Driving legislation

Driver and Vehicle Licensing Agency (DVLA)

Is an agency of the Department of Transport
Is responsible for issuing and revoking driving licences
Revokes licences if a person is disqualified (legally) or unfit to drive (medically)
Determines ‘fitness to drive’
Fitness to drive

A legal requirement based on medical disability from the Road Traffic Act 1988 and Motor Vehicles (Driving Licences) Regulations 1999
Guidance on this is produced by the Drivers Medical Group of the DVLA

DVLA licence groups

Group 1: Cars and motorcycles
Group 2: Lorries and buses.
Taxis: Group 2 informally since 2006 (but this is up to each Local Authority).

How long to stop driving for (in selected conditions)

Condition	Group 1	Group 2
First/single seizure with normal EEG/MRI	6 months	5 years
Seizure due to change in medication	6 months	5 years
Ongoing simple partial seizures only	1 year*	Never
Any other daytime seizure	1 year	10 years
Ongoing nocturnal seizures only	3 years from last awake seizure*	Never
Withdrawal of anti-epileptic drug	6 months**	10 years
Simple faint	Can drive	Can drive
Unexplained syncope (low risk - high risk)	1 mth - 6 mths	3 mths - 1 yr
Narcolepsy if untreated	Never	Never
TIA/stroke	1 month	1 year
Craniotomy (non-tumour surgery - high grade tumours)	6 mths - 2 yrs	2 yrs - Never
Acute coronary syndrome (ACS)	1 month	6 weeks***
Successful primary PCI for ACS	1 week	6 weeks***
CABG	4 weeks	3 months***
Diabetes treated on insulin	DVLA to assess****	DVLA to assess****
Frequent or no-warning hypoglycaemic episodes	DVLA to assess****	Never

*New 2013 regulations state that if a person is having sleep or simple partial seizures and has only ever had those types of seizures, then 1 year is sufficient.
**This is a recommendation by the DVLA, but not a legal requirement
***Patients should also be able to do Stage 3 of the Bruce protocol on exercise ECG and have LVEF >40%
****DVLA will assess and provide a 1-3 year licence or declare the patient unfit to drive

Provoked seizures

A first, single, 'unprovoked' seizure with less than 20% chance of recurrence, means that the time off driving can be reduced by half from 1 year to 6 months for Group 1, or 10 years to 5 years for Group 2. In practice, this means normal history and investigations (MRI and EEG).
Provoked seizures are those that occur at the time of head injury, after a stroke or intracranial surgery, or during eclampsia. Patients are allowed to drive after these if otherwise back to normal.
Provoked seizures do NOT include seizures due to alcohol or drug misuse, or sleep deprivation, or missed doses of anti-epileptic medication. If a seizure possibly occurred as a side-effect of prescribed medication, then that needs to be discussed with the DVLA regarding whether it was provoked or not.

GMC guidance on informing the DVLA

Only the DVLA can revoke a licence if unfit to drive
Licence holder should inform the DVLA
Doctors should explain to patients if a condition may impair their fitness to drive and should tell patients they are legally obliged to inform the DVLA
Patients can ask for a second opinion, but should not drive until then
If patients still drive, you ‘should make every reasonable effort to persuade them to stop’
If they still drive, inform the patient that you will tell the DVLA and do so

Process after informing the DVLA

Medical questionnaire given to the patient
The DVLA medical advisor will sometimes contact the patient’s doctor (with the patient’s permission)
The DVLA medical advisor may request a local specialist assessment or eye test or a special driving test
Then the DVLA will make a decision about a licence:

Issue a licence
Issue a licence for 1/2/3 years before another DVLA medical review
Issue a licence mentioning special controls in the car for a disability
Refuse a licence