Awareness of fitness to drive guidance amongst doctors in Black Country Healthcare NHS Foundation Trust : a survey
Abstract
Aims: Psychiatric patients have a higher risk of road traffic accidents than others. The Driver and Vehicle Licensing Agency (DVLA) has provided guidance on different psychiatric conditions and medication that would impact driving. The General Medical Council and Royal College of Psychiatrists advice doctors to notify the DVLA when patients unfit to drive fail to inform the DVLA themselves. In this context, it was aimed to study the awareness of doctors regarding DVLA guidance and its use in their clinical practice. Methods: We conducted a survey about doctors’ awareness of guidance on Fitness to Drive via an online questionnaire. Likert type scoring ranging from strongly agree to strongly disagree was used to assess the (i) awareness of DVLA guidance for psychiatric patients, (ii) confidence in advising patients, (iii) feeling it is a job requirement to advise patients on driving; and (iv) checking the driving status and if patients have informed DVLA where necessary. This included questions on years of experience in medicine, current grade and subspecialty of Psychiatry. Results: The sample consisted of 78 doctors, from various grades from Foundation Year 1 trainees to Consultants; working in different Subspecialties in Psychiatry. There were 36 trainees, 12 middle grades, 28 consultants and 2 ‘other’ doctors. The average year of experience of the responding doctors was 14.2±11.0 years with a range of 1-38 years. Majority (62.8%) of doctors responded that they are aware of the DVLA guidance for psychiatric patients; however 47.5% reported having confidence to advise patients on DVLA guidelines. Considerable proportions (79.5%) of doctors felt that as psychiatrists, it was their job to give advice on driving; but only 50% said they check the driving status and whether patients have informed the DVLA when necessary as part of routine practice. When using the Likert scale, comparing to other subspecialties, General Adult Psychiatrists responded that they check driving status less routinely (p<0.05), however there was no difference in other areas evaluated. Trainees’ responses indicated less awareness (p<0.001), confidence (p<0.001), and checking of driving related issues routinely in clinical practice (p<0.005). Conclusion: The survey results suggest variation in awareness of Fitness to drive guidance for psychiatric patients and their use in routine clinical practice amongst doctors. While trainees would need more information and training to increase their confidence, there is a need for all psychiatrists to use the guidelines in regular clinical practice.Citation
Sundhar, Reka; Chandra, Pallavi; Fraser, Alistair; Kar, Nilamadhab. (2023). Awareness of Fitness to Drive Guidance Amongst Doctors in Black Country Healthcare NHS Foundation Trust : A Survey. BJPsych Open. 9. S131-S131.Type
ArticleJournal
BJPsych OpenPublisher
Cambridge University Pressae974a485f413a2113503eed53cd6c53
10.1192/bjo.2023.364
Scopus Count
Collections
Related items
Showing items related by title, author, creator and subject.
-
Role of the Guidelines Evidence Specialist in the streamlining of Guidelines at a large acute NHS TrustHeer, Mandeep; Heer, Mandeep; Heer, Mandeep; CEBIS; CEBIS (University Hospitals Coventry and Warwickshire NHS Trust, 2023-11)Role of the Guidelines Evidence Specialist in the streamlining of Guidelines at a large acute NHS Trust
-
Faculty development: clinical dermatology for medical secretaries and administrative staffAgrawal, Rishi; Browne, Rachel; Baldwin, Nicola; Scott, H.; Tso, Simon; Agrawal, R.; Browne, R.; Baldwin, N.; Scott, H.; Tso, S.; et al. (Oxford University Press, 2020-06)A study investigating the potential benefits of specialty-specific clinical inductions for medical secretaries and administrative staff.
-
Mapping inpatient care pathways for patients with COPD: an observational study using routinely collected electronic hospital record data.Evison, Felicity; Cooper, Rachel; Gallier, Suzy; Missier, Paolo; Sayer, Avan A; Sapey, Elizabeth; Witham, Miles D; Evison, Felicity; Gallier, Suzy; Research and Development; et al. (European Respiratory Society, 2023-10-16)Introduction: Respiratory specialist ward care is associated with better outcomes for patients with COPD exacerbations. We assessed patient pathways and associated factors for people admitted to hospital with COPD exacerbations. Methods: We analysed routinely collected electronic health data for patients admitted with COPD exacerbation in 2018 to Queen Elizabeth Hospital, Birmingham, UK. We extracted data on demographics, deprivation index, Elixhauser comorbidities, ward moves, length of stay, and in-hospital and 1-year mortality. We compared care pathways with recommended care pathways (transition from initial assessment area to respiratory wards or discharge). We used Markov state transition models to derive probabilities of following recommended pathways for patient subgroups. Results: Of 42 555 patients with unplanned admissions during 2018, 571 patients were admitted at least once with an exacerbation of COPD. The mean±sd age was 51±11 years; 313 (55%) were women, 337 (59%) lived in the most deprived neighbourhoods and 45 (9%) were from non-white ethnic backgrounds. 428 (75.0%) had ≥4 comorbidities. Age >70 years was associated with higher in-hospital and 1-year mortality, more places of care (wards) and longer length of stay; having ≥4 comorbidities was associated with higher mortality and longer length of stay. Older age was associated with a significantly lower probability of following a recommended pathway (>70 years: 0.514, 95% CI 0.458-0.571; ≤70 years: 0.636, 95% CI 0.572-0.696; p=0.004). Conclusions: Only older age was associated with a lower chance of following recommended hospital pathways of care. Such analyses could help refine appropriate care pathways for patients with COPD exacerbations.