Hazardous driving

15 January 2010

A GP receives a letter from the DVLA advising that one of her elderly patients has had his driving licence withdrawn on the grounds of advanced senile dementia.

The patient had correctly informed the DVLA upon his initial diagnosis and the DVLA had contacted the GP for further information. It had also arranged for the patient to undergo a driving assessment. The assessment determined that the patient’s condition posed a risk and his licence was revoked.

A month later the GP sees the patient drive into the practice car park to attend an appointment. She later phones the MDDUS to ask for advice how to deal with the issue.

Analysis and outcome

The MDDUS adviser recommended that the GP contact the patient to say he must stop driving or she will contact the DVLA and the police if necessary. She is also advised that should it seem uncertain whether the patient intends to comply she should inform him of her intention to the contact the DVLA with or without his consent. Prompt disclosure here would be justified on the grounds of public interest.

Key points

• Patients with dementia must by law inform the DVLA.
• Doctors are entitled to breach patient confidentiality without consent in cases of overriding public interest.
• If possible, inform the patient first of your intention to breach confidentiality in such cases.