Setting

This audit is relevant to old age psychiatrists conducting memory clinics in an out-patient setting.

Background

Guidance from the Driving and Vehicle Licensing Agency (DVLA)(2009) states that:

ᐅ any person who holds a valid driving licence should inform the DVLA when given the diagnosis of dementia

ᐅ in early dementia, when sufficient skills are retained and progression is slow, a licence may be issued subject to annual review by the DVLA. The General Medical Council (2009) and Royal College of Psychiatrists (2005) have also published guidance on driving:

ᐅ It is the responsibility of doctors to advise patients when they are unfit to drive and to recommend that they inform the DVLA. This recommendation should be documented.

ᐅ If patients refuse to inform the DVLA, then the doctor should consider breaching confidentiality appropriately.

Standards

Based on above guidelines, the following standards can be obtained:

ᐅ Driving status should be recorded after the initial multidisciplinary assessment of any patient referred to a memory clinic.

ᐅ For patients with a diagnosis of dementia who are still driving, there should be documentation of the fact that information was given to them regarding informing the DVLA.

ᐅ If patients with dementia are still driving there should be documentation of a decision on whether or not to inform the DVLA.

ᐅ There should be documentation of action taken by the team if the patient has not acted on the advice to inform the DVLA.

ᐅ Expected compliance with the standards is 100%.

Method

Data collection

ᐅ A list was drawn up of all cases assessed in the memory clinic within a stipulated period for the audit. (DVLA procedures can be time-consuming and hence it is advisable to audit for at least 6 months in retrospect.)

ᐅ All documents (hand-written, computerised, printed) were examined.

ᐅ Exclusion criteria were set (e.g. patients who had died). Data analysis

ᐅ Data were analysed using spreadsheet software..

Resources required

People

It is advisable to have at least two people involved for the data collection. This partly depends on the duration of the study.

Time

It is estimated that 100 case notes will take approximately 30 hours to audit.