DVLA Guidelines Research Articles

An Audit to Assess Compliance With DVLA Guidelines on a Mental Health Rehabilitation Unit

An Audit to Assess Compliance With DVLA Guidelines on a Mental Health Rehabilitation Unit

Assessing Clinician Compliance With DVLA Guidelines for Psychiatric Inpatients

Assessing Clinician Compliance With DVLA Guidelines for Psychiatric Inpatients

Audit Against DVLA Guidance for New Psychiatric Patient Referrals at the Early Intervention for Psychosis Team (EIP)

AimsTo assess the compliance of the clinicians in EIP team with DVLA guidelines. Objectives: To assess if there was documented evidence of: 1)Patient's diagnosis, 2)Patients’ driving status, 3)Type of vehicle driven, 4)Informing the patient that their condition may affect their ability to drive, 5)Advice regarding driving restrictions where applicable, 6)Informing the patient that they have a legal duty to inform the DVLA about their conditionMethodsWe selected two-thirds of the patients(n = 40) enrolled in the EIP service in the last year by consecutive sampling. We collected the data retrospectively from the clinical documentation and analysed it using excel sheets.ResultsThe mean age of the study sample was 34 years. 95%(n = 38) had a documented diagnosis, 67.5%(n = 27) had a documented driving status. The documentation of driving status was completed by doctors in 52%(n = 14), nurses in 26%(n = 7) and by both in 22% (n = 6). The type of vehicle driven was documented for only 33%(5) of the drivers. Among the drivers identified 33%(n = 5) had been informed that their condition might affect their driving, 67%(n = 10) had received information on driving restrictions and 47%(n = 7) had received information that they have a legal duty to inform the DVLA.Discussion:One of the reasons for the low compliance may be because another team might have documented the information at the time of referral. It is possible that the professional involved did elicit the information but didn't document the same. Healthcare professionals(HCP) have to identify, discuss and document driving-related information as advised by the DVLA. In cases where the patients’ don't follow the advice, the HCP must notify the DVLA.ConclusionAssessment of driving history and the risks associated are critical. Awareness should be raised among the clinicians (through training and team meetings). This practice should be made an integral part of the structured initial assessments. Patients can be offered information leaflets. If successfully implemented, it will prevent unsafe driving and minimise the risk of harm for the patient and other road users.

TP9.1.2We must do better - An audit assessing local compliance with NICE Guidelines (2014) on giving patient discharge advice regarding driving following traumatic brain injury

Abstract Introduction Driving is a complex activity involving the coordination of a number of cognitive and physical skills, which may be impaired after head injury. It is a legal requirement that patients’ inform the licensing authority when they have sustained a head injury. Failure to do so results in possible fines, invalid insurance and prosecution. NICE recommends printed patient advice about driving once discharged following a head injury. Methods A retrospective analysis of all traumatic brain injury admissions under the surgical team over a 6 months was performed. The aim was to identify current practice regarding assisting patients to return to safe driving after head injury. Information related to patient demographics, documented driving status and advice (verbal and written) related to driving, was sought. Descriptive statistics were used to portray the results. Results 56 patients were admitted following a traumatic head injury. The average age was 77 (range of 24 to 94) Patients spent on average 4 days in hospital. Only 2 patients had their driving status documented. These two patients also had a documented occupation dependent on driving. No patients received advice specific to DVLA guidelines. Conclusion This study demonstrates that there is poor compliance with NICE guidelines. Indeed, there is a need for change in our practice. We have a duty of care for our patients and in ensuring the safety of the general public. The main limitation of this study relates to the adequacy of documentation. We provide solutions in order to tackle the findings of this audit.

Sleep Drivers

Driving while sleepy can have devastating consequences, but it is an under-recognised problem often associated with behavioural factors, medical conditions or medications. All drivers have a responsibility not to drive if sleepy and there are DVLA regulations restricting driving for patients with certain sleep disorders who are at risk of excessive sleepiness at the wheel. However, sleepiness can be difficult for patient and doctor to assess and guidelines open to interpretation. As doctors it is important we give consistent and reliable advice to patients who may be at risk when driving. This review suggests how to assess driving risk, educate patients about risk reduction, and clarifies DVLA guidelines in this area.

AKT question relating to DVLA Guidelines

AKT question relating to DVLA Guidelines

AKT answer relating to DVLA Guidelines

AKT answer relating to DVLA Guidelines

Knowledge of Driving Vehicle Licensing Agency guidelines among NHS doctors: a multicentre observational study.

ObjectivesOver half of the UK population holds a driver's licence. The DVLA have produced guidelines to ensure drivers with medical conditions drive safely. Doctors should ensure that patients are given appropriate information and advice if they have a medical condition affecting their driving. We sought to evaluate doctors' knowledge of DVLA guidelines.DesignA 25-point questionnaire was designed from DVLA guidelines (‘The DVLA Questionnaire’). Five questions were included for each of neurology, cardiology, drug and alcohol abuse, visual, and respiratory disorders.SettingEaling Hospital, Northwick Park Hospital, Watford General Hospital, Norfolk and Norwich University Hospital and Leeds Teaching Hospitals Trust.Participants140 UK doctors.Main outcome measuresQuestionnaire scores assessing knowledge of DVLA guidelines in five specialty areas.ResultsThe median overall questionnaire score was 28%, interquartile range 20–36% and range 0–100% [Watford 28%, Leeds 30%, Norfolk and Norwich 36%, Ealing 30%, Northwick Park 28%]. There were no significant differences between the scores for each centre (p = 0.1332), Mean scores for specialty areas were: neurology 33.1%, standard deviation 22.1; cardiology 35.6%, standard deviation 26.9; drug and alcohol abuse 30.6%, standard deviation 23.8; visual disorders 33.9%, standard deviation 23.5 and respiratory disorders 20.3%, standard deviation 24.8; overall score 30.7%. There was no significant difference between the scores of the specialty areas (p = 0.4060).ConclusionsKnowledge of DVLA guidelines in our cohort was low. There is a need for increased awareness among hospital doctors through focused education on driving restrictions for common medical conditions. Improving physician knowledge in this area may help optimise patient safety.

Audit to Establish Whether Patients Managed by the Brain Tumour Unit at UCLH/NHNN are following DVLA Guidelines for Patients with Brain Tumours

Background/Aim: The DVLA updated their “Current medical standards of fitness to drive” in May 20131. This audit aims to establish whether our Neuro-oncology MDT has been informing our brain tumour patients of their driving restrictions correctly.

1937 – Awareness and adherence to driving guidelines of psychotropic medication prescription: A brief survey of clinical practice (UK)

In many European countries, doctors and patients are required to inform their respective driving authorities of their condition and treatment. However, in the UK, there is no means to monitor performance and check if such advice is given during the treatment. The purpose of the survey was to evaluate the awareness and adherence to the DVLA (UK) guidelines about psychiatric diagnoses and the impact of psychotropic medications on skills such as driving. A questionnaire on clinical practice and advice given to patients about driving to mental health diagnoses and medication was sent out to psychiatrists working in the local hospital. The responses were collated and analysed for trends. Out of 42 doctors, 36 responded and 34 responses were eligible. The survey revealed that though all the doctors were aware of the guidelines only 38% discussed this with their patients. 50% of the doctors did not refer to guidelines and admitted of giving superficial advice to their patients. 50% of the doctors did not discuss the effect of medication on their motor abilities, concentration and sedation. About 60% of the times the advice was only verbal and not documented. Psychiatrists have a duty of care to inform the patients and document the advice on driving when they newly diagnose and start treatment. The survey suggests that the current practice needs further improvement. Psychiatrists should be aware of guidelines and realise the need to check the patients’ driving status and document the advice given.

A single centre audit into the outcome of transsphenoidal surgery in the treatment of acromegaly

A single centre audit into the outcome of transsphenoidal surgery in the treatment of acromegaly

Driving with a forearm plaster cast: patients’ perspective

Background:Forearm plaster casts are commonly used in orthopaedic practice for the treatment of fractures of the wrist and carpal bones. A common question put by patients seeks to clarify suitability...

Driving whilst plastered: is it safe, is it legal?: A survey of advice to patients given by orthopaedic surgeons, insurance companies and the police

Many patients, immobilised in a plaster cast after a fracture of the upper or lower limb, wish to drive. They frequently ask permission to do so from the treating surgeon. Insurance companies are apparently willing to insure these patients to drive if they obtain their doctors permission. The DVLA guidelines are unhelpful in these circumstances. We therefore established current practice within the south west region by canvassing 126 consultant orthopaedic surgeons, 27 insurance companies and the 6 regional police constabularies, sending them specific clinical scenarios and asking how they would advise these patients regarding safety to drive. The results were as follows: sixty-seven (53%) of surgeons responded of which 97% gave specific advice regarding safety to drive. The insurance companies were generally unwilling to respond and a national response was received from the Association of Chief Constables, which specifically stated that safety to drive was for the individual patient to decide and the doctor should not give advice. We consider this to be unsatisfactory for all parties and suggest how this situation could be improved for both the patient and other road users welfare.

Who can drive home from the emergency department? A questionnaire based study of emergency physicians’ knowledge of DVLA guidelines

Objective: To determine whether doctors working in emergency departments are aware which of the common conditions seen have driving restrictions associated with them and whether they routinely advise patients of...

DVLA and GMC guidelines on 'fitness to drive' and psychiatric disorders: knowledge following an educational campaign.

This paper reports on a questionnaire study of psychiatrists' knowledge of DVLA and GMC guidelines on 'fitness to drive', following the distribution of a synopsis of the DVLA regulations by the DVLA and the Royal College of Psychiatrists. In the context of a high response rate (74%) the results indicated a better level of knowledge than in previous studies. However, understanding of GMC guidelines on breaking confidentiality and the general knowledge of driving regulations amongst junior trainees remain areas of concern. Ways of addressing these deficits are suggested.