Fitness To Drive

General Guidelines:

• Unfit patients must inform the DVLA
• If the patient refuses and poses a risk, the clinician should notify DVLA

Driver Categories:

• Group 1: Motorcyclists and car drivers (age 17-70)
• Group 2: Taxi and lorry drivers
• Over 70s: License renewal every 3 years

Vision Requirements:

• Group 1: 20 metres vision
• Group 2: 6/9 vision
• Colour-blindness: No restrictions

Medical Conditions:

1. Substance Use (group 1)

• Alcohol/cannabis misuse: Withhold until controlled >6 months (group 1)
• Alcohol dependence/heroin, morphine, methadone misuse: Withhold until free >1 year

2. Cardiac Conditions (group 1) – Post-angiogram:

• Successful: No driving >1 week
• Unsuccessful: No driving >4 weeks
• PCI: No driving >1 week
• CABG: No driving >4 weeks
• Angina: Cease if symptoms are at rest/emotion or at the wheel
• Heart Failure: Cease if NYHA grade 4 – Hypertension: No restrictions – Arrhythmia:
  • Cease if causing incapacitation
  • Resume when controlled >4 weeks
  • Post-ablation: No driving >2 days
• Pacemaker: No driving >1 week

3. Neurological Conditions (group 1) – Stroke/TIA:
   • Single event: No driving for 1 month
   • Multiple TIAs: No driving for 3 months – Head contusion: No driving for 6-12 months – Epilepsy:
   • Definition: ≥2 unprovoked seizures >24 hours
   • First seizure: No driving for 6 months
   • Established epilepsy: Must be seizure-free for 12 months
   • Medication withdrawal: No driving >6 months
   • Seizure during withdrawal: No driving >1 year
   • Awake seizure: No driving >6 months-1 year
   • Sleep seizure: No driving >1 year
   • Can be licensed if >3 years since the original attack – Pituitary tumour craniotomy: No driving for 6 months – Syncope:
   • Simple fainting: No restrictions
   • Unexplained (low recurrence risk): 4 weeks off
   • Explained and treated: 4 weeks off
   • Unexplained: 6 weeks off

4. Diabetes

• Diet/Metformin only: No restrictions
• Other oral medications (except sulfonylureas):
  • Group 1: No restrictions if no hypos >12 months
  • Group 2: As Group 1, plus BM monitoring – Insulin-dependent + sulfonylureas:
  • Group 1: 1–3-year license
• Max 1 hypo in 12 months
• None in the last 3 months
• Full hypo awareness
• BM monitoring 2 hours prior/every 2 hours during driving
• Group 2: No hypos in 12 months, full awareness. BM monitoring like the above
• Annual review
• 3-month glucose readings
• D2 and D4 forms required

5. Other Conditions

– Parkinson’s/MS: Can drive if passes medical assessment