As a doctor you are sometimes faced with difficult decisions concerning older patients and their ability to drive.
As we get older our reactions can become slower, did you know that drivers over 65 take 22% longer to identify a hazard and react to it. At 70mph that is an additional two car lengths.
At the age of 70 you are no more at risk of being involved in a collision then any other group, in fact younger drivers are our highest risk on our roads. However research has shown that in your mid-70s, drivers sometimes start to have problems assessing complex or high-speed traffic situations
o Need more time to process information
o Make slower decisions and fail to predict hazards as quick
o Are less likely to speed
o More likely to be in a crash involving a right of way violation
o Most collisions occur at right turn T – junctions
o Have difficulties merging with fast traffic from a slip road
o Conduct a visual search poorly
Medical Practitioners pathway for assessments
UK – Click here to see pathway options for assessments / appraisals advice for Medical Practitioners. This is UK version
Hampshire – Click here to see pathway options for assessments for Medical practitioners. This document is for Hampshire.
Dorset – Click here to see pathway options for assessments from Medical practitioners
Notifiable Medical Conditions
There are many conditions that a driver must inform the DVLA about. To find out more on this Click Here
NHS flow chart for ‘Driving with Dementia’
Click here to download PDF version
DVLA Guidance to Medical Practitioners
The DVLA have produced guidance to Medical Practitioners on current medical standards for Fitness to Drive. This was revised in March 2016. The guide includes new and updated advice on a number of medical conditions, including loss of consciousness and sleep apnoea and it makes it clearer whether DVLA needs to be contacted or not. It’s important to point out that while there are a number of conditions which must be reported to the DVLA, it doesn’t mean a patient will lose their licence if they suffer from that health condition. The majority will be able to keep their entitlement either on a full licence or a short-term licence.
Click here for the Form for Medical Practitioners to inform the DVLA about a persons Medical condition if they refuse or can’t inform the DVLA themsleves
The guide also includes advice on when DVLA does not need to be informed of a medical condition, such as driving after surgery and the use of certain medications.
Click on the image to open the guide:
You might feel that there is a need to refer your patient for independent advice by an expert.
However, you would not want your relationship with them to be jeopardised or be concerned that you were condoning someone who might be unsafe on the road.
The Hampshire and Isle of Wight Older Drivers Forum, through its partners Hampshire County Council’s Older Driver’s Skills Scheme and Wessex Driveability, offers inexpensive refresher courses specifically tailored to the older driver.
Obviously doctors are not trained driving assessors, but the Approved Driving Instructors used in the aforementioned schemes, are.
Each assessment includes:
- Full consultation
- Professional advice
- Assessment in driver’s own vehicle – or a dual-controlled car (Wessex Driveability)
- Range of adaptations to try
- Detailed feedback
- Written report
For more information contact
Hampshire County Council on 01962 846100 or Wessex DriveAbility on 023 8051 2222
You can also find out more about these Courses by visiting our ‘Courses‘ page
Notifications to the DVLA
Dr Wyn Parry is the Senior Medical Adviser at the Driver and Vehicle Licensing Agency (DVLA) and has recently published the following advice.
Unfortunately there are instances where patients do not notify DVLA and we instead receive notifications from others – friends, family members or the police, for example. A significant number also come from doctors, either because a patient won’t follow their advice to inform DVLA or else in the interests of wider public safety. All such notifications are treated in confidence and the source is strictly protected.
All notifications made by doctors are treated in confidence and the source is strictly protected.
The GMC released advice on Confidentiality, you can see this by clicking here
Managing difficult conversations with patients
Deciding how to manage what can be a difficult conversation around stopping driving because of a medical condition and contacting DVLA can be challenging – even more so if the patient resists or refuses your advice to notify DVLA.
While you have a duty of care and confidentiality to the individual, it is equally important to consider the wider public interest and even possible medicolegal implications for a doctor who does not notify DVLA.
To help with this, DVLA and the GMC have collaborated over the years to provide support and advice to doctors in these situations. The GMC publishes guidance for doctors on Confidentiality: reporting concerns about patients to the DVLA or the DVA [PDF]
- Always consider driving in the context of consultations with your patients who are licence holders or applicants and if they have a relevant medical condition
- Emphasise your patient’s legal responsibility to notify DVLA of their condition and also consider whether you should advise your patient to stop driving in the interest of safety
- If you know, or consider it likely, that DVLA have not been notified by your patient, review the GMC’s advice on this and consider notifying DVLA yourself
Doctors can discuss cases in confidence with a medical adviser by phone (DVLA: 01792 782337, DVA: 028 703 41369) or seek advice by email (DVLA only: firstname.lastname@example.org).
We have worked with Rica, an independent research charity who publishes practical consumer information, to create an informative brochure titled ‘Driving Safely for Life’ which is a guide on keeping safe and driving for as long as possible. This guide is designed to help older drivers think about their driving and make the right decisions to stay safe and independent. It gives advice on how to continue driving safely and comfortably, to help older drivers stay on the road for as long as possible
This is available for you to download and read –
Managing Without a Car
Some Older Drivers may find it difficult or tiring to drive, or they are concerned about safety, they can just drive less or stop driving altogether.
Drivers of any age who travel less than 2000 miles a year are more at risk of having a collision than others. For those who do drive less than 2000 miles a year then it has been shown cheaper to use a taxi, even if you live in the country. The cost of using a taxi over a year is cheaper than paying for insurance, tax, petrol and maintenance of the vehicle.
Some people find this difficult to do, because of where they live or the places they need to travel to. The Older Drivers Forum have created a brochure to help the Older person get around without a car. It may be easier than they think….
The brochure gives suggestions and local information on ‘Managing with out a Car’ in Hampshire and the Isle of Wight, Dorset and the Thames Valley whilst still having independence and enjoying life.
To find the various ‘Managing Without a Car’ brochure then click here, then just click on the right one, download and read.
The Older Drivers Forum have created a number of helpful videos for Older Drivers and their family and friends, why not have a look at the videos page by clicking here
Additionally why not visit ‘Still Safe to Drive‘ which is a web site created from GEM Motoring Assist, which is the UK’s leading driving-based road safety association.
This web site shows three informative videos featuring broadcaster Valerie Singleton and covers subjects such as:
1) The process of ageing: essential information for drivers – Click to view video
2) Stay as safe as possible for as long as possible: top tips for staying mobile and reducing risk – Click to view video
3) Conversations about giving up driving: three families share their experiences
– Click here to view video