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Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
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Driving, cognition and mobility

Essential points for quick revision.

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Immediate driving risk

Recent unexplained blackout, seizure, acute stroke, delirium, severe visual loss, profound cognitive impairment, pedal-control failure or continued driving after explicit unsafe advice can place the person and public at immediate risk.

Action: Advise immediate cessation, treat the acute condition, document the clinical and legal advice and check current DVLA criteria; if a patient continues against advice and poses serious risk, follow GMC confidentiality guidance, inform them before necessary disclosure where practicable, and disclose only relevant information.

Synopsis

Assess whether cognition, vision, movement, episodes of impaired awareness and medicines affect driving, give clear current DVLA advice, protect public safety proportionately, and preserve autonomy through vehicle adaptation, formal assessment and mobility alternatives.

  • Age alone neither removes nor guarantees driving fitness; assess the medical condition, real driving function, licence group, vehicle and current DVLA rules.
  • Dementia must be notified to DVLA; diagnosis does not by itself determine an identical outcome for every Group 1 driver, because severity and functional safety matter.
  • First-line review uses collateral driving history, cognition including attention and visuospatial function, vision, neck and limb control, reaction, episodes of impaired awareness and medicines.

Key red flags

A blackout, seizure, acute stroke or new focal deficit requires immediate medical care and no driving while the relevant DVLA criteria are addressed.

Acute invalid assessment

Delirium, intoxication or rapidly fluctuating illness requires cessation and treatment rather than a routine office clearance.

Investigation priorities

01
Driving and collateral historyFirst stepFirst line

Identify real-world errors and compensation first line.

Management branches

First-line driving reviewDefine immediate risk and notification

A condition, family concern or functional change raises driving questions.

  1. Clarify licence group, condition, real-world driving, collateral, cognition, vision, physical control and medicines.
  2. Check the current DVLA professional standard for the exact diagnosis and decide whether immediate cessation is required.
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Sources and review status4 sources · checked 27 Aug 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom