PFD report

Billy Martyn WARWICK-JONES · Prevention of Future Deaths report

Pin Get email alerts Request correction

Issued 10 Sep 2021•West London

Report record

Published report and response evidence

This page connects the concerns raised in this report with statements found in recipients’ published responses. A link shows a clear evidence connection; it does not assign responsibility.

View original report
Concerns
4

Raised in this report

Recipients
5

Named on the report

Responses found
2

Of 5 recipients

Stated actions
2

Described in responses

Recipients and published responses

Source document

Full report text

This is the full text from the original published report.

Open published report

Concerns and recipient responses

Select any concern, action or position to view the source wording.

Concerns raised4

  1. Absence of specific driving guidance for sudden-onset confusion or delirium in physically unwell older people
  2. Failure to advise drivers and families that confusion, agitation or delirium may render driving unfit
    Part of recurring concern: Unreliable DVLA medical fitness notification arrangements
  3. Insufficient road-safety instruction for older drivers
Responses linked to these concerns

Each statement is shown once, even when linked to more than one concern.

Actions described in response An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised.1

  1. Action

    Fund and develop an older-driver website providing safety advice, assessment information and refresher-training details.

    Stated by Department for TransportStated completedThe respondent said that this action was complete when they made their response on 17 September 2021.

Respondent positions A position is what a recipient says about a concern when it does not describe a specific action.5

  1. Position

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

    Stated by General Medical CouncilOutside remitThe respondent said that this matter was outside its role or authority.

Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Absence of specific driving guidance for sudden-onset confusion or delirium in physically unwell older people

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. ”

Is this part of a recurring concern?

No recurring-concern membership is currently published.

Open source report

Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

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. ”

Is this part of a recurring concern?

Yes — Unreliable DVLA medical fitness notification arrangements.

Open source report

Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Insufficient road-safety instruction for older drivers

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. ”

Is this part of a recurring concern?

No recurring-concern membership is currently published.

Open source report

Source evidence

How this individual concern was interpreted

PFD Monitor created a concise, searchable interpretation from the report wording shown below. Response links show a clear evidence connection; they do not assign responsibility.

PFD Monitor interpretation

Insufficient road-safety testing of older drivers

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. ”

Is this part of a recurring concern?

No recurring-concern membership is currently published.

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

Fund and develop an older-driver website providing safety advice, assessment information and refresher-training details.

Verbatim wording from the response

“The Royal Society for the Prevention of Accidents, with funding from the Department, has developed an older driver website which can be accessed at: www.olderdrivers.org.uk. The website contains information to help older people to continue to drive for as long as they are safe to do so. It includes general advice, as well as details on driving assessments and refresher training.”

Source location

Response from Department for Transport
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

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

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 current driver licensing process at age 70 or over is considered to balance road safety and individual needs.

Verbatim wording from the response

“A driver’s age is, in itself, not an automatic barrier to driving. But the likelihood of having a medical condition that can affect safe driving does increase with age. The current process for drivers renewing their licences at age 70 or over is designed to balance road safety and the needs of the individual. There is little evidence to suggest that introducing a stricter regime which included mandatory testing or medical examinations would improve road safety. Drivers are encouraged to discuss any concerns about their driving fitness with their own medical professionals.”

Source location

Response from Department for Transport
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

There is little evidence that mandatory testing or medical examinations for older drivers would improve road safety.

Verbatim wording from the response

“A driver’s age is, in itself, not an automatic barrier to driving. But the likelihood of having a medical condition that can affect safe driving does increase with age. The current process for drivers renewing their licences at age 70 or over is designed to balance road safety and the needs of the individual. There is little evidence to suggest that introducing a stricter regime which included mandatory testing or medical examinations would improve road safety. Drivers are encouraged to discuss any concerns about their driving fitness with their own medical professionals.”

Source location

Response from Department for Transport
Page 2 · response
Published 17 September 2021

Open published response

Other statements in published responses

These actions and other statements could not be clearly connected to one concern in this report.

Recipient-stated actions An action is something a recipient says it has done, is doing, or plans to do in response to a concern raised.1

  1. 1

    Contact the Royal College of General Practitioners to alert it to risks associated with confusion involving current or previous urinary tract infections.

    Stated by General Medical CouncilStated completedThe respondent said that this action was complete when they made their response on 17 September 2021.

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

Contact the Royal College of General Practitioners to alert it to risks associated with confusion involving current or previous urinary tract infections.

Verbatim wording from the response

“We do however recognise the importance of highlighting the increased risks resulting from confusion where patients have, or have previously had UTIs, with the profession. To that end, we have contacted the Royal College of General Practitioners (RCGP) to alert them to these issues, so they can consider how best to raise awareness of this particular case and its implications with their members.”

Source location

Response from GMC
Page 2 · response
Published 17 September 2021

Open published response
Back to top

Information checked against the published report and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations

Data last updated 7 September 2026