Page 490 - ILAE_Lectures_2015

Chapter 54

Driving

JOHN S. DUNCAN

UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen
Square, London

Obtaining a licence to drive is subject to legislation. The regulations are necessary because
there is a higher rate of road traffic accidents and accidental deaths in drivers suffering from
epilepsy1-5. For this reason obtaining a licence to drive is subject to legislation in most
countries. Legislation needs to balance the excess risks of driving against the social and
psychological disadvantage to individuals of prohibiting driving. The following outlines the
regulations, and mechanisms for applying these, in the United Kingdom, and is based on
documentation provided by the licensing authority and the Epilepsy Society websites.

In the UK, the Driving and Vehicle Licensing Agency (DVLA) and in Northern Ireland the
DVLNI, have medical departments which, on behalf of the Secretary of State, are empowered
to consider the medical history of a licence applicant/holder and can, with the applicant’s
consent, obtain medical details from an applicant’s hospital doctor or general practitioner.
The DVLA, and not the patient’s personal medical advisors, make the decisions to allow/bar
licensing. This arrangement, not shared by most other countries, has the important advantages
that the medical aspects of the doctor-patient relationship are not overly compromised by
questions of driving and that the personal doctors are not liable for the consequences.

DVLA regulations and guidance does change, so consult the latest version of the DVLA
document ‘At a Glance Guide to the Current Medical Standards of Fitness to Drive’ is
available on the internet at:

https://www.gov.uk/current-medical-guidelines-dvla-guidance-for-professionals-
neurological-chapter-appendix

This document is recommended for a more detailed review of the current regulations and how
to manage particular situations.

Synopsis of current regulations

Group 1 includes motor cars and motor cycles.

Group 2 includes large lorries (category C) and buses (category D). The medical standards
for Group 2 drivers are stricter than those for Group 1 because of the size of the vehicles and
the higher risk entailed by the length of time the driver may spend at the wheel in the course
of his/her occupation.

All drivers who obtained entitlement to Group 1, category B (motor car) before 1 January
1997 have additional entitlement to category C1 and D1. C1 is a medium size lorry of weight
between 3.5 and 7.5 tonnes. D1 is a minibus of between 9 and 16 seats, not for hire or reward.
Holders of C1 and D1 entitlement retain the entitlement until their licence expires or it is
medically revoked. On subsequent renewal the higher medical standards applicable to Group
2 will apply. Under certain circumstances volunteer drivers can drive a minibus of up to 16
seats without having to obtain category D1 entitlement. Individuals should consult DVLA for
a detailed fact sheet.