Fitness to drive decision-making process and key assessment considerations

Key assessment steps and questions

• Establish the medical and driving history and consider the licence type
  • Note on the medical report if consulting with a person for the first time without access to their clinical history
• Undertake a clinical examination and consider the results, patient history and driving needs
  • Could fatigued driving exacerbate the person’s condition or medications?
  • Are there comorbidities that individually or additively impair driving ability?
  • Does the person rely on other body systems for adaptation or compensation? Have these been assessed?
• Inform and advise the patient of their fitness to drive and any driving restrictions
  • Is the patient capable of understanding, retaining or complying with this advice?
  • For progressive conditions, plan for the potential impacts on future driving ability
• Report to the driver licensing authority as appropriate
  • Check the legal requirements for reporting with the local driver licensing authority
  • Consider reporting to the driver licensing authority if the person continues driving despite appropriate advice and is likely to endanger the public
• Record keeping, sharing and follow-up
  • Document the advice in the person’s patient file
  • Has your advice been shared with the patient’s referring GP and/or other treating physicians?

Assessment and licensing responsibilities, obligations and considerations

Driver	Health Professional	Driver Licensing Authority
Responsible for meeting licensing obligations and managing their health conditions	Assesses driving fitness by: evaluating conditions against the medical standards providing advice to the driver on their fitness to drive	Makes the final licensing decision based on: private and commercial licensing standards medical advice and driver information
Licensing obligations Follow licensing requirements, including licence conditions or driving restrictions Report health changes within a reasonable timeframe Follow medical advice Provide accurate information to health professionals and the driver licensing authority	Medical and physical conditions affecting driving Temporary conditions Substance misuse and intoxication Chronic illness and conditions Disabilities Age-related changes Multiple medical conditions Medications and other treatments	Medical advice and driver information Advice from medical professionals Advice from independent medical panels Recommendations for licence conditions Periodic medical review Driving history
	Health professional’s advice Supports drivers to understand the impact of their condition and meet their licensing obligations Supports driver licensing authority make final decision	Driver licensing decision Issue Renew Apply a condition Suspend Cancel

Further information

• The driving task and assessing medical conditions refer to Part A section 2. Assessing fitness to drive – general guidance
• Roles, responsibilities and reporting options refer to Part A section 3. Roles and responsibilities
• Driver licensing standards and conditional licensing refer to Part A section 4. Licensing and medical fitness to drive
• Step-by-step guidance to performing an assessment refer to Part A section 5. Assessment and reporting process – step by step