Doctors must inform the DVLA (or DVA in Northern Ireland), if a patient continues to drive against medical advice and fails to do this themselves.

New draft guidance from the General Medical Council (GMC) emphasises a doctor's duty to disclose information to the DVLA or DVA, where the patient has failed to act.

The strengthened guidance is part of a public consultation on the GMC's core guidance on confidentiality, which aims to offer greater clarity for doctors on how to balance their legal and ethical duties of confidentiality with their wider public protection responsibilities.

Feedback from doctors is that they often feel anxious about being criticised if they disclose information - but the GMC's guidance is clear that confidentiality is not absolute. Doctors should disclose information if it is necessary to protect individuals or the wider public from risks of death or serious harm - whether that is from violent crime, serious communicable diseases, or the risks posed by patients who are not fit to drive.

The overhauled guidance provides extra clarity that, if a patient does pose a risk of serious harm to the public by continuing to drive when they are not fit to do so, the doctor should contact the DVLA or DVA, even if they do not have the patient's consent to do so. These steps should only be taken as a last resort, if efforts to encourage the patient to act responsibly fail.

The guidance also emphasises that when they diagnose a patient's condition, or provide treatment, doctors should keep the patient's ability to drive safely at the forefront of their minds.

Niall Dickson, Chief Executive of the General Medical Council, said:

'Doctors often find themselves in challenging situations. This is difficult territory - most patients will do the sensible thing but the truth is that a few will not and may not have the insight to realise that they are a risk to others behind the wheel of a car.

'A confidential medical service is a public good and trust is an essential part of the doctor-patient relationship. But confidentiality is not absolute and doctors can play an important part in keeping the wider public safe if a patient is not safe to drive.

'We are clear that doctors carrying out their duty will not face any sanction - and this new guidance makes clear that we will support those who are faced with these difficult decisions.'

Steve Gooding, director of the RAC Foundation, said:

'Thirty-seven million drivers depend on the car for getting about and for those with serious medical conditions there is a real fear around losing their license. But with the right treatment many illnesses will not lead to people having to hang up the keys. The worst thing motorists can do is ignore medical advice. If they don't tell the DVLA about something that impacts on their ability to drive safely then their GP will.

'Depriving someone of their ability to drive can create its own set of social and health issues and doctors will take reasonable steps to help keep people mobile though not at the cost of endangering the wider public. Ultimately the way forward must be for doctor and patient to work together rather than in isolation.'

The consultation on Confidentiality, including reporting concerns to the DVLA, will run from 25 November 2015 to 10 February 2016. The GMC have also launched a short questionnaire to gather the views of patients and doctors. Both documents are available on the GMC's website.

The final guidance is expected to be published in late 2016.

RCGP response to GMC announcement on GPs reporting patients to the DVLA or DVA.

Dr Maureen Baker, Chair of the Royal College of GPs, said:

"GPs have a duty of care to their patients, but they also have a responsibility to the wider community and this often leads to having to make difficult decisions.

"The unique relationship between GPs and their patients is one based on trust, and that works both ways, so where possible we try to leave the responsibility for reporting unfitness to drive in the hands of the patient. But we do follow up on recommendations we make, and in some cases - if a patient hasn't self-reported - we do take this step on their behalf.

"We are bound by the GMC to report a patient to the appropriate organisation, such as the DVLA if a patient is unfit to drive, when we know they pose a risk to themselves or to others."