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Advice on driving while under the care of a crisis resolution team: findings from two audits

  • Joanna Curwen (a1) and Amy Jebreel (a1)
Abstract
Aims and method

To examine the documentation regarding patients driving while under the care of a crisis resolution team and whether advice is being given by all members of the team. An audit was carried out looking at the case records of patients and information was collated about whether they had been asked if they were driving and whether any advice had been given. Following the audit there was a team presentation and guidelines distributed. The audit was repeated 6 months later.

Results

The first cycle of the audit included 58 patients. There was documentation about driving for two patients and appropriate advice given for one. The second cycle included 53 patients. There was documentation about two patients and advice given for one.

Clinical implications

Patients are not being asked whether they drive and advice is not routinely being given despite clear guidelines. Further research is needed to look at interventions at a local level that could improve this.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Joanna Curwen (joanna.curwen@candi.nhs.uk)
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 Driver and Vehicle Licensing Agency. At a Glance Guide to the Current Medical Standards of Fitness to Drive. TSO (The Stationery Office), 2011.
2 General Medical Council. Confidentiality: Reporting Concerns about Patients to the DVLA or DVA. GMC, 2009.
3 Royal College of Psychiatrists. Good Psychiatric Practice: Confidentiality and Information Sharing (2nd edn) (College Report CR160). Royal College of Psychiatrists, 2010.
4 Wise, MEJ, Watson, JP. Postal survey of psychiatrists' knowledge and attitudes towards driving and mental illness. Psychiatr Bull 2001; 25: 345–9.
5 Thompson, P, Nelson, D. DVLA regulations concerning driving and psychiatric disorders. Knowledge and attitudes of psychiatrists. Psychiatr Bull 1996; 20: 323–5.
6 Humphreys, SA, Roy, L. Driving and psychiatric illness. Psychiatr Bull 1995; 19: 747–9.
7 Orr, EM, Elworthy, TSE. Audit of advice on driving following hospitalisation for an acute psychotic episode. Psychiatr Bull 2008; 32: 106–7.
8 Nursing & Midwifery Council. The Code. NMC, 2008.
9 World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO, 1992.
10 Culshaw, M, Wootton, L, Wylie, S. Alcohol dependence and driving: a survey of patients' knowledge of DVLA regulations and possible clinical implications. Psychiatr Bull 2005; 29: 90–3.
11 Hawley, C. The Attitudes of Health Professionals to Giving Advice on Fitness to Drive. Department for Transport, 2010.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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Advice on driving while under the care of a crisis resolution team: findings from two audits

  • Joanna Curwen (a1) and Amy Jebreel (a1)
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eLetters

Advice on driving while under the care of a crisis resolution team: findings from two audits

Johannes L Pretorius, Psychiatrist
14 December 2012

As it happens we have been grappling with the same issues as Curwen and Jebreel(1), namely low rates of documented action taken in relation todriving risk in our crisis resolution team. We would like to share the approach we arrived at which might inspire others.

As was indeed suggested by Curwen and Jebreel, we did place a poster regarding the guidelines for driving with psychiatric illness in our team's work space, and repeatedly discussed the issue at team meetings. Unfortunately this did not make much difference, and documented action remained near zero. More successful was indicating driving status as part of the patient's details on our overview boards, and including a simple screening tool in the admission pack. This pack is used by practitioners at first assessment. This tool simply looks at the three general domains of psychiatric illness covered in the guidelines: 1.Depression Anxiety 2.Psychosis Hypomania Mania3.Dementia

The rater needs to broadly rate each of these domains according to:

Green: Low risk and no action needed

Amber: Sufficient risks present to refer for a medical opinion

Red: Risks are overwhelmingly clear and driving needs to stop immediately.

In the case that driving needs to stop, a letter is available in the admission pack, written on behalf of the unit, explaining the need to do so.

1. Curwen J and Jebreel A. Advice on driving while under the care of a crisis resolution team: findings from two audits The Psychiatrist Online2012, 36:424-426.

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Conflict of interest: None declared

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