Shortly after I qualified I drove in a small car from London to Cornwall to take up a locum post. It took 10 h at an average speed of 30 mph, there were no motorways and little traffic. Now, there are many faster cars, roads are busier and more dangerous, and there is a greater need to ensure that those who drive are fit to do so. We also have an ageing population, with many drivers now into their 80s and 90s. Many older drivers have driven for years and expect to continue because of the independence driving offers. For some older people driving is critical to their quality of life and their ability to maintain connections with others. However, they are driving cars that are faster and in conditions that are potentially more hazardous to the driver and the public than before.

Driving depends on minimum physical and mental functions, and the Driver and Vehicle Licensing Agency (DVLA)1 …