Geoffrey Toase and Michael Midgley
PFD Report
All Responded
Ref: 2024-0507
All 1 response received
· Deadline: 7 Oct 2024
Coroner's Concerns (AI summary)
DVLA's license re-issue process is flawed due to insufficient gathering of medical history from specialists and GPs, tick-box forms, and lack of verification for self-declarations. This prevents full assessment of applicants' fitness to drive.
View full coroner's concerns
I heard evidence from two representatives of the DVLA at the inquest, including a DVLA employed Doctor. That Doctor gave evidence about their role in the medical review and decision to re-issue a license to the driver of the car involved in the fatal collision. That evidence gave rise to the following concerns: a) DVLA Doctors are not actively encouraged by the DVLA to request further information about an applicant’s medical history.
b) The DVLA does not generally seek further information from any identified Speciality Doctor that may be involved in an applicant’s medical care and treatment; any requests for further information are usually directed to an applicant’s General Practitioner (GP).
c) The forms sent to an applicant’s GP by the DVLA for the purpose of obtaining further information are largely tick box in nature and do not provide sufficient scope for the GP to provide more detailed information and this therefore does not allow for a full assessment to be conducted by the reviewing DVLA Doctor.
d) Current DVLA working practices do not appear to allow DVLA Doctors to consider the interplay between different medical conditions an applicant may be suffering with.
e) There is no apparent system in place to verify the accuracy of the information provided by an applicant within their medical self-declaration and that this information is generally accepted by the DVLA without question.
f) The information provided by an applicant within their medical self-declaration is no longer sent to their GP by the DVLA alongside any request for further information, which limits any scope for the GP to identify if the information contained within a medical self-declaration is accurate.
g) The DVLA Doctor involved in this case gave evidence that they felt “constrained” by the DVLA guidance, standards and working practices they are required to work to.
h) The decisions made by DVLA Doctors when considering to re-issue a license are not subject to any form of audit procedure to ensure accuracy and consistency of decision-making.
b) The DVLA does not generally seek further information from any identified Speciality Doctor that may be involved in an applicant’s medical care and treatment; any requests for further information are usually directed to an applicant’s General Practitioner (GP).
c) The forms sent to an applicant’s GP by the DVLA for the purpose of obtaining further information are largely tick box in nature and do not provide sufficient scope for the GP to provide more detailed information and this therefore does not allow for a full assessment to be conducted by the reviewing DVLA Doctor.
d) Current DVLA working practices do not appear to allow DVLA Doctors to consider the interplay between different medical conditions an applicant may be suffering with.
e) There is no apparent system in place to verify the accuracy of the information provided by an applicant within their medical self-declaration and that this information is generally accepted by the DVLA without question.
f) The information provided by an applicant within their medical self-declaration is no longer sent to their GP by the DVLA alongside any request for further information, which limits any scope for the GP to identify if the information contained within a medical self-declaration is accurate.
g) The DVLA Doctor involved in this case gave evidence that they felt “constrained” by the DVLA guidance, standards and working practices they are required to work to.
h) The decisions made by DVLA Doctors when considering to re-issue a license are not subject to any form of audit procedure to ensure accuracy and consistency of decision-making.
Responses
Noted
The DVLA acknowledges the coroner's concerns, explains the current driver licensing requirements, and states that their processes and policies are kept under review. They mention a call for evidence to gather views on the medical driver licensing process, and the responses are being analyzed. (AI summary)
The DVLA acknowledges the coroner's concerns, explains the current driver licensing requirements, and states that their processes and policies are kept under review. They mention a call for evidence to gather views on the medical driver licensing process, and the responses are being analyzed. (AI summary)
View full response
Dear Jessica Swift, Thank you for your report of 12 August 2024 made under paragraph 7, Schedule 5 of the Coroners and Justice Act 2009 and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013, following the inquest into the deaths of Geoffrey Stewart Toase and Michael William Midgley. I was very sorry to learn of the circumstances of Mr Toase and Mr Midgley’s deaths and I would like to express my sincere condolences to their families. I have considered your report and its recommendations carefully and I can assure you that the Driver and Vehicle Licensing Agency (DVLA) takes such matters very seriously. The current driver licensing arrangements are underpinned by a legal requirement that all drivers, of any age, must inform the DVLA at any time if they develop a medical condition that may affect safe driving. All drivers must meet the appropriate medical standards for driving and a licence will only be issued to those who meet those standards. Where a driving licence holder or applicant is suffering from a relevant or prospective disability, driving licences may be issued for a shorter period so that fitness to drive can be regularly reviewed. This helps to ensure that drivers continue to meet the required medical standards for driving. These arrangements are designed to be balanced and proportionate for all drivers, balancing road safety and the mobility of individuals. The medical standards relating to fitness to drive are set out in the DVLA’s guidance: Assessing fitness to drive: a guide for medical professionals. The guidance is based on both domestic legislation and advice from the Secretary of State for Transport’s Honorary Medical Advisory Panels. The guidance advises members of the medical profession on the medical standards that need to be met by individuals to hold licences to drive various categories of vehicles. The medical panels provide the DVLA with expert medical advice about relevant medical conditions and their impact on driving and this feeds into the guidance provided. Driver and Vehicle Licensing Agency Head of Strategy and Policy Longview Road Morriston Swansea SA6 7JL Phone: Website:
Your Ref: Our Ref: Date: 4 October 2024
The guidance specific to diabetes is based on legislation and the advice provided by the Secretary of State for Transport’s Honorary Medical Advisory Panel on Driving and Diabetes Mellitus. The DVLA’s Drivers Medical team assesses all driving licence applications against the required standards. A medical questionnaire will be sent to the applicant in the first instance, asking them for more information about their condition. The applicant is also asked to provide authorisation for their healthcare professional to release information from their medical records to the DVLA. If further information is required, the DVLA will write directly to the relevant doctor and/or consultant managing the care and treatment of the applicant. This information is requested in the form of a questionnaire which is designed to be completed from medical records. Other registered healthcare professionals can also provide information to the DVLA where it is appropriate to do so. It is for the individual practice or hospital team to decide which appropriately registered healthcare professional is best placed to complete the questionnaire. Healthcare professionals can also contact the DVLA’s doctors directly if they have any concerns about their patient driving. Where more information is needed to establish fitness to drive, the DVLA may also request a medical examination and/or driving assessment. If the investigation finds that a driver has a relevant disability and cannot meet the medical standards, an existing licence will be revoked or an application refused. As outlined above, the DVLA can also issue a licence for a shorter period, typically between one and five years, allowing driving fitness to be more regularly monitored. Any applications referred to the DVLA’s doctors are usually more complex and often involve multiple medical conditions. A reviewing DVLA doctor wishing to carry out a full assessment can decide to write to the nominated healthcare professional to request any further information on the applicant’s health that they may consider relevant. The DVLA’s doctors take a holistic clinical view of each case and consider the impact that multiple medical conditions could have on fitness to drive in order to make a licensing decision. Particularly complex cases are sometimes referred to one of the expert members of the relevant medical panel to review and on occasion, cases may be discussed at the relevant medical panel meeting. All drivers have a legal responsibility to notify the DVLA of the onset or worsening of a relevant medical condition. It is an offence not to do so and drivers who fail to notify or make a false declaration can be fined up to £1,000. Drivers are encouraged to discuss any concerns about their ongoing driving fitness with their own healthcare professionals and to notify the DVLA where appropriate. The DVLA takes road safety very seriously and the UK’s roads are among the safest in the world. However, we are not complacent and our processes and policies are kept under review. Last year the DVLA issued a call for evidence to gather a wide range of views and evidence that may support future changes to the legal framework which underpins the current medical driver licensing process in Great Britain. The responses are currently being analysed.
I am grateful to you for bringing your concerns to my attention. I can assure you that we take road safety very seriously and we are focused on ensuring that only those who are fit to drive are granted a licence to do so.
Your Ref: Our Ref: Date: 4 October 2024
The guidance specific to diabetes is based on legislation and the advice provided by the Secretary of State for Transport’s Honorary Medical Advisory Panel on Driving and Diabetes Mellitus. The DVLA’s Drivers Medical team assesses all driving licence applications against the required standards. A medical questionnaire will be sent to the applicant in the first instance, asking them for more information about their condition. The applicant is also asked to provide authorisation for their healthcare professional to release information from their medical records to the DVLA. If further information is required, the DVLA will write directly to the relevant doctor and/or consultant managing the care and treatment of the applicant. This information is requested in the form of a questionnaire which is designed to be completed from medical records. Other registered healthcare professionals can also provide information to the DVLA where it is appropriate to do so. It is for the individual practice or hospital team to decide which appropriately registered healthcare professional is best placed to complete the questionnaire. Healthcare professionals can also contact the DVLA’s doctors directly if they have any concerns about their patient driving. Where more information is needed to establish fitness to drive, the DVLA may also request a medical examination and/or driving assessment. If the investigation finds that a driver has a relevant disability and cannot meet the medical standards, an existing licence will be revoked or an application refused. As outlined above, the DVLA can also issue a licence for a shorter period, typically between one and five years, allowing driving fitness to be more regularly monitored. Any applications referred to the DVLA’s doctors are usually more complex and often involve multiple medical conditions. A reviewing DVLA doctor wishing to carry out a full assessment can decide to write to the nominated healthcare professional to request any further information on the applicant’s health that they may consider relevant. The DVLA’s doctors take a holistic clinical view of each case and consider the impact that multiple medical conditions could have on fitness to drive in order to make a licensing decision. Particularly complex cases are sometimes referred to one of the expert members of the relevant medical panel to review and on occasion, cases may be discussed at the relevant medical panel meeting. All drivers have a legal responsibility to notify the DVLA of the onset or worsening of a relevant medical condition. It is an offence not to do so and drivers who fail to notify or make a false declaration can be fined up to £1,000. Drivers are encouraged to discuss any concerns about their ongoing driving fitness with their own healthcare professionals and to notify the DVLA where appropriate. The DVLA takes road safety very seriously and the UK’s roads are among the safest in the world. However, we are not complacent and our processes and policies are kept under review. Last year the DVLA issued a call for evidence to gather a wide range of views and evidence that may support future changes to the legal framework which underpins the current medical driver licensing process in Great Britain. The responses are currently being analysed.
I am grateful to you for bringing your concerns to my attention. I can assure you that we take road safety very seriously and we are focused on ensuring that only those who are fit to drive are granted a licence to do so.
Sent To
- Driver and Vehicle Licensing Agency
Response Status
Linked responses
1 of 1
56-Day Deadline
7 Oct 2024
All responses received
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Source: Courts and Tribunals Judiciary
Report Sections
Investigation and Inquest
On 8 August 2019 an inquest was opened into the deaths of Geoffrey Stewart Toase and Michael William Midgley.
The inquest concluded on 2 August 2024, the conclusion reached was the short form conclusion of road traffic collision.
The inquest concluded on 2 August 2024, the conclusion reached was the short form conclusion of road traffic collision.
Circumstances of the Death
On 3 August 2019, Mr Toase and Mr Midgley had arranged to spend the day riding their motocycles around Yorkshire, they were accompanied by two associates.
At around 3:45pm, whilst travelling down the A166 Garrowby Hill, Mr Toase and Mr Midgley were involved in a head on collision with a car that was travelling from the opposite direction. That car was located wholly on the wrong side of the carriageway at the point at which it collided with Mr Toase and Mr Midgley.
The driver of the car involved had a number of health-related conditions, including Type 1 Diabetes Mellitus, controlled by insulin injection. As a result of the diabetes, the driver of the car was required to reapply to the DVLA for a license every 3 years.
At the time of the collision, the driver of the car was, on the balance of probability, suffering a hypoglycaemic episode which had compromised their ability to drive in an appropriate manner.
Emergency services attended the collision scene swiftly, but the injuries suffered by both Mr Toase and Mr Midgley were such that nothing could be done to save them and they were both declared deceased at the incident scene.
At around 3:45pm, whilst travelling down the A166 Garrowby Hill, Mr Toase and Mr Midgley were involved in a head on collision with a car that was travelling from the opposite direction. That car was located wholly on the wrong side of the carriageway at the point at which it collided with Mr Toase and Mr Midgley.
The driver of the car involved had a number of health-related conditions, including Type 1 Diabetes Mellitus, controlled by insulin injection. As a result of the diabetes, the driver of the car was required to reapply to the DVLA for a license every 3 years.
At the time of the collision, the driver of the car was, on the balance of probability, suffering a hypoglycaemic episode which had compromised their ability to drive in an appropriate manner.
Emergency services attended the collision scene swiftly, but the injuries suffered by both Mr Toase and Mr Midgley were such that nothing could be done to save them and they were both declared deceased at the incident scene.
Copies Sent To
driver of the car involved in the collision
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Data sourced from Courts and Tribunals Judiciary under the Open Government Licence.