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What are DVLA regulations on schizophrenia and epilepsy?

Q - One of my patients has chronic schizophrenia and epilepsy and has applied for his driving licence to be restored. He is still on medications for both conditions and takes them reliably. I have been asked for medical information relating to his epilepsy from the DVLA. I think he is fit to drive though I am not sure. I feel anxious about providing evidence that he is not. Can you advise me?

A - The DVLA is legally responsible for deciding if a person is medically unfit to drive and all you are required to do is to answer the questions honestly on the basis of the medical record and your knowledge of the patient.

In relation to his epilepsy, providing the patient is taking his anti-epileptic medications regularly, has not had an attack while awake or asleep for more than a year and is not likely to cause danger to the public, there should be no problem. With regard to the schizophrenia, if his behaviour has been stable for at least three months, he is adequately compliant with treatment and has no adverse effects of medication that would impair his driving, and provided he has a favourable specialist report, there should also be no problem.

If he does not take his prescribed medications for either condition reliably this could endanger him and the public. If you believe he is not fit to be driving as a result you should discuss this with him before providing the report. You should show him the report you intend to send.

The full regulations relating to neurological disorders and psychological disorders are available on the DVLA website.

If you are anxious about showing the patient an unfavourable report, but believe his condition makes driving unsafe and that he is unable or unwilling to appreciate this, GMC guidelines advise breaking confidentiality and informing the DVLA (GMC Confidentiality Handbook). Your justification would

be that it was substantially in his

interest and also in the public interest to do so.

If you believe you could be at risk from the patient in this situation, you should disclose the minimum relevant medical information in strict confidence to the medical adviser at the DVLA. When you provide the report you should make it explicit (in writing) that the patient must not to be allowed to see the report at any time. This is permissible under the Data Protection Act.

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