June 2008)

Payments for Medical Reports

Invoice required regardless of VAT registration
Due to a tightening up of Government accounting procedures DVLA now requires all service providers to supply an invoice with every completed report submitted for payment.

Invoices should be on headed stationery and include:
Medical Practitioners name and address
Name and date of birth of patient
Case number (starting with the letter M followed by numbers)
Amount payable

If you are VAT registered we will require a VAT invoice which should include; the information listed above plus,
Amount payable before VAT
Amount of VAT
Amount payable with VAT added
The VAT registration number.

Your co-operation in this matter is very much appreciated

Topic 2  

(June 2008)

Data Protection Act

The DVLA would like to remind doctors of the requirements of the Data Protection Act as it applies to the release of medical information relevant to “medical fitness to drive” licensing enquiries. Drivers/patients provide DVLA, on request, with authority to seek information from their doctors and authority for their doctors to release information and reports about their condition to DVLA “relevant to my fitness to drive”. There is no consent for doctors to release details about other conditions unrelated to fitness to drive and it is therefore often inappropriate for copies of a patient’s complete medical records to be forwarded. You should only provide information that is directly relevant to the patient’s ability to drive and ensure that any sensitive information, irrelevant to driving, is removed before sending. Please do not send original reports, as we cannot guarantee their safe return; copies of relevant reports are fully acceptable.

Doctors are also reminded that under the Data Protection Act, and subject to exemptions, the patient is entitled to request copies of all medical documents held on their file at DVLA. If it is your professional opinion that the information you provide to DVLA is likely to cause serious harm, either to the patient or to any other person, please highlight this clearly. In the event that the patient subsequently makes a request for this information, we will need to consider your advice and may need to contact you again to confirm if this information meets the criteria to be exempt from release under the Act.

Topic 3  

(December 2008)

Sleep Disorders and Driving

A reminder to medical practitioners that drivers suffering from symptomatic sleep disorders such as Obstructive Sleep Apnoea syndrome (OSA) must inform DVLA and should cease driving until the condition has been effectively controlled.

Up to one fifth of accidents on motorways and other monotonous roads may be caused by drivers falling asleep at the wheel. The most common medical cause of excessive sleepiness is OSA. Doctors may need to be alert to the possibility that a patient who complains of tiredness, may be suffering from a sleep disorder. This has particular importance where the patient drives professionally.

The condition occurs most commonly, but not exclusively, in overweight individuals, particularly those with a large neck size. Partners often complain about the snoring and notice that sufferers seem to have irregular breathing during sleep. Sufferers of OSA rarely wake from sleep feeling fully refreshed and tend to fall asleep easily when relaxing; both have implications for safe driving.

If a doctor requires advice about a particular case, or about fitness to drive in general, they can speak to a DVLA Medical Adviser, in confidence, during normal office hours by telephoning 01792 782337.

Topic 4  

(Decemer 2008)

Recording advice given to patients on fitness to drive.

Doctors are reminded of the need to record clearly in the patient’s notes any advice given to patients with regard to their fitness to drive and/or of the need for the patient to notify DVLA. At a recent Coroner’s inquest some criticism and concern was expressed towards a doctor who had failed to record such advice contemporaneously, leaving a degree of uncertainty about subsequent liability.

It is in every doctor’s best interests to ensure that any “fitness to drive” advice is clearly recorded.

In addition, doctors are reminded of the guidance on confidentiality issued by the General Medical Council. This indicates that it would be viewed as a justifiable breach of confidentiality for a doctor to notify DVLA directly where a patient refuses to stop driving on the advice of a doctor, and poses a threat to public road safety.