Our recommendations: five core principles for implementation
1. Mandatory requirement for drivers to submit formal evidence of a recent sight test at application and every renewal
The sight test includes a vision assessment and eye health examination for all drivers at initial application, at every renewal (every 10 years and then every three years from age 70, to align with age-related eye conditions and deterioration in visual function).
- the sight test is a regulated function delivered by registered optometrists predominantly through community optometry practices on the High Street which is accessible and consistent across the UK
- ensures that the Snellen visual acuity standard for driving is assessed accurately and objectively in standardised conditions
- enables early detection (and treatment or referral, if appropriate) of notifiable (by driver) eye conditions that may otherwise be asymptomatic
Impact: Offers a significant improvement on the current system which is entirely dependent on self-declaration of meeting the vision standards for driving and over-reliance on the number plate test. Further, many eye conditions, do not have many (if any) symptoms in the early stages. This means drivers may unknowingly not meet the vision standards or may have a reportable eye condition, while larger improvements are possible this initial change will introduce a significant risk reduction in the risk of vision-related current and future driving accidents.
2. Strong emphasis on attending regular sight tests between renewals
Regular sight tests provide assurance that visual acuity continues to meet the vision standards, and eyes are healthy:
- early detection of eye disease means drivers can access treatment (if appropriate) and avoidable sight loss is prevented
- where significant refractive error is detected, visual correction can be provided to improve visual acuity
- early treatment of eye conditions and intervention with visual correction can enable and provide drivers with reassurance they meet the visual standards and can continue to drive
Impact: Regular sight tests are critical to reducing the current and future risk of driving accidents. Clear and sustained public communication (e.g. on application and renewal forms) on the vision standards and the benefits of regular sight test is needed to reach those who do not currently attend. Not only can driving safety be improved, but when an issue is identified, for example a cataract, advice and counselling can be provided to ensure that the person understands how they can take action to continue to drive.
3. Referral to DVLA following failure to meet the driving vision standard in the sight test
If following a sight test a driver cannot meet the 6/12 required Snellen standard, has a visual field defect or notifiable eye condition, the optometrist would follow the current system:
- inform the driver of the results, advise them not to drive and remind them of their duty to notify the DVLA; supported by agreed sector guidance
- the DVLA will investigate further and offer follow-up testing where appropriate at an approved provider – including an Esterman test
Impact: Ensures that drivers who fail to meet the required minimum standard during their appointment in a optical practice are evaluated using more robust methods, but also reminds drivers of their responsibility to ensure they are fit to drive.
4. Continued public awareness and education about driver responsibility between renewals
Drivers are reminded of their legal and ethical responsibility to:
- ensure they always meet the vision standards and aware of what they are
- what to do should they have any visual or eye health concerns (contact their local optometrist for advice in the first instance)
- have a sight test every two years, or more often if recommended by their optometrist
- notify DVLA if they fail to meet the vision standards for driving
- declare any notifiable eye condition that may affect driving at any time, not just at renewal
Impact: Supporting drivers to take ownership of the decision-making process it avoids, or reduces the perception of this process being over bureaucratic. By promoting the value of early intervention, it is hoped that drivers will embrace the maintenance of good vision and eye health, while having an added benefit of keeping them driving safely for longer. By raising public awareness, drivers will hopefully be motivated to ensure they attend for regular sight tests to avoid concerns about licence renewal.
5. Reinforce reporting guidance for primary eye care optometrists conducting the sight test on drivers
Where it is apparent that a driver who fails to meet the driving vision standards is unlikely to notify the DVLA, they intend to drive, or are observed them continuing to drive, optometrists should be supported to make a direct disclosure.
This can be achieved by :
- utilising existing guidance from healthcare regulators (eg GOC) and professional organisations on when and how to report
- a DVLA-defined reporting mechanism to support healthcare professionals to make direct disclosures
Impact: We are aware that healthcare professionals need the right support to determine what represents a danger to the public and when it is appropriate to make a direct disclosure to the DVLA. This can help provide healthcare professionals with reassurance and removes ambiguity when they are acting in the public interest and their decision outweighs their duty to patient confidentiality.