Recurring concern

Unreliable DVLA medical fitness notification arrangements

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First reported 8 Aug 2014•Latest report 27 Apr 2026

Definition

What this concern includes

Includes failures in the DVLA-related process for identifying medically relevant driving risks, advising patients about driving and their notification duties, and notifying the DVLA or DVA when appropriate, including unclear or poorly understood professional guidance and ineffective notification arrangements.

Not included

  • Excludes general clinical advice or diagnosis where no driving-safety or DVLA notification connection is identified.
  • Excludes DVLA licence re-issue assessment, audit and medical-review failures unless they directly concern notification of medically relevant driving risks.
  • Excludes driver training, vehicle safety, road design and enforcement concerns unrelated to the DVLA medical-fitness notification process.
  • Excludes failures occurring after an appropriate DVLA notification has been reliably made, including later licensing decisions.
Reports
15

Distinct published reports

Individual concerns
24

A report can raise multiple concerns

Date range
2014–2026

First to latest report issue date

Stated actions
44

Described in published responses

Reports over time

Reports over time

Reports about this concern issued each year.

* 2026 is projected from reports observed to 7 Sep 2026.

Most frequent recipients

Most frequent recipients

Reports about this concern sent to each recipient.

Department for Transport11
Driver and Vehicle Licensing Agency5
General Medical Council2
General Optical Council2
Department of Health and Social Care1
Emsworth Surgery1
GP1
Home Office1
Middleton Lodge Practice1
NHS England1
Nottingham University Hospitals NHS Trust1
Sherwood Forest Hospitals NHS Foundation Trust1

Concerns and responses across reports

Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.

  1. Nottinghamshire

    AI-generated summary

    Michael Chadwick · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Michael Chadwick died from injuries sustained when the motorcycle he was driving left the road. The principal concern was that, despite repeated reports of cough syncope, he was not advised to stop driving or notify the DVLA, raising concern that similar guidance may not be provided to other patients.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to provide patients with advice to stop driving and notify the DVLA about cough syncope

    Wider context from the report

    “1. On the multiple occasions that Mr Chadwick was assessed, and his cough syncope brought to the attention of the medical professionals, there was no advice given him to stop driving and to notify the DVLA of his cough syncope, either orally or in writing. I am concerned that clinicians may fail to provide similar guidance to other patients, which may lead to episodes of syncope whilst driving, with potentially fatal consequences. ”

    Source location

    Michael Chadwick · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Implement the Trust-wide “Fitness to Drive: Ask, Advise, Document” patient safety alert.

    Verbatim wording from the response

    “Patient Safety Alert – Fitness to Drive: Ask, Advise, Document”

    Source location

    Response from Sherwood Forest Hospitals NHS Trust
    Page 1 · response
    Published 17 July 2026

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    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Disseminate DVLA fitness-to-drive guidance to clinical governance leaders and clinicians through governance meetings, reports and email, requiring clinicians to familiarise themselves with it.

    Verbatim wording from the response

    “Communication to all Heads of Service and Clinical Governance Leads”

    Source location

    Response from Sherwood Forest Hospitals NHS Trust
    Page 1 · response
    Published 17 July 2026

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Add DVLA fitness-to-drive guidance to the Trust intranet.

    Verbatim wording from the response

    “Add DVLA guidance to the Trust intranet.”

    Source location

    Response from Sherwood Forest Hospitals NHS Trust
    Page 1 · response
    Published 17 July 2026

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Add DVLA fitness-to-drive guidance to the EOLAS learning area and resources.

    Verbatim wording from the response

    “Add the DVLA guidance to be added to the learning area on EOLAS, as part of the extended learning and resources.”

    Source location

    Response from Sherwood Forest Hospitals NHS Trust
    Page 1 · response
    Published 17 July 2026

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Add a DVLA medical-conditions link, including syncope guidance, to the Cardiology specialist intranet page.

    Verbatim wording from the response

    “The DVLA link regarding medical conditions to be added to Cardiology intranet page.”

    Source location

    Response from Sherwood Forest Hospitals NHS Trust
    Page 2 · response
    Published 17 July 2026

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Advise all clinicians to bookmark DVLA fitness-to-drive standards and guidance for easy access.

    Verbatim wording from the response

    “that this was a complex case, had multiple speciality input but on balance would and should have resulted in advice regarding fitness to drive. As a Practice this has highlighted the need to refresh our knowledge of the DVLA standards and guidance for medical professionals. All clinicians were advised to keep this guidance as a bookmark for ease of access. We have also identified the importance of accurate documentation, if this advice is given verbally but not documented, even if fitness to drive has been considered but deemed safe, both relevant and need clear documentation. There is also the ability to quick code this advice via our clinical system, SystmOne. This also includes a quick guide and notification responsibilities of the patient and clinicians.”

    Source location

    Response from Middleton Lodge Practice
    Page 2 · response
    Published 17 July 2026

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    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Review the Trust’s transient loss of consciousness guidance.

    Verbatim wording from the response

    “In response, the following actions are being taken:”

    Source location

    Response from Nottingham University Hospitals NHS Trust
    Page 2 · response
    Published 17 July 2026

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Circulate the transient loss of consciousness guidance to all Trust consultants.

    Verbatim wording from the response

    “1. Review of the NUH guidelines relating to Transient Loss of Consciousness”

    Source location

    Response from Nottingham University Hospitals NHS Trust
    Page 2 · response
    Published 17 July 2026

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Circulate Medical Director and DVLA driving-advice guidance to consultants and Care Group Governance teams, and publish it on KOHA.

    Verbatim wording from the response

    “2. Guidance from the Medical Director and DVLA circulated to all Consultants and Care Group Governance teams within the Trust to confirm the importance of providing this information to patients.”

    Source location

    Response from Nottingham University Hospitals NHS Trust
    Page 2 · response
    Published 17 July 2026

    Open published response
  2. Cumbria

    AI-generated summary

    James Scott COATES · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    James Scott Coates died after a head-on collision while driving around a bend at approximately 90 mph on an unlit rural road, where 75% of the Cats Eye reflectors were not functioning. He sustained unsurvivable injuries and was declared dead at the roadside. The principal concern was that drivers with potentially significant conditions, including epilepsy and cannabis use, may not notify the DVLA, while legislation places the reporting responsibility on licence holders rather than doctors, which was considered insufficiently robust to ensure proper licence review.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure of drivers to self-report potentially significant conditions to the DVLA

    Wider context from the report

    “I previously sent you a Prevention of Future Deaths Report (in relation to the deaths of Neil Errington and Gareth and Patricia Evans) highlighting my concern that the expectation that drivers would self-report their conditions (which arises as a matter of legislation) was not being followed. The evidence in this inquest provides further cause for concern. Once again, the evidence is that a person with potentially significant conditions never notified the DVLA, and that his doctors did not draw it to the DVLA's attention because legislation places the onus on licence holders and not their doctors. I remain of the view that this is insufficiently robust to ensure that drivers with serious conditions are not having their licences properly reviewed. ”

    Source location

    James Scott COATES · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Review and improve self-declaration forms and associated notification processes.

    Verbatim wording from the response

    “The actions being taken by my Department and the DVLA to address the issues raised in this Prevention of Future Deaths Report include reviewing the self-declaration forms for notifying the DVLA of a medical condition, raising public awareness of the legal duty to notify medical conditions to the DVLA and the consequences of not doing so and reinforcing the existing General Medical Council guidance which advises doctors when to notify the DVLA where a patient continues to drive despite being advised to notify the DVLA.”

    Source location

    Response from Department for Transport
    Page 2 · response
    Published 26 March 2026

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Raise public awareness of the legal duty to notify the DVLA about medical conditions and the consequences of non-notification.

    Verbatim wording from the response

    “The actions being taken by my Department and the DVLA to address the issues raised in this Prevention of Future Deaths Report include reviewing the self-declaration forms for notifying the DVLA of a medical condition, raising public awareness of the legal duty to notify medical conditions to the DVLA and the consequences of not doing so and reinforcing the existing General Medical Council guidance which advises doctors when to notify the DVLA where a patient continues to drive despite being advised to notify the DVLA.”

    Source location

    Response from Department for Transport
    Page 2 · response
    Published 26 March 2026

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Reinforce existing General Medical Council guidance on notifying the DVLA when patients continue driving despite advice to notify.

    Verbatim wording from the response

    “The actions being taken by my Department and the DVLA to address the issues raised in this Prevention of Future Deaths Report include reviewing the self-declaration forms for notifying the DVLA of a medical condition, raising public awareness of the legal duty to notify medical conditions to the DVLA and the consequences of not doing so and reinforcing the existing General Medical Council guidance which advises doctors when to notify the DVLA where a patient continues to drive despite being advised to notify the DVLA.”

    Source location

    Response from Department for Transport
    Page 2 · response
    Published 26 March 2026

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Deliver educational sessions for healthcare professionals encouraging direct DVLA notifications when patients cannot or will not notify themselves.

    Verbatim wording from the response

    “I can confirm that the DVLA is engaging with healthcare professionals and has delivered a series of educational sessions to encourage clinicians to notify the DVLA directly where a patient is unable or unwilling to do so themselves. Further engagement with regulatory bodies, clinical networks and healthcare professionals will continue to better understand any concerns or issues that may be preventing notifications being made to the DVLA by doctors and driving licence holders.”

    Source location

    Response from Department for Transport
    Page 2 · response
    Published 26 March 2026

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Continue engagement with regulatory bodies, clinical networks and healthcare professionals to identify barriers to DVLA notifications.

    Verbatim wording from the response

    “I can confirm that the DVLA is engaging with healthcare professionals and has delivered a series of educational sessions to encourage clinicians to notify the DVLA directly where a patient is unable or unwilling to do so themselves. Further engagement with regulatory bodies, clinical networks and healthcare professionals will continue to better understand any concerns or issues that may be preventing notifications being made to the DVLA by doctors and driving licence holders.”

    Source location

    Response from Department for Transport
    Page 2 · response
    Published 26 March 2026

    Open published response
  3. Birmingham and Solihull

    AI-generated summary

    Christopher Graham Ayerst SAMPSON · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Christopher Graham Ayerst Sampson was a front-seat passenger in a Mazda that was struck by a Mercedes travelling at speeds exceeding 100 mph after its driver suffered an unexpected medical event. Christopher sustained unsurvivable injuries and was declared deceased at the scene. The principal concern was the risk of future deaths arising from drivers failing to self-report medical conditions to the DVLA, and uncertainty about the effectiveness and awareness of medical professionals’ reporting guidance.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Insufficient awareness among medical professionals of guidance on notifying the DVLA

    Wider context from the report

    “7. I am aware that the DVLA publishes guidance on GOV.UK called “Assessing fitness to drive: a guide for medical professionals” to support healthcare professionals (https://www.gov.uk/government/publications/assessing-fitness-to-drive-a-guide-for-medical-professionals). What is unclear, however, is whether a) that guidance is well known amongst medical professionals, and b) whether that process is an effective mechanism for doctors to report patients with health issues, as there does not appear to be any published statistical evidence on the issue. 8. I am also aware that The General Medical Council (GMC) and the General Optical Council (GOC) offer guidance about notifying DVLA when the person cannot or will not exercise their own legal duty to do so. Again, it is unclear whether a) that guidance is well known amongst medical professionals, and b) whether that process is an effective mechanism for doctors to report patients with health issues, as there does not appear to be any published statistical evidence on the issue. ”

    Source location

    Christopher Graham Ayerst SAMPSON · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Uncertainty about the effectiveness of mechanisms for doctors to report patients' health issues to the DVLA

    Wider context from the report

    “7. I am aware that the DVLA publishes guidance on GOV.UK called “Assessing fitness to drive: a guide for medical professionals” to support healthcare professionals (https://www.gov.uk/government/publications/assessing-fitness-to-drive-a-guide-for-medical-professionals). What is unclear, however, is whether a) that guidance is well known amongst medical professionals, and b) whether that process is an effective mechanism for doctors to report patients with health issues, as there does not appear to be any published statistical evidence on the issue. 8. I am also aware that The General Medical Council (GMC) and the General Optical Council (GOC) offer guidance about notifying DVLA when the person cannot or will not exercise their own legal duty to do so. Again, it is unclear whether a) that guidance is well known amongst medical professionals, and b) whether that process is an effective mechanism for doctors to report patients with health issues, as there does not appear to be any published statistical evidence on the issue. ”

    Source location

    Christopher Graham Ayerst SAMPSON · Prevention of Future Deaths report
    Page 1 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure of medical professionals to report patients' health issues to the DVLA

    Wider context from the report

    “9. Drivers may not self-report medical conditions due to a variety of reasons. This can be due to a lack of understanding, insight, or simply because someone has not explicitly told them what to do or how to do it. There are then those who are reckless and knowingly avoid notifying the DVLA of a health condition when explicitly told to do so - either through arrogance, pride or through fear of losing employment. The end result is the same: people are dying needlessly on our roads due to people who, legally, should not be on our roads. 10. There is a risk of future deaths occurring where drivers do not self-refer their conditions to the DVLA, or where medical professionals do not report those health issues to protect the wider public. ”

    Source location

    Christopher Graham Ayerst SAMPSON · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to ensure drivers understand how and when to notify the DVLA of medical conditions

    Wider context from the report

    “9. Drivers may not self-report medical conditions due to a variety of reasons. This can be due to a lack of understanding, insight, or simply because someone has not explicitly told them what to do or how to do it. There are then those who are reckless and knowingly avoid notifying the DVLA of a health condition when explicitly told to do so - either through arrogance, pride or through fear of losing employment. The end result is the same: people are dying needlessly on our roads due to people who, legally, should not be on our roads. 10. There is a risk of future deaths occurring where drivers do not self-refer their conditions to the DVLA, or where medical professionals do not report those health issues to protect the wider public. ”

    Source location

    Christopher Graham Ayerst SAMPSON · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure of drivers to self-report medical conditions to the DVLA

    Wider context from the report

    “9. Drivers may not self-report medical conditions due to a variety of reasons. This can be due to a lack of understanding, insight, or simply because someone has not explicitly told them what to do or how to do it. There are then those who are reckless and knowingly avoid notifying the DVLA of a health condition when explicitly told to do so - either through arrogance, pride or through fear of losing employment. The end result is the same: people are dying needlessly on our roads due to people who, legally, should not be on our roads. 10. There is a risk of future deaths occurring where drivers do not self-refer their conditions to the DVLA, or where medical professionals do not report those health issues to protect the wider public. ”

    Source location

    Christopher Graham Ayerst SAMPSON · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Continue engaging healthcare professionals and regulatory bodies to reinforce notification of the DVLA when drivers cannot or will not self-report medical conditions.

    Verbatim wording from the response

    “Officials will also continue to engage with healthcare professionals and their regulatory bodies to reinforce the importance of notifying the DVLA if their patient lacks the capacity or willingness to inform the DVLA of their condition themselves.”

    Source location

    Response from Department for Transport
    Page 2 · response
    Published 14 November 2025

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    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Embed DVLA/DVA notification expectations in education and training requirements for registrants.

    Verbatim wording from the response

    “• Making sure our expectations are made clear within the education and training of the people on our register. Although the detailed content of curricula is the responsibility of schools, royal colleges and faculties, we set the expected outcomes based on Good medical practice, which includes duties to protect and promote the health of patients and the public. Specifically, the DVLA/DVA notification processes are highlighted in the ‘national legislative requirements’ section of the Generic professional capabilities framework (see domain 3). This framework is embedded in postgraduate training curricula, meaning that all specialty training programmes need to cover these requirements.”

    Source location

    Response from General Medical Council
    Page 2 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Raise awareness of fitness-to-drive confidentiality guidance through registrant talks, workshops and published communications.

    Verbatim wording from the response

    “• Raising awareness of the guidance through our direct communication and engagement channels with doctors, PAs and AAs. Our outreach teams across the UK regularly give talks and run workshops on confidentiality and making decisions about disclosing information in the public interest to our registrants. These workshops will often highlight the importance of sharing information about a patient's medical condition(s) with the DVLA/DVA where necessary. We have also previously published several blogs, including one from the DVLA’s Senior Medical Advisor in 2015 which outlined the DVLA’s processes and reinforced our advice on doctors’ responsibilities.”

    Source location

    Response from General Medical Council
    Page 2 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Collaborate with partner organisations and medical defence bodies to support appropriate responses when patients may be unfit to drive.

    Verbatim wording from the response

    “• Working in collaboration with other organisations who help us engage with registrants. As part of our work to develop and consult on the confidentiality guidance as part of the last review in 2016, we hosted two roundtables with partner organisations to support doctors to respond appropriately when patients may not be fit to drive. We also worked closely with medical defence bodies to develop materials they produced for their members on this issue.”

    Source location

    Response from General Medical Council
    Page 2 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Develop accessible learning materials, including a case study and video, on fitness-to-drive responsibilities.

    Verbatim wording from the response

    “• Developing accessible learning materials, including a case study and a video to support awareness of the expectations in this area.”

    Source location

    Response from General Medical Council
    Page 2 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Plan and progress a targeted awareness campaign through registrant and responsible-officer communication channels.

    Verbatim wording from the response

    “We have begun planning for using our communication channels, such as the e-newsletters we send out regularly to all our registrants and to responsible officers, to run a new targeted awareness campaign for the guidance in the new year. As part of this, we have spoken to colleagues in the General Optical Council to explore the possibilities for joint working, including how we might collaborate on some shared messages to our registrants, and coordinate timing to maximise the impact of any communications activity. We will continue to progress this work over the coming weeks.”

    Source location

    Response from General Medical Council
    Page 3 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Explore joint awareness work with the General Optical Council, including shared messages and coordinated communications timing.

    Verbatim wording from the response

    “We have begun planning for using our communication channels, such as the e-newsletters we send out regularly to all our registrants and to responsible officers, to run a new targeted awareness campaign for the guidance in the new year. As part of this, we have spoken to colleagues in the General Optical Council to explore the possibilities for joint working, including how we might collaborate on some shared messages to our registrants, and coordinate timing to maximise the impact of any communications activity. We will continue to progress this work over the coming weeks.”

    Source location

    Response from General Medical Council
    Page 3 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Review and refresh outreach materials for 2026 onward, including wider references to fitness-to-drive guidance and responsibilities.

    Verbatim wording from the response

    “Finally, our outreach teams are currently looking at their materials to see whether and how these might be refreshed for 2026 and beyond. This includes looking at opportunities to include further references to the fitness to drive guidance and a reminder of responsibilities in this area across a wider range of sessions, including our free Welcome to UK practice sessions that we run with doctors who are new to practice in the UK.”

    Source location

    Response from General Medical Council
    Page 3 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Remind registrants about existing guidance on reporting patients who may be unfit to drive to authorities.

    Verbatim wording from the response

    “You have identified the issue of drivers failing to self-refer health issues (including deteriorating or poor eyesight) as a persisting public safety issue and have called for action to be taken. We are mindful that this issue has been highlighted in other recent Prevention of Future Deaths reports. In April following the publication of HM Senior Coroner for Lancashire’s report, we took prompt action to remind registrants of our existing guidance on when they should report patients who are unfit to drive to the authorities.”

    Source location

    Response from General Optical Council
    Page 2 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Include information in the next registrant newsletter highlighting responsibilities concerning drivers’ health and fitness to drive.

    Verbatim wording from the response

    “Whilst we await the strategy, we will also carry out the following actions:”

    Source location

    Response from General Optical Council
    Page 3 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Explore using the annual registrant survey to identify barriers preventing referrals about drivers’ ability to drive.

    Verbatim wording from the response

    “Whilst we await the strategy, we will also carry out the following actions:”

    Source location

    Response from General Optical Council
    Page 3 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Maintain guidance explaining when registrants should disclose confidential information about patients who may be unfit to drive.

    Verbatim wording from the response

    “We set standards for the individuals and businesses on our register. Standard 11 of our Standards of Practice (10 in the Standards for Optical Students) outlines that our registrants must promptly raise concerns about their patients, colleagues, employer or other organisation(s) if patient or public safety might be at risk. This would include raising concerns where a patient may not be safe to drive but where the registrant believes that the patient will not/cannot inform the Driver Vehicle Licensing Agency (DVLA). To help our registrants comply with this standard, we have produced guidance on disclosing confidential information (which includes a section on driving vision standards), as you note in the Report.”

    Source location

    Response from General Optical Council
    Page 2 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Consider the self-declaration process alongside evidence from the 2023 call for evidence and findings from recent inquests.

    Verbatim wording from the response

    “My department also recognises that the volume and complexity of driving licence applications for those with one or more medical conditions is increasing, reflecting both an ageing population and a strong desire among drivers to maintain the independence that driving provides. We are considering the evidence gathered during the 2023 call for evidence, alongside findings from recent inquests, and as part of this work, consideration will be given to the process of self-declaration. Road safety measures have not been reviewed for over a decade, and my department has developed a new Road Safety Strategy, which has been published today, 7 January.”

    Source location

    Response from Department for Transport
    Page 2 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Schools, royal colleges and faculties are responsible for the detailed content of curricula covering fitness-to-drive notification requirements.

    Verbatim wording from the response

    “• Making sure our expectations are made clear within the education and training of the people on our register. Although the detailed content of curricula is the responsibility of schools, royal colleges and faculties, we set the expected outcomes based on Good medical practice, which includes duties to protect and promote the health of patients and the public. Specifically, the DVLA/DVA notification processes are highlighted in the ‘national legislative requirements’ section of the Generic professional capabilities framework (see domain 3). This framework is embedded in postgraduate training curricula, meaning that all specialty training programmes need to cover these requirements.”

    Source location

    Response from General Medical Council
    Page 2 · response
    Published 14 November 2025

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Government must decide the road safety strategy and whether to introduce mandatory reporting or mandatory sight testing for drivers.

    Verbatim wording from the response

    “The road safety strategy will frame or narrow what initiatives might most effectively respond to those concerns, but the options available to Government include legislating to introduce mandatory reporting of concerns by healthcare professionals (as happens in cases of suspected Female Genital Mutilation) and mandatory sight testing for drivers. Whichever approach the Government takes in their strategy, they will need to be mindful of unintended consequences. Mandatory reporting by healthcare professionals in the absence of mandatory sight tests might disincentivise people from having sight tests for fear of losing their licence even if this would not be the outcome. This could have the perverse effect of making the roads more dangerous as well as adversely impacting the quality of life of those avoiding sight testing.”

    Source location

    Response from General Optical Council
    Page 3 · response
    Published 14 November 2025

    Open published response
  4. Cumbria

    AI-generated summary

    Martin Gareth EVANS and 2 others · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Martin Gareth Evans and Patricia Mary Evans died after another driver experienced syncope and collided with their vehicle on 13 February 2023. Neil Errington died after another driver had a seizure and collided with his vehicle; he died in hospital on 12 May 2022. The substantive concern was that relying on drivers with medical impairments to self-report to the DVLA may allow some to continue driving despite advice not to do so, risking future deaths.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Reliance on drivers to self-refer medical impairments to the DVLA

    Wider context from the report

    “(1) The DVLA witnesses confirmed to me that the scheme created by section 94 of the Road Traffic Act 1988 requires that 'licence holders' notify the DVLA if they suffer from a relevant or prospective disability. In turn the DVLA place the emphasis on the expectation that licence holders will themselves honestly inform the DVLA of their condition. Although medical professionals can inform the DVLA of a patient's unfitness to drive, the DVLA proceed on the basis that notifications will not usually come via this route. In each of these three inquests the drivers responsible for the collisions had repeatedly lied to the DVLA about their fitness to drive. I was told that this was 'disappointing' but not wholly surprising. I am aware that HM Senior Coroner for Lancashire and Blackburn with Darwen addressed a PFD report to you (ref: 2025-0196) on April 24th 2025 in which a death had been caused by a driver who, by reason of their condition, lacked the necessary insight to self-refer to the DVLA. Each of these cases illustrate the problem with expecting that those who have medical impairments should self-refer to the DVLA. There will be cases where, despite repeated advice not to drive, a person is unable or unwilling to inform the DVLA of their situation. My concern is that this risks future deaths. I consider that whilst self-referral remains the default position, more drivers will be able to continue driving whilst endangering lawful road users. ”

    Source location

    Martin Gareth EVANS and 2 others · Prevention of Future Deaths report
    Page 3 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Carry out a comprehensive review of the self-declaration forms.

    Verbatim wording from the response

    “Although the self-declaration process for notifying medical conditions to the DVLA is intended to empower drivers to take personal responsibility for their fitness to drive, I recognise that some drivers wilfully ignore medical advice and will not notify the DVLA and continue driving. This can have potentially devastating consequences. Officials will carry out a comprehensive review of the self-declaration forms and consider ways to further raise awareness of the importance of notifying conditions to the DVLA and the potential far reaching consequences of failing to do so. Officials will also continue to engage with healthcare professionals and their regulatory bodies to reinforce the importance of notifying the DVLA if their patient lacks the capacity or willingness to inform the DVLA of their condition themselves.”

    Source location

    Response from Department of Transport
    Page 2 · response
    Published 20 October 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Consider ways to raise awareness of notifying the DVLA and the consequences of failing to do so.

    Verbatim wording from the response

    “Although the self-declaration process for notifying medical conditions to the DVLA is intended to empower drivers to take personal responsibility for their fitness to drive, I recognise that some drivers wilfully ignore medical advice and will not notify the DVLA and continue driving. This can have potentially devastating consequences. Officials will carry out a comprehensive review of the self-declaration forms and consider ways to further raise awareness of the importance of notifying conditions to the DVLA and the potential far reaching consequences of failing to do so. Officials will also continue to engage with healthcare professionals and their regulatory bodies to reinforce the importance of notifying the DVLA if their patient lacks the capacity or willingness to inform the DVLA of their condition themselves.”

    Source location

    Response from Department of Transport
    Page 2 · response
    Published 20 October 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Continue engaging healthcare professionals and regulatory bodies to reinforce notification when patients cannot or will not notify the DVLA.

    Verbatim wording from the response

    “Although the self-declaration process for notifying medical conditions to the DVLA is intended to empower drivers to take personal responsibility for their fitness to drive, I recognise that some drivers wilfully ignore medical advice and will not notify the DVLA and continue driving. This can have potentially devastating consequences. Officials will carry out a comprehensive review of the self-declaration forms and consider ways to further raise awareness of the importance of notifying conditions to the DVLA and the potential far reaching consequences of failing to do so. Officials will also continue to engage with healthcare professionals and their regulatory bodies to reinforce the importance of notifying the DVLA if their patient lacks the capacity or willingness to inform the DVLA of their condition themselves.”

    Source location

    Response from Department of Transport
    Page 2 · response
    Published 20 October 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Review existing evidence alongside findings from recent inquests.

    Verbatim wording from the response

    “My department also recognises that the volume and complexity of driving licence applications for those with one or more medical conditions is increasing, reflecting both an ageing population and a strong desire among drivers to maintain the independence that driving provides. We are reviewing the evidence already gathered alongside the findings from recent inquests. As part of this work consideration will be given to the process of self-declaration.”

    Source location

    Response from Department of Transport
    Page 2 · response
    Published 20 October 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Consider the process for self-declaration as part of the evidence review.

    Verbatim wording from the response

    “My department also recognises that the volume and complexity of driving licence applications for those with one or more medical conditions is increasing, reflecting both an ageing population and a strong desire among drivers to maintain the independence that driving provides. We are reviewing the evidence already gathered alongside the findings from recent inquests. As part of this work consideration will be given to the process of self-declaration.”

    Source location

    Response from Department of Transport
    Page 2 · response
    Published 20 October 2025

    Open published response
  5. Nottinghamshire

    AI-generated summary

    Rosemary MacAndrew · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Rosemary MacAndrew, aged 64, died on 5 July 2024 after being struck by a reversing motor car while she was a pedestrian in a car park. The report raises concern that the current vehicle-licensing system relies largely on older drivers recognising and self-reporting medical conditions that may compromise their driving ability, creating a risk of future deaths.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Reliance of vehicle licensing on drivers’ self-reporting of medical conditions

    Wider context from the report

    “The UK population is of increasing age and the number of older drivers is increasing rapidly. The current system for vehicle licensing relies largely upon the self-awareness of a driver and their willingness and/or ability to self-report medical conditions to the DVLA. I am concerned that older drivers with vulnerabilities, including age, decreasing mobility and cognitive decline pose a risk of future deaths through compromised driving ability thereby creating a risk of deaths in the future. ”

    Source location

    Rosemary MacAndrew · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Continue engaging healthcare professionals and regulatory bodies to identify circumstances where appropriate DVLA notifications could be encouraged or supported.

    Verbatim wording from the response

    “To ensure that the DVLA is notified about drivers who have conditions that may impair their insight into their health and driving abilities, my Department will continue to engage with healthcare professionals and their regulatory bodies to understand if there may be circumstances where doctors and health care professionals could be encouraged or supported in notifying the DVLA when appropriate.”

    Source location

    Response from Department for Transport
    Page 2 · response
    Published 19 May 2025

    Open published response
  6. Lancashire and Blackburn with Darwen

    AI-generated summary

    Mary Frances Cunningham and 3 others · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Mary Frances Cunningham, Grace Foulds, Anne Elizabeth Ferguson and Peter Anthony Westwell died in separate road traffic collisions involving drivers whose eyesight was below the legal standard for driving. The report raises concerns about the UK licensing system, including reliance on self-reporting, the lack of periodic visual checks, and the limitations of the number-plate test. It states that the DVLA continued to license the drivers involved despite their impaired vision.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Unexplained reduction in driver self-reporting of major eye conditions

    Wider context from the report

    “Between 2019 and 2023 there has been a collapse of drivers self-reporting the four major conditions of diabetic retinopathy, cataracts, glaucoma and macular degeneration resulting in a 70 to 76% reduction in notifications. As the diseases are unchanged, the patient cohort is unchanged and the DVLA have not altered their processes, the DVLA have no explanation for this substantial reduction in driver self-reporting over such a short period. ”

    Source location

    Mary Frances Cunningham and 3 others · Prevention of Future Deaths report
    Page 4 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to communicate unsafe visual assessments promptly to the DVLA

    Wider context from the report

    “Doctor/optometrist-patient medical confidentiality is an entrenched aspect of UK medical practice and is only rarely breached and this only occurs after protracted patient negotiations during which time a driver continues to drive their car. Unless there were to be some form of requirement for a driver's visual assessment that is believed the legal limit to be communicated to the DVLA, this safeguard by which the DVLA may be notified of a driver continue to drive against advice produces only a minimal number of cases each year. This is already known to the DVLA. ”

    Source location

    Mary Frances Cunningham and 3 others · Prevention of Future Deaths report
    Page 4 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Investigate the reduction in notifications of diabetic retinopathy, cataracts, glaucoma and macular degeneration and identify any necessary action.

    Verbatim wording from the response

    “DVLA officials are also considering why there has been a reduction of notification of diabetic retinopathy, cataracts, glaucoma and macular degeneration between 2019 and 2023, with a view to understanding the cause and identifying what action may need to be taken.”

    Source location

    Response from Department for Transport
    Page 3 · response
    Published 25 April 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Work with eye healthcare professionals and regulatory bodies to identify and address barriers to notifying the DVLA when disclosure is in the public interest.

    Verbatim wording from the response

    “However, I recognise that this may be challenging where there are concerns about confidentiality and the ethical implications of disclosing sensitive health information without a patient’s consent and where drivers dishonestly declare themselves to be non-drivers. I also acknowledge that this often involves protracted negotiations between healthcare professionals and their patients before a notification is made to the DVLA. My Department will work with eye healthcare professionals and their regulatory bodies to identify and aim to address any concerns and issues that may be preventing them from notifying the DVLA when it is in the public interest to do so.”

    Source location

    Response from Department for Transport
    Page 3 · response
    Published 25 April 2025

    Open published response
  7. Lancashire and Blackburn with Darwen

    AI-generated summary

    Sheila Margaret Edwards · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Sheila Margaret Edwards was a front-seat passenger in a car whose driver became unresponsive, leading to a head-on collision on 8 January 2023. The report identified concerns that drivers with dementia and other conditions may not recognise or report them to the DVLA, creating risks to other road users, and that such conditions may be under-recorded in collision data.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure of drivers with dementia to self-report medical conditions to the DVLA

    Wider context from the report

    “1. Dementia affects approximately half a million sufferers in the United Kingdom of which the DVLA has only been notified of approximately 30,000 drivers. It would appear that there is significant underreporting of drivers who may suffer from dementia 2. The current system for vehicle licensing relies upon the self-awareness of a driver and their ability to self-report medical conditions to the DVLA. A system that relies upon the self-awareness of a person applying for a driving licence to self-report a medical condition of dementia where the condition itself is characterised by a lack of self-awareness is inherently unsafe and exposes other road users to the risk of death or serious injury ”

    Source location

    Sheila Margaret Edwards · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to report multiple medical conditions requiring DVLA monitoring

    Wider context from the report

    “5. In this case, the driver suffered from focal epilepsy, which was the primary cause of the collision resulting Sheila Edwards' death. However, the memory deficit caused by dementia resulted in a lack of awareness of an underlying neurological condition. In such cases there is a substantial risk that neither of the conditions will be reported to the DVLA for monitoring. The result is that a driver with two conditions that should be monitored by the DVLA who is both unaware of their illnesses and the need to report themselves to the DVLA. This creates a substantial risk to other road users. ”

    Source location

    Sheila Margaret Edwards · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Continue engaging healthcare professionals and regulatory bodies to identify and address obstacles to reporting conditions when patients lack insight or capacity.

    Verbatim wording from the response

    “Although the process for establishing that a driver meets the medical standards for driving is based on self-declaration, I recognise that this may be difficult for those drivers with conditions that may impair their insight into their health status. My department will continue to engage with healthcare professionals and their regulatory bodies to identify and address any obstacles that may hinder the reporting process, particularly where their patient lacks the insight or capacity to inform the DVLA of their condition themselves.”

    Source location

    Response from Department for Transport
    Page 2 · response
    Published 24 April 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Consider research and evidence, including any additional research needed, to inform potential future changes to the driver licensing system.

    Verbatim wording from the response

    “Officials are considering the research and evidence provided and what additional research may be needed to inform potential future changes. These considerations include the system of self-declaration and the potential for the introduction of age-based testing. Consideration is also being given to policy options as part of the Government’s Road Safety Strategy, which is being developed and the details of which will be provided in due course.”

    Source location

    Response from Department for Transport
    Page 3 · response
    Published 24 April 2025

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Continue working with healthcare professionals, driving organisations and regulatory bodies to identify and assess people who pose road-safety risks because of unrecognised medical conditions.

    Verbatim wording from the response

    “My Department will continue to work with healthcare professionals, driving organisations and regulatory bodies to enhance the safety of our roads and ensure that those who pose a risk to road safety due to lack of awareness of their medical condition are appropriately identified and assessed.”

    Source location

    Response from Department for Transport
    Page 4 · response
    Published 24 April 2025

    Open published response
  8. Dorset

    AI-generated summary

    Richard Andrew Collins · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Richard Andrew Collins, who had bipolar affective disorder, was struck by an articulated lorry after walking into the eastbound carriageway of the A421 on 9 February 2022, and his death was confirmed despite resuscitation attempts. The report raises concerns that, after his mental health deterioration and hospital admission, his driving fitness and duty to notify the DVLA were not revisited by medical professionals, and that similar missed opportunities may occur nationally.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure of secondary mental health services to revoke driving licences on medical grounds

    Wider context from the report

    “2. I have concerns with regard to the following: i. Whilst considerable work has been undertaken within the secondary mental health services in Dorset, I am concerned that there may be similar issues or missed opportunities nationally within other trusts which could lead to the lack of revocation of driving licences on medical grounds, putting the patients and other road users at risk of death. ”

    Source location

    Richard Andrew Collins · Prevention of Future Deaths report
    Page 3 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Ask colleagues in each NHS region to raise awareness of GMC and DVLA fitness-to-drive guidance with local systems and providers.

    Verbatim wording from the response

    “As a result of the concerns highlighted in your Report, colleagues from each of the seven NHS regions will be asked to raise awareness of the GMC and DVLA guidance with their systems and providers.”

    Source location

    Response from NHS England
    Page 2 · response
    Published 14 March 2024

    Open published response

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Ask colleagues in each NHS region to raise awareness of GMC and DVLA driving-fitness guidance with systems and providers.

    Verbatim wording from the response

    “As a result of the concerns highlighted in your Report, colleagues from each of the seven NHS regions will be asked to raise awareness of the GMC and DVLA guidance with their systems and providers.”

    Source location

    Response from Department of Health and Social Care
    Page 2 · response
    Published 14 March 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    The GMC is responsible for setting doctors’ professional standards on fitness to drive and reporting concerns.

    Verbatim wording from the response

    “The General Optical Council also issue similar guidance. The GMC are responsible for setting the standards doctors and those who train them need to meet. It is expected that all doctors use their professional judgement to apply the standards set by the GMC in their day-to-day practice. Trusts are expected to have due regard to existing guidance from organisations such as the GMC and Royal Colleges, and to develop their own local policies. We note that in this case, Dorset Healthcare University NHS Foundation Trust (DHUFT) did not have a local policy in place at the time of Richard’s death.”

    Source location

    Response from NHS England
    Page 1 · response
    Published 14 March 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Individual NHS Trusts are expected to develop local policies addressing duties concerning medical revocation of driving licences.

    Verbatim wording from the response

    “The General Optical Council also issue similar guidance. The GMC are responsible for setting the standards doctors and those who train them need to meet. It is expected that all doctors use their professional judgement to apply the standards set by the GMC in their day-to-day practice. Trusts are expected to have due regard to existing guidance from organisations such as the GMC and Royal Colleges, and to develop their own local policies. We note that in this case, Dorset Healthcare University NHS Foundation Trust (DHUFT) did not have a local policy in place at the time of Richard’s death.”

    Source location

    Response from NHS England
    Page 1 · response
    Published 14 March 2024

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Existing GMC and DVLA guidance sets responsibilities for doctors and healthcare professionals regarding fitness to drive and licence revocation.

    Verbatim wording from the response

    “In preparing this response, Departmental officials have made enquiries with NHS England and have been informed that it is not within the remit of NHS England to issue guidance on the revocation of driving licences. As your report states, there is existing national guidance issued by the General Medical Council (GMC) on this issue (Patients’ fitness to drive and reporting concerns to the DVLA or DVA) which outlines the following (section 4):”

    Source location

    Response from Department of Health and Social Care
    Page 1 · response
    Published 14 March 2024

    Open published response
  9. West London

    AI-generated summary

    Billy Martyn WARWICK-JONES · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Billy was killed while riding his motorbike when he was struck head-on by a car travelling on the wrong side of the A3. The driver was elderly, unwell with a urinary tract infection, delirious and had driven for 16 hours. The concerns included insufficient advice about delirium-related unfitness to drive and inadequate testing and guidance on road safety for older drivers.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to advise drivers and families that confusion, agitation or delirium may render driving unfit

    Wider context from the report

    “The driver of the vehicle that caused this death was unwell with a urine tract infection. He had previously been treated for a urine tract infection. There is no evidence to suggest that he or his family were advised that he may demonstrate symptoms of confusion, agitation or delirium as a consequence of this and they would render him unfit to drive. There appears to be insufficient testing and instruction of the older population with regards to road safety, which led to this tragic outcome. While there are guidelines for driving for dementia or mild cognitive impairment produced by the General Medical Council, there appears to be nothing specific to other sudden onset confusion or delirium which is a well recognised and common symptom in the elderly when physically unwell. It is recognised that our population are growing older and that an increasing number of this cohort will have a driving licence. It is of concern that a situation can arise that leads to the loss of another drivers life, and additional lives could very easily have been lost as a consequence of this incident. Consideration should be given to more frequent, rigorous testing and to consider the duties that should be placed on the driver, their medical practitioners and also family members/carers to report changes in presentation or health to the Driver and Vehicle Licensing Agency. ”

    Source location

    Billy Martyn WARWICK-JONES · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Setting clinical standards and providing clinical guidance on specific driving conditions falls outside the respondent’s role.

    Verbatim wording from the response

    “We do not specify particular conditions that might affect a patient’s fitness to drive or give guidelines for driving with particular conditions as we do not set clinical standards or provide clinical guidance. This is the role of a wide range of other bodies. However, we outline to doctors that when assessing a patient’s condition and providing treatment, they should refer to the DVLA’s guidance Assessing fitness to drive- a guide for medical professionals, which includes more detailed information about specific disorders and conditions that can impair a patient’s fitness to drive.”

    Source location

    Response from GMC
    Page 2 · response
    Published 17 September 2021

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    The DVLA and DVA are legally responsible for deciding whether a person is medically unfit to drive.

    Verbatim wording from the response

    “The Driver and Vehicle Licensing Agency (DVLA) in England, Scotland and Wales and the Driver and Vehicle Agency (DVA) in Northern Ireland are legally responsible for deciding if a person is medically unfit to drive, and we say that if a doctor is unsure whether the patient’s condition would affect their ability to drive safely, they should seek advice from an experienced colleague or the DVLA or DVA’s medical adviser.”

    Source location

    Response from GMC
    Page 2 · response
    Published 17 September 2021

    Open published response

    Source evidence

    How this respondent position was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Particular conditions and a general duty for increased testing cannot be specified because fitness to drive requires case-by-case assessment and DVLA or DVA involvement.

    Verbatim wording from the response

    “For the reasons outlined above, we are unable to specify particular conditions in our guidance including a general duty for increased testing, as each patient would need to be considered by their doctor on a case by case basis before being assessed by the DVLA.”

    Source location

    Response from GMC
    Page 2 · response
    Published 17 September 2021

    Open published response
  10. Hampshire, Portsmouth and Southampton

    AI-generated summary

    Andrew BIDDLECOMBE · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Andrew BIDDLECOMBE died on 10 July 2020 after the motor car he was driving collided with a sign-post and rolled over, causing fatal head and neck injuries. It could not be ascertained whether he suffered a medical episode or whether poor eyesight and mobility hindered him in avoiding the collision. The concerns included that he had not been advised about the impact of his medical conditions on safe driving or the legal requirement to notify the DVLA, and that the practice did not inform the DVLA of relevant medical conditions.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to inform the DVLA of medical conditions relevant to safe driving

    Wider context from the report

    “The deceased was 70 years of age. The deceased had several medical conditions including Parkinson’s disease; had suffered possible epileptic seizures; had bilateral posterior capsular opacity. The deceased was known to have problematic double vision and was partially sighted in his right eye. The deceased was known to have poor mobility. The deceased was prescribed medications namely Ipninia XL a medication with a recognised side-effect of sudden sleep onset episodes and Ramipril a medication with recognised side-effects of blurred vision, confusion and dizziness. It was known that the deceased was a current driver, noting the Parkinson’s review in February 2020. The deceased had not been advised of the impact of his medical conditions on his ability to drive safely nor had he been advised of the legal requirement to notify the DVLA of his medical conditions. The practice did not inform the DVLA of the deceased’s medical conditions relevant to the deceased’s ability to drive safely. ”

    Source location

    Andrew BIDDLECOMBE · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to advise drivers of the legal requirement to notify the DVLA of medical conditions

    Wider context from the report

    “The deceased was 70 years of age. The deceased had several medical conditions including Parkinson’s disease; had suffered possible epileptic seizures; had bilateral posterior capsular opacity. The deceased was known to have problematic double vision and was partially sighted in his right eye. The deceased was known to have poor mobility. The deceased was prescribed medications namely Ipninia XL a medication with a recognised side-effect of sudden sleep onset episodes and Ramipril a medication with recognised side-effects of blurred vision, confusion and dizziness. It was known that the deceased was a current driver, noting the Parkinson’s review in February 2020. The deceased had not been advised of the impact of his medical conditions on his ability to drive safely nor had he been advised of the legal requirement to notify the DVLA of his medical conditions. The practice did not inform the DVLA of the deceased’s medical conditions relevant to the deceased’s ability to drive safely. ”

    Source location

    Andrew BIDDLECOMBE · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below.

    PFD Monitor interpretation

    Failure to advise drivers of the impact of their medical conditions on safe driving

    Wider context from the report

    “The deceased was 70 years of age. The deceased had several medical conditions including Parkinson’s disease; had suffered possible epileptic seizures; had bilateral posterior capsular opacity. The deceased was known to have problematic double vision and was partially sighted in his right eye. The deceased was known to have poor mobility. The deceased was prescribed medications namely Ipninia XL a medication with a recognised side-effect of sudden sleep onset episodes and Ramipril a medication with recognised side-effects of blurred vision, confusion and dizziness. It was known that the deceased was a current driver, noting the Parkinson’s review in February 2020. The deceased had not been advised of the impact of his medical conditions on his ability to drive safely nor had he been advised of the legal requirement to notify the DVLA of his medical conditions. The practice did not inform the DVLA of the deceased’s medical conditions relevant to the deceased’s ability to drive safely. ”

    Source location

    Andrew BIDDLECOMBE · Prevention of Future Deaths report
    Page 2 · concerns

    Open source report

    Source evidence

    How this respondent action was interpreted

    PFD Monitor created a concise, searchable interpretation from the published response wording shown below.

    PFD Monitor interpretation

    Write to patients with epilepsy or Parkinson’s disease to remind them of DVLA notification responsibilities and identify current drivers for record updates.

    Verbatim wording from the response

    “Emsworth Surgery have undertaken a significant event analysis as part of the action arising from the Regulation 28 Report received. We have reviewed the templates that could be used for chronic disease review to ensure there are questions relevant to the patient’s driving status. We have also written to all our patients on the Epilepsy and Parkinson’s Disease register to remind them of their responsibilities to inform the DVLA of their diagnosis. We have asked the patients on these registers to inform us if they are current drivers so we can ensure their records are up to date. Finally, we have sent a medication leaflet to all patients on Ropinirole detailing possible side effects including sudden drowsiness to remind patients of these and the importance of reporting side effects.”

    Source location

    2021-0053-Response-from-Emsworth-Surgery_Published
    Page 2 · response
    Published 1 March 2021

    Open published response
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Data last updated 7 September 2026