1. The DVLA's Drivers Medical Croup (DMG) handles around 800,000 medical cases a year where a decision is made about an individual's continued fitness to drive 2. Most cases are straightforward, but some 10% to 15% require detailed assessment by clinical specialists 3. The DMG employs around 30 medical advisers and seven nurse case workers 4. In 1968, the UK became the first country to publish medical standards on fitness to drive 5. UK driver medical standards are informed by panels of medical experts in six clinical disciplines: neurological disease, drug and alcohol misuse/dependency, psychiatry, cardiovascular disease, visual disorders and diabetes mellitus 6. The panels review current medical evidence and provide expert opinion, for example on complex cases where no medical standard exists 7. For most medical conditions it is not yet - and may never be - possible to quantify exactly the increased risk of having a vehicle accident associated with a particular medical condition (or conditions) and standards are set on best available evidence and expert opinion 8. The fatal accident inquiry into the Glasgow bin-lorry crash of 2014, which killed six members of the public, helped prompt a major review of the presentation of the UK's guidance on medical standards on fitness to drive 9. Completely redesigned, user-friendly guidance for medial professionals on assessing fitness to drive was published in 2016 10 The CMC, in consultation with the DVLA, has also revised its good-practice guidance on confidentiality as it relates to patients' fitness to drive, with a new edition published in 2016. It is hoped that guidance for optometrists and nurses will follow.
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