A number of changes have been made to the medical standards for fitness to drive. These changes reflect current knowledge about how health conditions affect driving ability, and how effectively they can be treated. The changes also reflect considerations of how clients are managed and what is practical in terms of the review process.
Changes may be with respect to the following.
(i.e. how long a person should not drive following a health episode, such as seizure, cardiac arrest, stroke etc).
Some non-driving periods have been extended, for example, for blackouts, seizures and stroke in commercial vehicle drivers. Others have been reduced, for example, for commercial vehicle drivers after an acute myocardial infarction. For some medical conditions a non-driving period has been introduced e.g. drug or alcohol dependence in commercial vehicle drivers.
Requirements for periodic review (i.e. how frequently a person should be reviewed to monitor their medical condition, and who should undertake the review – GP or specialist).
Requirements for specialist review for commercial vehicle drivers have been relaxed for some common conditions that are usually managed by a person’s GP (e.g. hypertension, diabetes treated with metformin). Some conditions now require specialist review for private vehicle drivers, reflecting the complexity of assessing fitness to drive in these circumstances (e.g. hypertrophic cardiomyopathy, congenital cardiac disorders).
Specific clinical criteria to be met for licensing
(i.e. what clinical criteria need to be met for a person with a medical condition to be considered for an unconditional or conditional licence).
For some conditions such as renal failure, liver failure and respiratory failure, there are no longer specific criteria for fitness to drive, but management should be according to first principles. For other conditions, new criteria have been introduced where previously there have been none specific to that condition (e.g. monocular vision for commercial drivers, subarachnoid haemorrhage). For some conditions, the clinical criteria have been changed for various technical reasons.