Clarity for doctors when disclosing patient information to DVLA

01 Jun 2012

There is a fine balance between disclosing information in the public interest and protecting the confidentiality of a patient

Following communication from Humberside police about possible confusion among doctors, the Medical Protection Society (MPS) is reminding members of the issues to take into account when deciding whether to disclose patient information to the Driver and Vehicle Licensing Agency (DVLA).

This follows reports from police that some doctors appear uncertain as to what information they can and should provide to the DVLA if a patient presents with issues that may impair their ability to drive.

Dr Stephanie Bown, MPS Director of Policy and Communications says: “There is a fine balance between disclosing information in the public interest and protecting the confidentiality of a patient. Trust is a foundation stone of the doctor-patient relationship and careful consideration must be made before any disclosure to the DVLA occurs.

“Disclosure in the public interest will be justified if a doctor believes it is necessary to prevent risk of harm or death to others. Judging where the right balance lies can be a difficult decision and should you be unsure as to whether a patient is fit to drive, you should seek the advice of an experienced colleague or a DVLA medical adviser.

“Where a patient wishes to drive and is, or may be impaired, doctors should take every reasonable step to help the patient understand and fulfil their own legal obligations to inform the DVLA. A second opinion may be helpful for both the doctor and the patient.

Keeping clear and objective records of all relevant conversations and documentation will be invaluable in demonstrating the reasoning behind such judgements if challenged

“Ultimately, if the patient does not inform the DVLA, or continues to drive, then a doctor may need to inform the DVLA of their concerns in order to fulfil their own obligations to protect the wider public. They should first inform the patient that they are obliged to do so. Keeping clear and objective records of all relevant conversations and documentation will be invaluable in demonstrating the reasoning behind such judgements if challenged.”

MPS explores this issue further in a case report below, which will be appearing in the June edition of Your Practice

More information

For further comment please contact Gareth Cockman, Press Officer at MPS on +44 (0)207 399 1319 or email gareth.cockman@mps.org.uk for more information.

Notes to editors

  1. Medical Records – An MPS guide
  2. GMC publication, Confidentiality: Supplementary Guidance (paragraphs 1-8 Reporting Concerns About Patients to the DVLA)
  3. DVLA, At a Glance Guide to the Current Medical Standards of Fitness to Drive.

Your Practice – Case report

MPS Solicitor Mark Jordan describes a case where a defamatory claim against a doctor was successfully struck out

Attached to the request was a consent form recently signed by Mr J, providing his authority for Dr C to disclose any relevant information to the DVLA. It indicated that he did not wish to have sight of the report before it was submitted to the DVLA

Dr C had been on a short period of leave and when she returned she reviewed the post that had been received in her absence. In and amongst the assorted hospital correspondence and PMA requests, Dr C came across a letter from the DVLA seeking updated medical information in relation to a Mr J. Attached to the request was a consent form recently signed by Mr J, providing his authority for Dr C to disclose any relevant information to the DVLA. It indicated that he did not wish to have sight of the report before it was submitted to the DVLA.

Dr C had been Mr J's GP for several years and had assisted him primarily in relation to his difficulties with alcohol dependency. As a consequence of Mr J's alcohol dependency, which was corroborated by abnormal blood markers, the DVLA had revoked his licence for a period of one year, and this had led to Mr J being dismissed from his job as a salesman of commercial air-conditioning units. Unfortunately, this further compounded Mr Johnston's difficulties with alcohol, which culminated in a recent hospital admission as a result of acute alcohol intoxication (which was, once more corroborated by abnormal blood markers). The reason why the DVLA were now seeking updated medical information was to consider to whether or not it would be appropriate to reinstate Mr J's licence.

The request from the DVLA was in the form of a questionnaire and Dr C completed it in an entirely factual and reasonable way. In response to a question asking if there was any recent evidence of alcohol misuse (including binge drinking), Dr C provided information in relation to the recent hospital admission. Given that Mr J had provided his consent to share relevant information with the DVLA, and that he had not requested sight of the report before, Dr C submitted, the completed questionnaire. On the basis of the information provided, the DVLA determined that Mr J's licence would remain revoked until he could demonstrate a minimum period of controlled drinking (or abstinence) accompanied by the normalisation of the blood markers.

Several weeks later, Dr C was served with a Claim Form, in which she was the named defendant in an action of defamation brought by Mr J (acting as a litigant-in-person). The basis of the action was that the information was not true, it was provided without consent and that, as a consequence of the disclosure, the DVLA declined to reinstate Mr J's licence. Dr C did not feel that her actions were open to legitimate criticism and was left unnerved.

Dr C contacted MPS and was assisted by a medicolegal adviser and an in-house solicitor. The solicitor went on the record with the court on Dr C's behalf and made an application for the action to be struck out on the basis that the information provided was factually correct, provided with Mr J's consent and that it was a matter for the DVLA to decide as to whether or not Mr J was medically fit to drive.

The application for the action to be struck out was heard promptly by a County Court Judge who agreed that the claim had no basis and therefore struck out the action. Dr C was relieved that MPS were able to take over the correspondence and have the action struck out so promptly.

MPS medicolegal reports are an educational aid to MPS members and act as a risk management tool.  The reports are based on issues arising in MPS cases from around the world.  Unless otherwise stated, facts have been altered to preserve confidentiality.

 

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