Rosemary MacAndrew
PFD Report
All Responded
Ref: 2025-0214
All 1 response received
· Deadline: 1 Jul 2025
Coroner's Concerns (AI summary)
The vehicle licensing system relies on older drivers, including those with cognitive decline, to self-report medical conditions. This self-reporting is inadequate and poses a risk of future road deaths.
View full coroner's concerns
The UK population is of increasing age and the number of older drivers is increasing rapidly. The current system for vehicle licensing relies largely upon the self-awareness of a driver and their willingness and\or ability to self-report medical conditions to the DVLA. I am concerned that older drivers with vulnerabilities, including age, decreasing mobility and cognitive decline pose a risk of future deaths through compromised driving ability thereby creating a risk of deaths in the future.
Responses
Action Planned
The DVLA is considering research and evidence, including evidence presented during the inquest, to inform potential changes to the law that governs driver licensing for those with medical conditions. The Department is also developing its Road Safety Strategy and will set out more details in due course. (AI summary)
The DVLA is considering research and evidence, including evidence presented during the inquest, to inform potential changes to the law that governs driver licensing for those with medical conditions. The Department is also developing its Road Safety Strategy and will set out more details in due course. (AI summary)
View full response
Dear Beth, Thank you for your report made under the Coroners and Justice Act 2009 and Regulations 28 and 29 of the Coroners (Investigations) Regulations 2013, following the inquest you conducted into the death of Rosemary MacAndrew. I am responding as Minister for the Future of Roads and am grateful for the opportunity to consider and respond to the concerns you have raised. I was very sorry to learn of the tragic circumstances that led to Rosemary MacAndrew’s death and would like to express my sincere condolences to her family. I have considered your report and its recommendations very carefully. Your report raises concerns about the risks to road safety posed by the current driver licensing system which is based on drivers self-declaring medical conditions. The current driver licensing arrangements are underpinned by the Road Traffic Act 1988, which makes it a legal requirement on all drivers to inform the Driver and Vehicle Licensing Agency (DVLA) if at any time they develop a medical condition that may affect safe driving. The current arrangements balance the risks that an individual poses to road safety with personal mobility and are designed to be fair and proportionate to all drivers who remain fit and competent to drive, regardless of their age. When drivers reach the age of 70, they must renew their licence and then do so at most every three years thereafter. The driving licence renewal process provides a timely reminder to individuals to consider their health in the context of driving. Drivers are encouraged to discuss any concerns about their driving fitness with their own medical professionals.
The DVLA is responsible for ensuring that drivers with medical conditions meet the required medical standards of fitness to drive and will investigate those who notify a medical condition. This investigation involves obtaining information from the driver and or their doctor or healthcare professional or asking the driver to attend a medical examination or driving assessment. The law states that the DVLA must have reasonable grounds to initiate medical investigations into anyone holding or applying for a driving licence. In practice, this means that an applicant or driver must notify the DVLA of a medical condition before an assessment of their medical fitness to drive can begin. However, the DVLA can also investigate where a notification of a health condition has been made by a third party, for example the police, healthcare professionals, family or friends. This recognises that there may be occasions where a driver lacks insight into their ongoing ability to drive safely. Healthcare professionals play a vitally important role in the driver licensing process by providing advice to their patients about the implications of their condition, the effect of any treatment or medication they are receiving and when they must inform the DVLA. To support healthcare professionals, the DVLA publishes guidance called “Assessing fitness to drive: a guide for medical professionals”. The DVLA also provides a dedicated email service for healthcare professionals to contact one of its doctors for either case-specific advice or general guidance. While healthcare professionals are not legally obliged to notify the DVLA about a patient who may be medically unfit to drive, guidance issued by the regulatory bodies does state that they should consider the safety of their patient and the public and notify the DVLA in certain circumstances. This aims to ensure that individuals who are potentially unfit to drive or lack self- awareness into their condition are identified and appropriately assessed by the DVLA. The General Medical Council provides guidance to doctors regarding circumstances where it is justifiable to breach patient confidentiality. This guidance advises that doctors do not have to seek a patient’s consent to contact the DVLA if they do not feel it is “safe and practicable to do so”. The guidance also states that doctors should still “make every reasonable effort” to persuade patients to contact the DVLA voluntarily. To ensure that the DVLA is notified about drivers who have conditions that may impair their insight into their health and driving abilities, my Department will continue to engage with healthcare professionals and their regulatory bodies to understand if there may be circumstances where doctors and health care professionals could be encouraged or supported in notifying the DVLA when appropriate.
In 2023, the DVLA carried out a call for evidence about driver licensing for people with medical conditions. The call for evidence sought views on the current legislative basis for establishing whether an individual is medically fit to drive and what may be improved and changed. The DVLA is considering the research and evidence provided and the additional research needed. The DVLA will also consider the evidence presented during the inquest to inform potential changes to the law that governs driver licensing for those with medical conditions. Work in this area is ongoing and includes consideration of the process of self-declaration and the challenges posed by an ageing population where certain conditions may become more prevalent. Following the Sheriff’s determinations from a Fatal Accident Inquiry (FAI) into the death of in Scotland, the DVLA has initiated discussions with the Secretary of State for Transport’s Honorary Medical Advisory Panel on driving and psychiatric disorders to consider the challenges that impairment of cognitive function presents in the context of the medical licensing process. The panel met on 8 May 2025 to discuss the expert papers and recommendations made at the FAI. The DVLA will continue to work closely with the panel to consider this important issue. The Government takes road safety very seriously and we are focused on ensuring that only those who are fit and safe to drive hold a valid driving licence. My Department will continue to work with healthcare professionals, driving organisations and regulatory bodies to enhance the safety of our roads and ensure that those who pose a risk to road safety are appropriately identified and assessed. The Department is also developing its Road Safety Strategy and will set out more details in due course. Best wishes,
MINISTER FOR THE FUTURE OF ROADS
The DVLA is responsible for ensuring that drivers with medical conditions meet the required medical standards of fitness to drive and will investigate those who notify a medical condition. This investigation involves obtaining information from the driver and or their doctor or healthcare professional or asking the driver to attend a medical examination or driving assessment. The law states that the DVLA must have reasonable grounds to initiate medical investigations into anyone holding or applying for a driving licence. In practice, this means that an applicant or driver must notify the DVLA of a medical condition before an assessment of their medical fitness to drive can begin. However, the DVLA can also investigate where a notification of a health condition has been made by a third party, for example the police, healthcare professionals, family or friends. This recognises that there may be occasions where a driver lacks insight into their ongoing ability to drive safely. Healthcare professionals play a vitally important role in the driver licensing process by providing advice to their patients about the implications of their condition, the effect of any treatment or medication they are receiving and when they must inform the DVLA. To support healthcare professionals, the DVLA publishes guidance called “Assessing fitness to drive: a guide for medical professionals”. The DVLA also provides a dedicated email service for healthcare professionals to contact one of its doctors for either case-specific advice or general guidance. While healthcare professionals are not legally obliged to notify the DVLA about a patient who may be medically unfit to drive, guidance issued by the regulatory bodies does state that they should consider the safety of their patient and the public and notify the DVLA in certain circumstances. This aims to ensure that individuals who are potentially unfit to drive or lack self- awareness into their condition are identified and appropriately assessed by the DVLA. The General Medical Council provides guidance to doctors regarding circumstances where it is justifiable to breach patient confidentiality. This guidance advises that doctors do not have to seek a patient’s consent to contact the DVLA if they do not feel it is “safe and practicable to do so”. The guidance also states that doctors should still “make every reasonable effort” to persuade patients to contact the DVLA voluntarily. To ensure that the DVLA is notified about drivers who have conditions that may impair their insight into their health and driving abilities, my Department will continue to engage with healthcare professionals and their regulatory bodies to understand if there may be circumstances where doctors and health care professionals could be encouraged or supported in notifying the DVLA when appropriate.
In 2023, the DVLA carried out a call for evidence about driver licensing for people with medical conditions. The call for evidence sought views on the current legislative basis for establishing whether an individual is medically fit to drive and what may be improved and changed. The DVLA is considering the research and evidence provided and the additional research needed. The DVLA will also consider the evidence presented during the inquest to inform potential changes to the law that governs driver licensing for those with medical conditions. Work in this area is ongoing and includes consideration of the process of self-declaration and the challenges posed by an ageing population where certain conditions may become more prevalent. Following the Sheriff’s determinations from a Fatal Accident Inquiry (FAI) into the death of in Scotland, the DVLA has initiated discussions with the Secretary of State for Transport’s Honorary Medical Advisory Panel on driving and psychiatric disorders to consider the challenges that impairment of cognitive function presents in the context of the medical licensing process. The panel met on 8 May 2025 to discuss the expert papers and recommendations made at the FAI. The DVLA will continue to work closely with the panel to consider this important issue. The Government takes road safety very seriously and we are focused on ensuring that only those who are fit and safe to drive hold a valid driving licence. My Department will continue to work with healthcare professionals, driving organisations and regulatory bodies to enhance the safety of our roads and ensure that those who pose a risk to road safety are appropriately identified and assessed. The Department is also developing its Road Safety Strategy and will set out more details in due course. Best wishes,
MINISTER FOR THE FUTURE OF ROADS
Sent To
- Department for Transport
Response Status
Linked responses
1 of 1
56-Day Deadline
1 Jul 2025
All responses received
About PFD responses
Organisations named in PFD reports must respond within 56 days explaining what actions they are taking.
Source: Courts and Tribunals Judiciary
Report Sections
Investigation and Inquest
On 4 November 2024 an inquest was opened into the death of Rosemary MacAndrew, aged 64. The inquest concluded on 28 April 2025. I made a determination at inquest that she died as a result of a road traffic collision.
Circumstances of the Death
Rosemary MacAndrew died on 5 July 2024 at Waitrose, Newark, Nottinghamshire, as a result of chest injuries, sustained in a Road Traffic Collision, when she was a pedestrian in the carpark of the store. She was struck by a motor car that was reversing at speed and became trapped beneath the vehicle. The motor vehicle was being driven by an 89-year-old male who was not able to account for the manner in which the vehicle was driven. It was suspected by paramedics who attended the scene that the driver may have had a neurological event whilst driving the vehicle. In the two years preceding the collision his mobility had reduced, he reported back and leg pains to his GP, and in October 2023 he presented to the local Emergency Department with neurological symptoms, suspected to be as a result of a TIA. In the months preceding the collision he had seen his GP with itching and pains in his legs. He died eight months after the collision of dementia and gangrene in both feet. As the guidance currently stands, none of the above conditions present prior to the collision were notifiable to the DVLA pursuant to the ‘Assessing Fitness To Drive: a Guide for Medical Professionals’. The above conditions would have been self-reportable by the driver if he considered they could affect his driving safety. No such self-referral had been made.
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Data sourced from Courts and Tribunals Judiciary under the Open Government Licence.