Synopsis
Assess how psychiatric symptoms, cognition, substances and treatment affect driving and safety-critical work, give current licensing advice, support proportionate occupational adjustment and disclose without consent only when a serious-harm or legal threshold justifies it.
- Ask about licence type, vehicle, professional driving, recent incidents, near misses, sleep, cognition, impulsivity, psychosis, mood, substances and medicine effects.
- Use the current DVLA medical-professional guidance for Great Britain or DVA route in Northern Ireland because standards differ by condition, severity, treatment and licence group.
- Advise the patient clearly when they must stop driving and when they have a legal duty to notify the licensing agency, recording the exact discussion.
- Do not provide an unsupported permanent ban or fixed interval from memory; check the current condition-specific standard and specialist requirements.
- If a patient continues driving against advice and creates serious danger, make reasonable efforts to persuade them, explain possible disclosure and seek senior advice.
- GMC guidance permits disclosure of relevant information to the licensing authority without consent when necessary to protect individuals or the public from death or serious harm.
- Tell the patient before disclosure where practicable, share the minimum necessary facts with the correct agency and document reasoning and communication.
- For safety-critical work, assess functional demands, hours, fatigue, access to weapons or machinery, lone work and treatment effects rather than diagnosis alone.
- Use occupational health to consider temporary restriction, graded return and reasonable adjustment while preserving confidentiality and reviewing recovery.
Key red flags
Suicidal intent involving a vehicle, deliberate collision, driving to a lethal location or transporting a weapon requires emergency risk management beyond ordinary licensing advice.
Active psychosis, mania, severe depression, impaired attention, dissociation, sedating treatment, intoxication or withdrawal may make driving unsafe even before a formal licensing decision.
Group 2 bus and lorry standards are generally more stringent than Group 1 car and motorcycle standards, so licence category must be confirmed.
DVLA governs Great Britain, while the Driver and Vehicle Agency operates in Northern Ireland; notification and forms follow the relevant licensing authority.
An employer is not automatically entitled to diagnosis or therapy records; occupational disclosure should answer necessary functional and safety questions with consent wherever possible.
Investigation priorities
Define licence group, exposure, professional use, collisions, near misses, police events and symptom-linked journeys.
Management branches
A psychiatric condition or treatment may affect safe driving or notification duties.
- Clarify licence, exposure, incidents and current symptoms, cognition, sleep, substances and medicine effects.
- Check the current DVLA or DVA standard and advise cessation and notification explicitly where indicated, providing written information.
- Document the evidence, advice, patient response and review plan and reassess actual driving behaviour at follow-up.