We read with interest the study by Frampton of emergency physicians’ knowledge of DVLA guidelines.¹

Following a national questionnaire survey of lead clinicians in UK Accident and Emergency departments in 2003 (41% return), we found results consistent with those in Frampton’s study: correct driving advice was given in 97% post seizure, 75% post transient ischaemic attack (TIA), and 65% post unstable Supraventricular Eachycardia (SVT) in our study.

We also looked at musculoskeletal injury, for which no national guidance is available,² and found there is little consistency in advice being given to patients with short lived (<3 months) musculoskeletal injuries on safe driving.

We would advocate the development of simple guidance on driving safely for patients with short term musculoskeletal injury:

• lower limb—ability to stand on injured limb and raise body with plantar flexion (braking/clutch/accelerator safety), and

• upper limb—ability to grip with equal force to the uninjured side and fully pronate and supinate the forearm (steering wheel safety).

We would also reinforce the importance of emergency department doctors being aware of the existing medical restrictions to driving.