Presentation by Anu Varshney

1. Driving with a
disability – rules and
regulations in the UK
Anu Varshney
Consultant Practitioner/Head of Service
Driving Mobility; Chair:2013-2017
South East DriveAbility,
Kent Community Health NHS Foundation Trust

2. Michon’s Driving Hierarchy
Adapted from Michon 1979,
Wedding 1992
Driving Mobility · Tel: 0800 559 3636 · Email: info@drivingmobility.org.uk Driving Mobility is

3. Sensory Skills
 Vision
• Distance Vision
• Field of Vision
• Depth Perception
• Accommodation (Near vision focusing)
• Night Vision (Glare Recovery)
 Hearing
 Touch/Proprioception

4. Physical Skills and Abilities
• Physical strength
• Physical & Mental stamina and
Muscle Flexibility
• Good Joint range of motion and Co-
ordination

5. Cognitive & Perceptual Skills
• Concentration & Attention/Information Processing
• Memory
• Reasoning ability
• Visual/Spatial ability
• Executive Function
• Behaviour (Impulsive)

6. Ways in which MS may affect your driving
ability and safety
Recent studies show following can
affect driving performance
• Cognitive changes and
• spasticity (Muscle stiffness &
spasm) – difficulty with car control
• Effects of medications
( With increasing number of
medications to manage symptoms
and with increasing doses, the
likelihood increases that they could
affect “Wakefulness, concentration,
co-ordination and reaction time)

7. Your ability to drive safely may be affected if
you experience any of the following
• Difficulty in getting in/out of car
• Muscle weakness or spasm/cramps/pain in arms, legs
• Loss of sensation in the feet or hands
• Impaired co-ordination
• Slowed reaction time
• Fatigue – low arousal
• Seizures or loss of consciousness
• Blurred vision, blind spots, double vision
• Cognitive problems (Inability to multitask, disorientation etc.)

8. Driving Licence
Regulations The EU Driving Licence
Directive (91/439/EC,
2006/126/EC) :–
“expects a critical evaluation of
the functional capacities of
applicants in relation to the
driving task.”
DIRECTIVE 2006/126/EC OF
THE EUROPEAN
PARLIAMENT AND OF THE
COUNCIL of 20 December
2006 on driving licences: 3rd
Driving Licence Directive
Article 7 1. …
(a) who have passed a test
of skills and behaviour
and a theoretical test and
who meet medical
standards, in accordance
with the provisions of
Annexes II and III;
Driving Mobility · Tel: 0800 559 3636 · Email: info@drivingmobility.org.uk Driving Mobility is
the working name of the Forum of Mobility Centres. Registered charity number: 298178. A

9. Licence Holder’s Duty
Section 94(1) 1988 RTA
“ If at any stage during the period for which his/her licence
remains in force, a licence holder becomes aware.. That
he has a relevant or perspective disability…the licence
holder must notify the secretary of state of the nature &
extent of the disability”
Source: DVLA Medical Branch
Driving Mobility · Tel: 0800 559 3636 · Email: info@drivingmobility.org.uk Driving Mobility is the
working name of the Forum of Mobility Centres. Registered charity number: 298178. A

10. Doctors and other healthcare
professionals should (New
Guidelines from DVLA)
•Advise the individual on the impact of
their medical condition for safe driving
ability
•Advise the individual on their legal
requirement to notify the DVLA of any
relevant condition
•Treat, manage and monitor the
individual’s condition with on-going
consideration of their fitness to drive
Notify the DVLA when fitness to drive requires notification but an individual cannot or will not
notify the DVLA themselves.
Of course, this last obligation on professionals may pose a challenge to issues of consent and
the relationship between patient and healthcare professional. The GMC and The College of
Optometrists offer guidance on this. (Note that the GMC has currently updated this guidance.)

11. NEW DRUG DRIVING RULES

12. Sativex and driving
• In England and Wales the law says that anyone found with certain drugs in
their body while driving can be prosecuted, whether their driving is impaired
or not.
• The roadside tests the police use to check for drugs can detect very small
amounts of the drug in your system. Unfortunately, this means that if you
take Sativex, you may test positive for cannabis.
• However, if you are taking Sativex as prescribed by your health professional,
you can claim a ‘medical defence’, as long as your driving is not impaired.
• The government recommend that if you are taking Sativex, that you have
evidence, such as a letter from the DVLA, prescription receipt or a letter from
your MS specialist, in your car to avoid any problems if stopped. If you don’t
have the evidence on you, you may have to present it at a later date.
For more information, or if you have any concerns, contact the DVLA.

13. The DVLA and your driving licence
If you have a driving licence, you have to tell the Driver and Vehicle Licensing
Agency (DVLA) that you have been diagnosed with MS. They will assess your
fitness to drive using the information you provide, and they may ask you to have
a medical examination or a driving assessment.
You may be:
 allowed to keep your licence
 given a temporary licence, valid for one, two or three years
 given a licence that specifies which adaptations you need to use, or
 in extreme cases told to stop driving
Source: https://www.mssociety.org.uk/ms-support/practical-and-financial help/driving-and-dvla

14. Changes in the Driver
• Physical
• Vision alters
• Cognitive changes
• Health conditions:
existing ones change,
new ones develop

15. Challenge for us: Giving up Driving

16. Driving Mobility
Formerly known as the Forum of Mobility Centres
Driving Mobility is a
network of 16 independent
organisations covering
England, Scotland, Wales
and Northern Ireland,
which offer professional,
high quality information,
advice and assessment to
people who need to gain
or retain independence
through mobility.

17. Driving Mobility
• Governing Body in UK for all Mobility Centres
• Accreditation
• Standards for our sector
• Collaboration with other organisations/agencies – Older Drivers Forum,
Motability
• Research & Development
• International partnership –CIECA
• Innovation – Fitness to drive initiative with Hampshire Constabulary
Driving Mobility · Tel: 0800 559 3636 · Email: info@drivingmobility.org.uk Driving Mobility
is the working name of the Forum of Mobility Centres. Registered charity number:
298178. A company limited by guarantee. Registered number: 2192584

18. Who do we offer advice
and assessment to?
• People with a medical condition that may impact their ability to make
appropriate decisions with regards to safe driving
• People with a disability who think they may need special modifications to a
motor vehicle in order to be able to control it safely
• Experienced, older drivers who may have concerns about their standard of
driving
• Parents/Carers who need to transport people, including children, with
restricted mobility in a motor vehicle
• People considering a wheelchair accessible vehicle (WAV)
• People who wish to begin, or return to driving following an illness, injury or
accident
• People who are recovering from an accident or injury which may temporarily
affect their ability to drive or transfer to a vehicle.
Driving Mobility · Tel: 0800 559 3636 · Email: info@drivingmobility.org.uk Driving Mobility is
the working name of the Forum of Mobility Centres. Registered charity number: 298178. A

19. What do we offer?
Assessment and advice:
 on adaptations to overcome physical problems with vehicle control
with regard to your ability to drive safely
 on wheelchair and scooter loading and transportation regarding passenger /
driver access to vehicles
The following assessment and advice are available at some Centres:
 wheelchair/scooter selection
 motorcycles or heavy goods vehicles
 vocational assessments for taxi drivers and PSV licence holders
 postural support seating solutions for air travel
 paediatric assessment including powered wheelchairs and car seats
 Try before you Fly
Driving Mobility · Tel: 0800 559 3636 · Email: info@drivingmobility.org.uk Driving Mobility is
the working name of the Forum of Mobility Centres. Registered charity number: 298178. A

20. The Assessment Process
 Vision
 Physical Abilities
 Cognitive
Assessment
 Seating and Posture
 Static Testing
 Practical On-Road
Drive

21. ASSESSMENT
Physical
• Range of movement and
muscle strength
• Manual dexterity
• Sensation in the hands and
feet
• Proprioception
• Co-ordination
• Praxis
Cognitive
• No one assessment tool has
yet been approved for use in all
Centres; each Centre has its
own battery of assessments.
• Currently used Tools such as
MOCA, RDB, Trail Making,
FAST to highlight possible
problems on the drive and
provide evidence in the event
of a negative outcome

22. STATIC TESTING
• Carried out on a Driver Testing Station or in-car.
• Tests for steering strength; brake/clutch
pressure and reaction to emergency stops.
• Considers whether client is able to operate
secondary controls within the vehicle.

23. PRACTICAL DRIVE
• Carried out in a dual-controlled vehicle
• Looking for a safe drive with good observations,
the ability to keep up with traffic, due regard for
other road users and the ability to forward plan
and deal with hazards as they occur
• Carried out on pre-determined routes

24. Outcome of Assessment
At the end of the assessment, the client will be told the
outcome, which will generally be:
• Safe to drive without adaptations
• Safe to drive, with adaptations
• Safe to retrain to drive with adaptations (review
required when competent)
• Unsafe to drive
DVLA will make the final decision about Licence

25. Driving Licence Code:
Automatic 78 Audible Bleeper
Switch
35 Modified Driver’s Seat 43
Manufacturers Power
Steering
40 Push/Pull Hand
Control
30 Push Button Start 35
City Power Steering 40 Push Brake 20 Push Button Gear
Selector
10
Lightened Power
Steering
40 Steering Ball Left Not
coded
Modified Driver’s Seat 43
Integrated Indicator
Switch
35 Steering Ball Right Not
coded
Accelerator Under Ring 25
Wireless/Infra Red
Device
35 Left Foot
Accelerator
25 Accelerator Over Ring 25

26. Alternative Mobility Options
• Access to Work Scheme
• Mobility Allowance
• Bus Pass
• Senior Railcard / Disabled Persons Railcard
• Assistance with Holiday Travel
• Community Transport Services
• Taxi Card / Token Schemes
• Mobility Scooters
• Shop Mobility
• Delivery of Shopping

27. Skills -set required to work in our Field
• “Nerve of steel”
• Target driven
• Skills for debriefing session-”Saying NO is not easy”
• Collaborative working with Stat/non stat./voluntary sectors
• Business enterprise
• Project management
• Teaching and Training
• Social Marketing
• Dealing with Media & Communication
• Writing up Business Plan
• Legislation
• Public Health Agenda
• Product design- adaptations
• Working as “Expert Witness” level skills development
• Willingness to undertake PG Cert/Prof. Cert course in Driving assessment &
outdoor mobility from University of Chester

28. Lots of help at Hand
• DVLA and Driving with MS
• MS Society
• Blue badge scheme
• The Forum of Mobility Centres
• Motability scheme

29. Driving Mobility · Tel: 0800 559 3636 · Email: info@drivingmobility.org.uk Driving Mobility is the
working name of the Forum of Mobility Centres. Registered charity number: 298178. A

30. Latest News from Tech world!!!!!!
Google is to start building its
own self-driving cars
'Google says it will initially
build 100 prototype
vehicles
Google says it
expects its self-
drive cars to be on
the road 'within a
year
Source: http://www.bbc.co.uk/news/technology-27587558

31. ANURAJ VARSHNEY
CONSULTANT PRACTITIONER/Head of Service
South East DriveAbility
Kent Community Health NHS Trust/Forum of Mobility
Centres
The First Floor, Aylesford Logistics Centre,
Bellingham way, Aylesford, Kent ME20 6XS
Tel: 03000134886
Email: anuraj.varshney@nhs.net
Driving Mobility · Tel: 0800 559 3636 · Email: info@drivingmobility.org.uk Driving Mobility is the
working name of the Forum of Mobility Centres. Registered charity number: 298178. A