🛑 In the UK, driving with an unreported medical condition that impairs safety is a criminal offence. Both patients and doctors have legal responsibilities → failure to comply can lead to fines, prosecution, or professional consequences. It is for the doctor to advise and the patient to self report to the DVLA either by phone or mail. The ultimate decision on driving is for the DVLA medical professionals to decide. A formal driving assessment can sometimes help.

🚗 DVLA Legal Framework

📄 Road Traffic Act 1988: makes it an offence to drive if unfit through medical reasons.
👤 Driver’s duty: Must notify the DVLA of any medical condition that may impair driving (e.g. epilepsy, syncope, stroke, dementia).
💡 Doctor’s duty: Advise patients of their obligation. If a patient refuses to notify DVLA and continues to drive, the doctor may need to breach confidentiality and inform DVLA directly (GMC guidance).
📝 Insurance providers must also be informed once DVLA is notified.

📊 Driving & DVLA – Condition Summary Table (Group 1 Licence)

Condition	Driving Restriction	Patient Duty 🚗	Doctor Duty 👨‍⚕️	DVLA / Legal Notes ⚖️
⚡ First Seizure	❌ No driving for 6 months (if recurrence risk <20%/yr).	Notify DVLA, stop driving.	Advise of restriction & record advice.	DVLA may require neuro report. Licence restored if low recurrence risk.
⚡ Epilepsy (diagnosis)	❌ No driving until seizure-free for 1 year.	Must inform DVLA & insurer.	Clarify regulations, document advice.	DVLA monitors ongoing seizure control.
🧠 Stroke / TIA	❌ No driving for 1 month (longer if deficits persist).	Notify DVLA if residual deficit or recurrent TIAs.	Check recovery, advise re DVLA rules.	Multiple TIAs → 3-month ban. DVLA may request medical evidence.
❤️ ACS (STEMI, NSTEMI, unstable angina)	✅ Drive after 1 week (if PCI + LVEF ≥40%). 🕓 4 weeks if medically managed.	No DVLA notification if uncomplicated.	Assess LV function, ensure no complications.	Notification only if ongoing angina, LV dysfunction, or arrhythmias.
❤️ Angina	❌ Must not drive if occurs at rest, with stress, or while driving. ✅ Resume if controlled.	No notification if stable.	Advise on activity-related restrictions.	DVLA requires notification if symptoms unpredictable.
😵 Simple Faint (vasovagal)	✅ No restriction if provoked + prodrome + postural (“3 Ps”).	No need to notify DVLA.	Reassure, confirm typical features.	DVLA not involved unless atypical/unexplained.
😨 High-Risk Syncope	❌ No driving 4 weeks if cause treated. ❌ 6 months if unexplained.	Notify DVLA if unexplained or untreated.	Identify/treat cause, advise restrictions.	DVLA may revoke licence pending cardiology/neuro review.
🙂 Low-Risk Syncope	✅ Resume after 4 weeks if normal ECG & no structural heart disease.	No DVLA notification required.	Document normal findings & safety advice.	DVLA not notified if clearly low risk.
🧠 Dementia / Cognitive Impairment	❌ Cannot drive if unsafe. May drive in early mild dementia if passed assessment.	Must notify DVLA on diagnosis.	Assess cognition, advise DVLA rules, report if unsafe.	DVLA may order on-road assessment. Licence often revoked as disease progresses.
👁 Visual Defects	❌ No driving if visual acuity <6/12 or visual field defect affecting both eyes.	Must notify DVLA if vision fails standards.	Check Snellen & fields; advise accordingly.	DVLA requires visual field testing before licence decision.
🚗 Diabetes (insulin-treated)	✅ Allowed if good control + awareness of hypos. ❌ Stop driving after severe hypo (requires 3rd party assistance) → must report.	Inform DVLA if insulin-treated or recurrent hypos.	Check hypo awareness; reinforce rules.	DVLA may revoke if recurrent severe hypos.

🧑‍⚕️ GMC & Professional Duties

🔑 GMC guidance: patient safety outweighs confidentiality if there is a clear risk to the public.
Doctors should record advice clearly in the notes, including whether the patient understood.
If a patient insists on driving against medical advice → escalate to DVLA in writing, informing the patient of your actions.
Failure to advise appropriately could expose a doctor to legal liability if the patient is involved in an accident.

Driving assessment centres (e.g. Driving Mobility Centres in the UK) provide independent, specialist evaluations for people whose medical conditions may affect their ability to drive safely. They support both patients and clinicians in borderline or complex cases.

🧠 Cognitive & Visual Testing: Assess attention, reaction time, memory, spatial awareness, and visual fields (especially post-stroke, dementia, head injury).
✋ Physical Ability: Check limb strength, coordination, and control of pedals/steering for conditions such as Parkinson’s disease, MS, or after amputation.
🚙 Practical On-Road Assessment: Patients drive a dual-controlled vehicle with an assessor and occupational therapist, allowing real-life evaluation of safety.
🛠 Adaptations & Modifications: Recommend vehicle adaptations (hand controls, left-foot accelerators, steering aids) for people with disabilities.
📑 Reports to DVLA: Centres provide written reports that help DVLA decide on licensing, or support appeals if a licence has been revoked.
🤝 Patient Support: Guidance on returning to driving, alternative transport, and planning for eventual driving cessation.

📚 Clinical Context

Referral often made after stroke, TBI, early dementia, visual loss, or progressive neurological disease.
Doctors can suggest referral if fitness to drive is uncertain, avoiding unilateral decisions.
Driving assessments reduce conflict — giving objective, documented evidence to support DVLA decisions.
Centres also help young drivers with congenital disabilities explore safe, adapted driving options.

⚖️ Liability Issues

🚘 If a patient drives without notifying the DVLA → driver is legally liable for offences and accidents.
👨‍⚕️ If a doctor fails to advise properly → potential professional negligence claim if harm results.
📑 Insurers may refuse to cover damages if the condition was not disclosed → patient may face personal financial liability.
⚠️ Criminal charges possible if unfit driver causes death/serious harm.

📚 Practical Pearls

Always document advice in medical notes.
Use the DVLA “At a Glance” Guide 📘 for quick reference in clinic.
When uncertain → advise not to drive until DVLA advice obtained.
Patients often unaware that even “minor” conditions (syncope, TIAs, seizures) carry restrictions.

🔗 Useful Links

Cases — DVLA Driving Advice: Ultimate decision is by the DVLA

Case 1 — First seizure ⚡: A 28-year-old man has his first unprovoked seizure. He holds a Group 1 licence (car/motorcycle). DVLA advice: must stop driving for 6 months (if investigations show low recurrence risk; otherwise 12 months). Notification to DVLA required.
Case 2 — Insulin-treated diabetes 💉: A 40-year-old woman with Type 1 diabetes uses basal–bolus insulin. No episodes of hypoglycaemia. DVLA advice: Group 1 drivers may continue if regular glucose monitoring and hypoglycaemia awareness. Must check glucose within 2 hours of driving and during long journeys. Must inform DVLA of insulin use.
Case 3 — Stroke 🧠: A 65-year-old man has an ischaemic stroke with mild residual left arm weakness. DVLA advice: must not drive for 1 month. If no significant residual deficit, may resume. If persistent neurological deficit affecting control of a vehicle → DVLA must be notified.
Case 4 — Syncope/cardiac arrhythmia ❤️: A 58-year-old man has recurrent unexplained syncope due to paroxysmal VT. DVLA advice: must stop driving until condition treated and risk of recurrence low, typically 6 months off driving after successful treatment. Notification mandatory.
Case 5 — Visual field defect 👁️: A 72-year-old woman with glaucoma has bilateral visual field loss. DVLA advice: Driving is only permitted if she meets the visual acuity and field standards. If fields fall below threshold → licence revoked. Must notify DVLA.

Teaching Point 🩺: DVLA driving advice hinges on: - Neurological events (seizure: 6–12 months off; TIA/stroke: 1 month off if recovery complete). - Diabetes (insulin: must notify DVLA, strict glucose monitoring, risk of hypoglycaemia). - Cardiac conditions (syncope/arrhythmia: off until risk controlled). - Vision (acuity ≥6/12, field ≥120° horizontally). Always check the latest DVLA guidance (At a Glance Guide).

The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms.

Driving Advice

⚖️ Law, Driving Assessments & Medical Liability