Driven to despair

Comments from DVLA and the Department for Transport

During the course of our investigation and in response to a draft of this report, DVLA gave us information about what it has done, and is planning to do, to put right the failings that we have found. We recognise that DVLA is taking steps to make improvements to DMG’s service since we started our investigation, and DVLA has already shown some of the work that it has done to improve its own service. As part of this, it has carried out the following pieces of work: 

  • Put in place a new triage team who aim to complete the first action on the case (including making a licensing decision on a case where that is possible) within five days of DMG receiving a complaint.
  • Developed a semi-automated system for dealing with the most straightforward ordinary licence cases within the triage area37. DVLA has told us that 60% of cases can be dealt with in this area.
  • Started to develop an automated portal on its website which in time will make the process of notifying DVLA of a medical condition more interactive. This would speed up the time it takes for cases to get to DMG (currently it can take up to two weeks for correspondence to reach DMG after it has reached DVLA). 
  • Entered into a formal contract with SpecSavers to provide eye-tests so that there is consistency in eye tests and improved turnaround times of test results being returned to DVLA.
  • Redrafted standard letters and reminders sent to doctors as well as template letters and questionnaires to make them easier to understand and complete. 
  • Made changes to its communication processes so it is now more likely to inform licence holders if their case is being delayed by their GP or consultant. 
  • Started to investigate multiple medical conditions simultaneously rather than sequentially.
  • Made changes to reduce the number of vocational drivers whose cases need to be assessed by DMG. 
  • Launched a new reference document for medical professionals in March 2016 to replace its At a Glance Guide. 

DVLA also told us that it has (and is continuing to) recruit both caseworkers and MAs in an effort to improve the service offered. It is also carrying out a detailed review of how it investigates the most complex cases. It has set up a bespoke team to prioritise customers who wish to challenge its decisions. DVLA has also carried out research with medical professionals about its At a Glance Guide. This has informed changes to the Guide and its communication campaign about that. 

A senior manager has been appointed to ensure continuous improvement of medical services, including analysis of complaint and call data to inform further, ongoing service improvements. DVLA has also told us that a significant programme of work is underway to bring together changes to process, organisational structure, technology, policy and communication of DMG services. 

DVLA is also working towards reviewing and improving the way that medical standards are set and evaluated. It has not shared details of this with us so we are unable to say whether this will rectify the failings that we have identified in this report. 

The Department for Transport has also told us that its new motoring services reform strategy agenda will focus on DMG performance. It told us that this will be monitored closely over the next four years by the Department. 

We are pleased to see that DVLA and the Department for Transport are taking action to address some of the concerns that we have identified in this report. In light of their decision not to accept our recommendations around medical standards and the implementation of an effective process to put right the failings identified for others similarly affected, we engaged in further discussions with them. As a result, the Department for Transport told us that it agrees that the legal requirement is for it to make sure that a driver does not cause a threat to road safety because of any medical condition that affects that person’s ability to drive. It told us that in the majority of cases DVLA’s assessment of societal risk has to focus on the risk of a sudden event causing a danger to the public rather than an ongoing reduction on functional ability. It added that DVLA MAs make decisions based on the balance of probabilities using their clinical judgement, in line with relevant legislation and advice from its Panels. 

We do not dispute the need for DVLA to make evidence and risk-based decisions on fitness to drive, in fact we endorse that. We also accept fully the need for DVLA to take the risk of a sudden event into account when evaluating fitness to drive. We are not suggesting that DVLA disregards risk in any way, rather we are asking it to make sure that it develops a more robust approach to risk, taking into account all relevant considerations. 

As we have explained in our findings above, we are concerned that there is a lack of transparency around the standards applied by DMG. There is very little in the terms of reference for the Panels from the Department for Transport and no clear framework of accountability in relation to who sets the standards in cases not covered by legislation. The research relied on by Panels is not published so there is no publicly available information to demonstrate that relevant considerations are taken into account in setting standards. We have not seen any attempt by DVLA or the Department for Transport to set out a strategy towards identifying or commissioning appropriate research to support the application and setting of standards that takes into account the most recent scientific research and evidence. 

We are also concerned about DVLA’s failure to take into account information from a driver’s own clinician in preference to that provided by its MAs (who are generalists) or DVLA commissioned medical professionals. We have also questioned DVLA’s approach to risk. It says that it relies on the Canadian Risk of Harm Formula but has provided no evidence to show how it has applied this to a UK context or to conditions not affecting the heart. The formula says it is for guidance only and should not replace the clinical judgement of the person’s medical professionals. In addition, we have seen no evidence that DVLA has put the impact of potential sudden events into the context of specific conditions when assessing risk. 

Finally we describe in this report a lack of consideration for the driver’s needs or situation as an individual. We are seeking reassurance that DVLA makes proper assessments in each case based on real and perceived risks. As DVLA and the Department for Transport have accepted our findings, we cannot see that there is a reasonable basis for them to refuse to accept our recommendation in this area.

The Department for Transport has also given us assurances that steps are being put in place at DVLA to improve its complaints handling. It told us that DVLA recognises the impact that decisions concerning driving licences can have on its customers, particularly if a licence is revoked. It told us that if any customer has their driving licence revoked because of a medical condition, they have the opportunity to provide further supporting information which may help their case. We understand that this information is prioritised to ensure a quicker outcome for the licence holder. The Department for Transport told us that since the work with us began, DVLA has simplified its complaints process to make it easier for customers to understand and use. It is also undertaking a further review of its complaints processes, taking on the learning from our investigations which it says will involve increased scrutiny from senior managers and the setting up of a specific quality assessment team with responsibility for looking at complaints from the perspective of the customer, and the introduction of externally accredited specialised complaints training. The Department for Transport has also told us that DVLA will be undertaking much more detailed trend analysis of complaints to ensure root causes are identified and resolved.

We are pleased that our investigations have resulted in learning from complaints and that this will potentially lead to improved services in the future. Nevertheless, the Department for Transport has repeated its view that a publicised process to put right failings for others similarly affected is not the best approach to resolving our concerns. Instead it argues that DVLA should review previous complaints to identify areas for improvement and to ensure that similar cases identified are dealt with in line with its new approach. The intention behind our recommendation was to ensure that a robust process to deal with such cases once and for all would be implemented and that this would not disadvantage those who had not previously complained. The approach put forward by the Department for Transport fails to provide this reassurance, particularly when there is an unwillingness to identify precisely how redress would be applied to anyone eligible without them having to go through the full complaints process. 

We are publishing this report in the public interest and laying it before Parliament so that its findings and recommendations can be considered.

37 When we visited DVLA in July 2015 the semi-automated system was being piloted for simple diabetic, cognitive, chronic neurological, H1 (pacemaker), defibrillator, sleep issues and Parkinson’s cases with a view to expanding the number of conditions covered over time. This system is used if a licensing decision can be made on the basis of the questionnaire received from the licence holder alone.