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Doctors concerned over talking to DVLA about patients

New GMC guidance on doctors disclosing information to DVLA comes into effect today

Louise Prime

Tuesday, 25 April 2017

Doctors’ questions about regulations around patient confidentiality are one of the leading reasons for them calling the Medical Defence Union, it has revealed. The General Medical Council’s new guidance on reporting concerns regarding patients’ safety to drive to the Driver and Vehicle Licensing Authority (DVLA) comes into effect today, and the MDU has advised doctors how to put this into practice.

The MDU reported that 3,640 members contacted its 24-hour medicolegal advice line in 2016 for advice on confidentiality, with many querying whether to pass on information to the DVLA about a patient who refuses to stop driving. The MDU said that patient confidentiality is vital to their relationship with their doctor, and that without it they might be reluctant to disclose information to their doctor, which could have a negative impact on their care. But the GMC has previously said it doesn’t agree that reporting should be made mandatory and that doctors should still apply their professional judgment, in conjunction with its guidance, to the individual situation.

The new GMC guidance advises doctors that if a patient has a condition or is undergoing treatment that could impair their fitness to drive they should:

  • explain this to the patient and tell them that they have a legal duty to inform the DVLA or DVA;
  •  tell the patient that the doctor might be obliged to disclose relevant medical information about them, in confidence, to the DVLA or DVA if they continue to drive when they are not fit to do so;
  • make a note of any advice given to a patient about their fitness to drive in their medical record.

Then, if a doctor becomes aware that a patient is continuing to drive when they might not be fit to do so, they should make every reasonable effort to persuade the patient to stop. If they continue to drive against the doctor’s advice, the doctor should consider whether the patient’s refusal to stop driving leaves others exposed to a risk of death or serious harm – and if they believe that it does, they should contact the DVLA or DVA promptly and disclose any relevant medical information, in confidence, to the medical adviser.

Dr Nicola Lennard, medico-legal adviser at the MDU, said: “Confidentiality is paramount to the relationship between a patient and doctor. Without this, patients may be reluctant to give doctors the information they need in order to provide good care.

“Regarding the DVLA, it is the responsibility of the doctor to explain to the patient that they have a medical condition or will be receiving treatment that may affect their ability to drive and that they have a legal obligation to inform the DVLA and to stop driving. You should also tell the patient that you may be obliged to disclose relevant medical information to the DVLA if they continue to drive against your advice.”

She also pointed out that it is not unusual for patients to sometimes complain when a disclosure has been made – and she added that, in some cases, these complaints have been referred to the GMC. She continued: “If this happens, having clear and comprehensive records can help you provide a robust response and demonstrate that you have followed the proper process. Your medical defence organisation can help to make sure you follow the GMC’s and DVLA’s guidance, and we recommend that you consult us at an early stage.”

Last month, GMC chief executive Charlie Massey said: “Our updated advice on reporting concerns to the DVLA … states that doctors should disclose information to the agency if others may be at risk – even if the patient does not agree to this.”

But he went on: “We don’t agree that reporting should be made mandatory. There is a clear public good in having a confidential medical service and we would be concerned about the wider implications if the trust between a doctor and their patient was eroded. We should let doctors use their professional judgment, in conjunction with our guidance, to the individual situation.”

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