I knew it wasn't new, Jim - just restated and, perhaps, a little less woolly. But it is handy sometimes to remind team members that they can't ignore a problem. Within our caseload there are at least two clients who, in my opinion, should not be driving despite meeting the DVLA criteria (being in an approved programme etc) because they have medical problems that would be issues for anyone else, and it frustrates me that one or two doctors won't go to DVLA (citing confidentiality) when they probably would do so if substance misuse were not involved, when they become hypersensitive.

For example, one client has seriously deficient eyesight as a result of his injecting behaviour. Never mind how he got it, in my view he is a danger to others. His prescriber repeatedly said it was for the client to tell DVLA and in the end the rest of us said that while we respected the doctor's right to judge for himself, would he object if we contacted DVLA (after warning the client etc)? We could imagine the newspaper headlines if the client ran someone over and it became known that the team had known what was absolutely clear, that he couldn't see well enough to find the consultation room unless we came out to fetch him.

Nobody disputes the difficulty that these cases present, nor that they differ and have to be approached individually; but sometimes I think colleagues shirk a responsibility.

I suspect that, given a case such as I describe above, most of you would agree that he cannot be allowed to go on driving, and the question is how best to bring that about.

quote:

Originally posted by Graham Brack:
His prescriber repeatedly said it was for the client to tell DVLA and in the end the rest of us said that while we respected the doctor's right to judge for himself, would he object if we contacted DVLA (after warning the client etc)? We could imagine the newspaper headlines if the client ran someone over and it became known that the team had known what was absolutely clear, that he couldn't see well enough to find the consultation room unless we came out to fetch him ..... sometimes I think colleagues shirk a responsibility. .

I absolutely agree and sympathise with your situation. We DO have guidelines and although these are difficult situations, doctors are protected by them. Where clear guidelines do not exist, as in your situation, you are very exposed