Table of Contents
Possible stations
- 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 standards depending 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)
Reference: DVLA ‘Assessing fitness to drive: a guide for medical professionals’ 2022
Test your knowledge
What would you do if, despite a clear explanation, a patient with a seizure refuses to inform the DVLA and says they are going to continue to drive?
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Where can you find more information if you are unsure if a there is a driving restriction for a particular condition?
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