Updated guidelines remind doctors of duty to protect the public

The General Medical Council (GMC) has updated its guidance for doctors, clearly explaining the steps they should take when dealing with ‘fitness to drive’ concerns with patients.

The new guidance, which came into effect on 25 April, set out the steps doctors should take if a patient’s refusal to stop driving ‘exposes others to a risk of death or serious harm’.

While the guidelines state doctors owe a duty of confidentiality to their patients, they also remind them of the wider duty to protect and promote the health of patients and the public.

The DVLA (DVA in Northern Ireland) is legally responsible for deciding if a person is medically unfit to drive, and as such needs to know if a licence holder has a condition or is undergoing treatment that may now, or in the future, affect their safety as a driver.

The new GMC guidance explain how the principles of confidentiality apply to doctors when considering their responsibilities to disclose information about patients to the DVLA

The guidance say a doctor should first assess the patient’s fitness to drive against the required standard, being aware that this can be affected by either a condition or diagnosis, or a treatment they may be receiving or about to receive.

Different standards apply to professional drivers, such as HGV drivers and bus drivers, which need to be taken into consideration when coming to a decision.

If a patient is undergoing treatment that could affect their ability to drive, the doctor should explain to the patient that they have a legal duty to inform the DVLA. Moreover, the doctor should inform the patient that they may have to disclose relevant medical information to the DVLA, in confidence, should the patient continue to drive if they are not fit to do so.

If a patient does continues to drive when advised not to, doctors should consider contacting the DVLA – but only after making ‘every reasonable effort’ to persuade the patient to stop. When making the decision, consideration should be given as to whether a patient’s refusal to stop driving leaves others ‘exposed to a risk of death or serious harm’.

While the guidance state that only the minimum amount of information necessary needs to be disclosed, the GMC advises doctors to keep clear and comprehensive records about what was discussed with the patient before the decision was made.