Fitness to Drive

The DVLA "At A Glance Guide for Medical Practitioners to the Current Medical Standards of Fitness to Drive" is the standard reference text on this subject and is available online.

• Chapter 1: Neurological disorders¹
• Chapter 2: Cardiovascular disorders²
• Chapter 3: Diabetes mellitus³
• Chapter 4: Psychiatric disorders⁴
• Chapter 5: Drug and alcohol misuse and dependency⁵
• Chapter 6: Visual disorders⁶
• Chapter 7: Renal, respiratory disorders and sleep disorders⁷
• Chapter 8: Miscellaneous conditions and elderly drivers⁸
• Annex 1: Disabled drivers⁹
• Annex 2: Disabled drivers' assessment centres¹⁰

Ordinary UK driving licences issued by the DVLA (Driver & Vehicle Licensing Agency) are inscribed with:

• It is the responsibility of the driver to inform the DVLA.
• It is the responsibility of their doctors to advise patients that medical conditions (and drugs) may affect their ability to drive and for which conditions patients should inform the DVLA.
• Drivers should also inform their insurance company of any condition disclosed to the DVLA.

If in doubt ask your defence union.

DVLA state that they must be informed if there is:¹¹

• An epileptic event (seizure or fit)
• Sudden attacks or disabling giddiness, fainting or blackouts
• Severe mental handicap
• A pacemaker, defibrillator or anti-ventricular tachycardia device fitted
• Diabetes controlled by insulin or tablets
• Angina while driving
• Parkinson's disease
• Any other chronic neurological condition
• A serious problem with memory
• A major or minor cerebrovascular event
• Any type of brain surgery, brain tumour or severe head injury involving in-patient treatment at hospital
• Any severe psychiatric illness or mental disorder
• Continuing/permanent difficulty in the use of arms or legs which affects your ability to control a vehicle
• Dependence on or misuse of alcohol, illicit drugs or chemical substances in the past 3 years (do not include drink/driving offences)
• Any visual disability which affects BOTH eyes (do not declare short/long sight or colour blindness).

New drivers vision should reach the following standards:

• 6/9 on the Snellen scale in the better eye
• 6/12 on the Snellen scale in the other eye (wearing glasses or contact lenses, if needed)
• 3/60 in each eye without glasses or contact lenses.

Driving must cease for at least 1 week after:

• Angioplasty
• Non-ST elevation myocardial infarction with successful angioplasty
• Pacemaker implantation

Driving must cease for at least 4 weeks after:

• Coronary Artery Bypass Graft
• ST elevation MI
• Non-ST elevation MI (not followed by successful angioplasty)

Driving should cease if:

• Patient has angina at rest (until symptoms are controlled)
• Left ventricular assist device is inserted

DVLA should be notified if:

• Patient has abdominal aortic aneurysm ≥6 cm diameter. NB: Patient disqualified if diameter >6.5 cm
• Arrythmias present (if patient incapacitated)
• Left ventricular assist device in situ

• All drivers on oral hypoglycaemics or insulin must inform DVLA.
• In general it is wise to stop driving for 1 month after starting insulin to become stable on the treatment.¹²
• Drivers must demonstrate satisfactory control and must recognise hypoglycaemia.
• Check that vision conforms to required standard (above).
• Advise avoid driving if hypoglycaemic risk e.g. meal delay, or after excess exercise.
• Patients should not drive if they feel hypoglycaemic or if their blood glucose is less than 4.0 mmol/l. Driving should not be resumed until 45 minutes after blood glucose has returned to normal.
• Patients should carry rapidly absorbed sugar in vehicle and stop, turn off ignition and eat it if any warning signs.
• A card should be carried to say which medications they are using to aid with resuscitation if needed.
• If an accident is due to hypoglycaemia a diabetic driver may be charged with driving under the influence of drugs.

• A person who has suffered an epileptic attack whilst awake, must not drive for one year from the date of the attack. There must be a medical review before re-starting to drive.
• A person who has suffered an attack whilst asleep, must also refrain from driving for one year from the date of the attack, unless they have had an attack whilst asleep more than three years ago and have not had any awake attacks since that asleep attack.
• In any event, they should not drive if they are likely to cause danger to the public or themselves.
• Patients with transient ischaemic attack (TIA) or cerebrovascular event should not drive for at least one month.
• If TIAs have been recurrent and frequent, a 3 month period free of attacks may be required.
• Patients who have had a single episode of loss of consciousness (no cause found) still need to have at least one year off driving.
• Disabling giddiness, vertigo and problems with movements preclude driving.
• DVLA need to know about unexplained blackouts, multiple sclerosis, Parkinsons (any freezing or on/off effects), motor neurone disease, recurrent TIAs and cerebrovascular events.
• In the latter the licence is usually withheld for 3 months depending on an examination by an independent doctor and sometimes a driving test.
• Those with dementia should only drive if the condition is mild (do not rely on armchair judgements: on-the-road trials are better).

The DVLA states that:

Driving is prohibited if:

• Severe mental disorder (including severe mental impairment)
• Severe behavioural disorders
• Alcohol dependency (including inability to refrain from drink driving)
• Drug abuse and dependency
• Psychotic medication taken in quantities to impair driving ability
• Vision acuity (± spectacles) should be sufficient to read a 79.4mm-high number plate at 20.5 metres
• Monocular vision is allowed only if the visual field is full
• Binocular field of vision must be ≥120°
• Diplopia is not allowable unless mild and correctable e.g. by an eye patch

• Not to drive until they are sure of side-effects
• Not to drink and drive
• Not to drive if feeling unwell
• Never to drive within 48 hours of a general anaesthetic