The College of Optometrists

If you think a patient is unfit to drive

The DVLA and the DVA have legal responsibility for deciding if a person is medically unfit to drive.
The patient is legally responsible for informing the DVLA or DVA if they do not meet the vision standard for driving. Information on how they can do this is in the Useful information section below. However, if you think the patient may pose a very real risk of danger to the public, but you are not sure whether you should act, ask yourself: 
  1. what might the outcome be in the short or longer term if I do not raise my concern? And,
  2. how could I justify why I did not raise the concern?
If you decide that the patient is unfit to drive, you should:
  1. first tell the patient that they are unfit to drive and give the reasons. You may wish to discuss your concerns with a relative or carer, if the patient consents to this
  2. tell the patient that they have a legal duty to inform the DVLA or DVA about their condition
  3. put your advice in writing to the patient
  4. record your advice and keep a copy of any correspondence to the patient on the patient record, and 
  5. notify the patient’s GP, if appropriate, with the patient’s consent.
Sometimes the actions in para A223 might not achieve their aim, or would take too long to do so. You have a duty of confidentiality to the patient, but this is not absolute and can be broken if it is in the public interest to do so. Guidance from the Department of Health includes the example of reporting a driver who rejects medical advice not to drive as one where the public interest can be a defence to breaching patient confidentiality.78
If you conclude the public interest outweighs the duty of confidentiality, you should:
  • notify the appropriate authority (DVLA or DVA) in writing, and, if appropriate, provide evidence of clinical findings (see useful information below)
  • notify the patient’s GP of the action being taken, and
  • notify the patient, if appropriate.
If you are considering informing the DVLA or DVA that the patient may not be fit to drive,79 you may wish to contact your professional or representative body for advice.

See section on Confidentiality.

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