An epileptic patient has agreed not to drive but a nurse saw him parking today before his review
A heavy goods vehicle driver has had a seizure and you must break the news regarding driving restrictions
A patient who presented with a seizure is now being discharged: you must speak to them about lifestyle changes
A relative is concerned about a patient who has an ‘alcohol problem’ and is driving
Phrases to help you
‘Safety precautions’
‘The tablets don’t guarantee your safety and the safety of others if you are driving.’
‘Have you been able to follow the advice given to you with regards to driving?’
‘If you drive you will be breaking the law and your insurance will not be valid.’
Aims of the station
Show that you can be firm but also sympathetic and non-judgemental
Address the patient’s concerns and pick up on their cues
Use a ‘breaking bad news’ approach
Clearly communicate the importance of not driving
You may need to be firm with them – how would they feel if they had a seizure at the wheel and harmed/killed their own family or other people?
Offer solutions to the patient’s problems or sources of help if you have any (if not, just listen and empathise)
Know the DVLA rules
The DVLA rules
The rules differ for licence type
Group 1 (normal licence) = cars, motorcycles
Group 2 (heavy goods vehicle licence) = buses, lorries, large vehicles
Note: taxi drivers are usually also required to meet Group 2 medical standardsdepending on local councils
Below are some example restrictions but many other conditions also require the patient to inform the DVLA
If a patient drives after being advised not to, their insurance is invalid and they are breaking the law
Some important conditions with driving restrictions
Group 1 (normal licence)
Group 2 (heavy goods vehicle licence)
Diabetes
Must meet certain criteria to drive (depends on hypoglycaemia episodes, hypoglycaemia awareness, glucose monitoring and complications)
Must meet certain criteria to drive (depends on hypoglycaemia episodes, hypoglycaemia awareness, glucose monitoring and complications)
First unprovoked seizure
6 months
5 years
Other seizure
1 year
10 years
Stroke/TIA
1 month*
1 year
Unexplained syncope
6 months
1 year
MI treated with stent
1 week*
6 weeks (but need tests)
Alcohol misuse
6 months (of controlled drinking/abstinence)
1 year (of controlled drinking/abstinence)
Alcohol dependence
1 year (free of alcohol-related problems)
3 years (free of alcohol-related problems)
*Do not need to inform DVLA if no residual symptoms (all others need to inform DVLA)
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