“Do you know you can't drive?”: an audit to establish whether the Brain Tumour Unit at UCLH/NHNN is supporting DVLA guidelines with regards to patients with brain tumours and driving
Descriptor
At the Brain Tumour Unit at UCLH/NHNN, patients with a variety of brain tumours, both benign and malignant, are seen by different members of the MDT at different times during their diagnosis and treatment. The DVLA updated their “Current medical standards of Fitness to drive” in July 2013. This audit aims to establish whether our unit has been informing our patients of their driving restrictions correctly and consequently, whether they have been adhering to the guidelines.
Background
The idea for this audit was triggered when a patient who had received surgery and craniospinal radiotherapy for a desmoblastic medulloblastoma attended their oncology follow-up appointment and mentioned that they had just been driving around Europe, unaware that there were driving restrictions related to their diagnosis and treatment.
The Cycle
The standard:
The DVLA states that it is the duty of the licence holder to notify the DVLA of any medical condition which may affect safe driving. The adjunct to this (as included in GMC guidelines) is that the professional looking after the patient must explain to the patient that the condition may affect their ability to drive and they must inform the DVLA. The DVLA has defined driving restrictions for each tumour type depending on grade and treatment.
Target:
To assess whether patients were adhering to the DVLA guidelines, whether they were aware of them and whether any discussions had been documented.
Assess local practice
Indicators:
A questionnaire was given to a random selection of patients in the oncology outpatient clinic over a month.
Questionnaire items:
- Do you have a licence?
- When did you last drive?
- Have you discussed driving with your clinical team?
- Do you know the driving restrictions for your tumour type and treatment?
Data items to be collected:
Questionnaire answers were collect for each patient and then clinic letters and notes reviewed to identify the patient's age, diagnosis, date of surgery, when they last had a seizure and if there was any documentation of a discussion about driving.
Suggested number:
40 patients.
Suggestions for change if target not met
• A survey will be sent to the members of the neuro-oncology MDT to identify who each member thinks should be responsible for telling patients about informing the DVLA and when they should be told and how it should be documented
• A leaflet will be made to hand out in the radiotherapy department to inform patients about DVLA driving restrictions
• To re-audit after 6 months
Resources
• The questionnaire was produced by the registrar running the audit and handed to the patients by the registrar and the CNS in the outpatient clinic
• The data was inputted into an excel spreadsheet
• The patients' electronic and paper notes were reviewed which took approximately 5-10 hours
Submitted by
Dr Rachel Lewis MBBS BSc MRCP FRCR