Possible D licence revocation due to high blood pressure

[MarkMini]

Hi. Hoping someone can help.

It is looking like I will have my D licence revoked by DVLA for high blood pressure.

Issue 1) my bloods are only above the limit by 1-3 points and only on the bottom number, and then only in a medical setting. At home, they are well below and near normal readings most of the time.

Issue 2) I drive a 12-seater minibus using my D licence (not sure of its weight). I am paid wages, do not possess a specific D1 test pass. I obviously have an unrestricted B licence. If I lost my D licence, can I still drive this minibus for work on any other licensing rules?

Has anyone got advice regarding this, or my blood readings that don't seem to match DVLA's requirements, please? Thanks very much in advance.

 

[computerSaysNo]

Hi. Hoping someone can help. It is looking like I will have my D licence revoked by DVLA for high blood pressure. Issue 1) my bloods are only above the limit by 1-3 points and only on the bottom number, and then only in a medical setting. At home, they are well below and near normal readings most of the time. Issue 2) I drive a 12-seater minibus using my D licence (not sure of its weight). I am paid wages, do not possess a specific D1 test pass. I obviously have an unrestricted B licence. If I lost my D licence, can I still drive this minibus for work on any other licensing rules? Has anyone got advice regarding this, or my blood readings that don't seem to match DVLA's requirements, please? Thanks very much in advance.

Not an expert.
The D category has a subsection D1 which is more restrictive than the full category D. If you only sit an exam for category D1 then that's all you get on your license but if you pass the exam for category D then you get entitlement for both. I would assume that the medical requirements are the same for both so losing your cat D for a medical reason would automatically cause you to lose the D1.

Regarding the blood pressure. You say your readings at home are within the legal limits but not your readings at the medical exam. Presumably the readings rise during the exam due to stress. What you've got to remember and what the DVLA will (presumably) be taking into account is that driving is not a zero-stress activity. If the stress of being in a medical setting is enough to cause your pressure to exceed the legal limit then it's very likely, I would guess, that the stress of driving will do the same.

As I said above though, I'm not an expert, I'm sure someone with more knowledge will be along shortly, but these are just my thoughts.

 

[MotCO]

Are you on any medication for your blood pressure? If not, if your GP prescribes some medicine, and your blood pressure drops to below the maximum levels, would this no longer be a problem?

 

[Snow1964]

Are you on any medication for your blood pressure? If not, if your GP prescribes some medicine, and your blood pressure drops to below the maximum levels, would this no longer be a problem?

You should get a GP appointment (not easy in some places, I realise) and ask for a hypertension review. Make it clear that you (marginally) failed a medical which could affect your income/livelihood. (Hopefully the latter will stop you being fobbed off with phone appointment etc)

 

[Busaholic]

I'm no expert either, but I've the personal experience of being on successful blood pressure reduction medication since the end of the last century.

First, I gave up home readings 25 years ago, when the reading told me I was technically dead though feeling fine!

Second, I quickly realised that both the time of day and state of mind and body could produce hugely variable blood pressure readings. In particular, my initial checks all taking place when the surgery opened and I'd had no breakfast, but had a black coffee half an hour beforehand, did me no favours. As soon as I booked afternoon appointments avoiding either alcohol or coffee for some hours before improved both higher and lower level.

There are basically two types of pills for the condition, and your individual circumstances will decide which you are prescribed: it could be that, like me, you and your GP eventually settle on a combination of low levels of each. I expect to be on this for the rest of my life, which suits me fine.

 

[Cumberlandkev]

In my opinion, if you lose your D entitlement you will revert to having your B car entitlement and D1 (minibus) but that will be a restricted D1 as in “not for hire or reward”. You will not be able to drive a minibus for a commercial operator operating under a full operators licence. You might be able to drive for a community bus operator running under a Section 22 permit but I suspect this is not your current position?
However, all that said, if the DVLA say you are not fit to drive PCV’s ( D) would you be comfortable driving a minibus?
I am an ex - minibus driver trainer but have no legal expertise - just experience. Good luck in getting your condition back below the limits.

 

[Roger1973]

A few thoughts -

I think there is a recognition that the stress of being in a medical environment can cause some peoples' blood pressure to register higher than normal. I'm not sure if there's a way you can ask for a re-test if you're borderline over, or what the process is for getting re-licensed if you stabilise the situation through medication or whatever.

As regards driver licensing, DVLA leaflet INF 52 has more on what you can drive on a car licence, and if in doubt, seek advice from the DVLA not random people on the web.

My understanding is that up to a certain date (think it was mid 90s) you got category D1 (up to 16 seats) with a car licence, but only on not for hire and reward basis (code 101 on current issue driving licences.) This (unlike the car licence bit) doesn't renew on self declaration at age 70, you do need to do the vocational medical, but I'm fairly sure that you would keep the D1 (not hire and reward) if for any reason you didn't keep your D entitlement at a younger age.

I'm fairly sure the vehicle weight isn't relevant to whether a vehicle needs category D or D1 or not.

However, my understanding is that If you want to drive a 9 to 16 seat vehicle as part of a business then you would need unrestricted D1 entitlement (or D of course) and the vehicle needs to be run under a PSV Operator's Licence. Sorry if that's not the answer you were hoping for (although again, I'd advise checking with DVLA rather than taking my word for it.)

At one time if a vehicle was not strictly for 'hire and reward', e.g. a contractor's bus, then it didn't need to be a PSV - the law round this and driver licensing did change a few times in the 1990s, and there is a danger of people remembering bits of obsolete law.

There are, as have been mentioned, some exceptions for volunteer drivers of section 19 / 22 permit operations (voluntary groups and community bus operations) which I'm not quite up to date on, and also for driving historic buses, but don't think these are the case here.

I don't think the medical standards for D1 are any different to for D, but I'm not entirely sure.

 

[MarkMini]

In my opinion, if you lose your D entitlement you will revert to having your B car entitlement and D1 (minibus) but that will be a restricted D1 as in “not for hire or reward”. You will not be able to drive a minibus for a commercial operator operating under a full operators licence. You might be able to drive for a community bus operator running under a Section 22 permit but I suspect this is not your current position?
However, all that said, if the DVLA say you are not fit to drive PCV’s ( D) would you be comfortable driving a minibus?
I am an ex - minibus driver trainer but have no legal expertise - just experience. Good luck in getting your condition back below the limits.

Thanks for that. I do drive for a community transport company which i think is classed as a charity with a board of trustees and all that. some staff are volunteers such as the bus escorts whilst most drivers are paid drivers. I work just term time solely on a school contract (am and pm runs). I've asked a couple of solicitors this question, but all I got back was they can't do anything until the DVLA has actually revoked my licence, and they didn't answer this specific licence question. It's this point that people I have asked, that they disagree on, it seems ridiculously complicated. Thanks for your input, it's helpful.

Not an expert.
The D category has a subsection D1 which is more restrictive than the full category D. If you only sit an exam for category D1 then that's all you get on your license but if you pass the exam for category D then you get entitlement for both. I would assume that the medical requirements are the same for both so losing your cat D for a medical reason would automatically cause you to lose the D1.

Regarding the blood pressure. You say your readings at home are within the legal limits but not your readings at the medical exam. Presumably the readings rise during the exam due to stress. What you've got to remember and what the DVLA will (presumably) be taking into account is that driving is not a zero-stress activity. If the stress of being in a medical setting is enough to cause your pressure to exceed the legal limit then it's very likely, I would guess, that the stress of driving will do the same.

As I said above though, I'm not an expert, I'm sure someone with more knowledge will be along shortly, but these are just my thoughts.

Thanks for your reply. The licence thing is so complicated, as you'll see there are differences of opinion even here. I've emailed the DVLA with the specific licence enquiry. Thanks.

Are you on any medication for your blood pressure? If not, if your GP prescribes some medicine, and your blood pressure drops to below the maximum levels, would this no longer be a problem?

Thanks for your reply. I am on medication, yes, and GP is reluctant to do any more as home readings are in the ok category, so more medication would reduce it too low. The licence thing is so complicated, as you'll see there are differences of opinion even here. I've emailed the DVLA with the specific licence enquiry. Thanks.

You should get a GP appointment (not easy in some places, I realise) and ask for a hypertension review. Make it clear that you (marginally) failed a medical which could affect your income/livelihood. (Hopefully the latter will stop you being fobbed off with phone appointment etc)

Thanks for your reply. I am on medication, yes, and GP is reluctant to do any more as home readings are in the ok category, so more medication would reduce it too low. The licence thing is so complicated, as you'll see there are differences of opinion even here. I've emailed the DVLA with the specific licence enquiry. Thanks.

I'm no expert either, but I've the personal experience of being on successful blood pressure reduction medication since the end of the last century.

First, I gave up home readings 25 years ago, when the reading told me I was technically dead though feeling fine!

Second, I quickly realised that both the time of day and state of mind and body could produce hugely variable blood pressure readings. In particular, my initial checks all taking place when the surgery opened and I'd had no breakfast, but had a black coffee half an hour beforehand, did me no favours. As soon as I booked afternoon appointments avoiding either alcohol or coffee for some hours before improved both higher and lower level.

There are basically two types of pills for the condition, and your individual circumstances will decide which you are prescribed: it could be that, like me, you and your GP eventually settle on a combination of low levels of each. I expect to be on this for the rest of my life, which suits me fine.

Thanks for your reply with a couple of helpful insights. I am on medication, yes, and GP is reluctant to do any more as home readings are in the ok category, so more medication would reduce it too low. The licence thing is so complicated, as you'll see there are differences of opinion even here. I've emailed the DVLA with the specific licence enquiry. Thanks.

 

[MarkMini]

A few thoughts -

I think there is a recognition that the stress of being in a medical environment can cause some peoples' blood pressure to register higher than normal. I'm not sure if there's a way you can ask for a re-test if you're borderline over, or what the process is for getting re-licensed if you stabilise the situation through medication or whatever.

As regards driver licensing, DVLA leaflet INF 52 has more on what you can drive on a car licence, and if in doubt, seek advice from the DVLA not random people on the web.

My understanding is that up to a certain date (think it was mid 90s) you got category D1 (up to 16 seats) with a car licence, but only on not for hire and reward basis (code 101 on current issue driving licences.) This (unlike the car licence bit) doesn't renew on self declaration at age 70, you do need to do the vocational medical, but I'm fairly sure that you would keep the D1 (not hire and reward) if for any reason you didn't keep your D entitlement at a younger age.

I'm fairly sure the vehicle weight isn't relevant to whether a vehicle needs category D or D1 or not.

However, my understanding is that If you want to drive a 9 to 16 seat vehicle as part of a business then you would need unrestricted D1 entitlement (or D of course) and the vehicle needs to be run under a PSV Operator's Licence. Sorry if that's not the answer you were hoping for (although again, I'd advise checking with DVLA rather than taking my word for it.)

At one time if a vehicle was not strictly for 'hire and reward', e.g. a contractor's bus, then it didn't need to be a PSV - the law round this and driver licensing did change a few times in the 1990s, and there is a danger of people remembering bits of obsolete law.

There are, as have been mentioned, some exceptions for volunteer drivers of section 19 / 22 permit operations (voluntary groups and community bus operations) which I'm not quite up to date on, and also for driving historic buses, but don't think these are the case here.

I don't think the medical standards for D1 are any different to for D, but I'm not entirely sure.

Thanks for your reply with some helpful thoughts. I am on medication, yes, and GP is reluctant to do any more as home readings are in the ok category, so more medication would reduce it too low. The licence thing is so complicated, as you'll see there are differences of opinion even here. Even though seeing the GP may cause stress, and the DVLA would say this translates to the same stress in a driving situation, I would disagree with that view as visiting the GP when one's job is at risk is entirely different from driving when the latter is a job and experience that I thoroughly enjoy and do not feel stressed in at all. I've emailed the DVLA with the specific licence enquiry. Thanks.

 

[Titfield]

Thanks for that. I do drive for a community transport company which i think is classed as a charity with a board of trustees and all that. some staff are volunteers such as the bus escorts whilst most drivers are paid drivers. I work just term time solely on a school contract (am and pm runs). I've asked a couple of solicitors this question, but all I got back was they can't do anything until the DVLA has actually revoked my licence, and they didn't answer this specific licence question. It's this point that people I have asked, that they disagree on, it seems ridiculously complicated. Thanks for your input, it's helpful.


. I've emailed the DVLA with the specific licence enquiry. Thanks.

Whilst you are waiting for the DVLA to respond May I suggest you take a look at https://ctauk.org/cta-advice-service/faq/

One issue of significance is under what "permission" is the organisation you are driving for operating. Section 19, Section 22 or Section 10b Permits? Or is it under a full O Licence?

One pedantic point but it helps to get it right. As I understand you are having your entitlement to drive category D vehicles revoked, you are not having your driving licence revoked.

 

[Bletchleyite]

"White coat hypertension" is very common indeed. Usually it is dealt with by having the patient take 2 readings per day at home, or, if the doctor is concerned these may be falsified, by way of a 24 hour blood pressure monitor.

 

[paul1609]

I'm no expert either, but I've the personal experience of being on successful blood pressure reduction medication since the end of the last century.

First, I gave up home readings 25 years ago, when the reading told me I was technically dead though feeling fine!

Second, I quickly realised that both the time of day and state of mind and body could produce hugely variable blood pressure readings. In particular, my initial checks all taking place when the surgery opened and I'd had no breakfast, but had a black coffee half an hour beforehand, did me no favours. As soon as I booked afternoon appointments avoiding either alcohol or coffee for some hours before improved both higher and lower level.

There are basically two types of pills for the condition, and your individual circumstances will decide which you are prescribed: it could be that, like me, you and your GP eventually settle on a combination of low levels of each. I expect to be on this for the rest of my life, which suits me fine.

In my experience take any blood pressure medication first thing, dont eat any breakfast or drink anything at all gets the lowest readings.

 

[MarkMini]

Whilst you are waiting for the DVLA to respond May I suggest you take a look at https://ctauk.org/cta-advice-service/faq/

One issue of significance is under what "permission" is the organisation you are driving for operating. Section 19, Section 22 or Section 10b Permits? Or is it under a full O Licence?

One pedantic point but it helps to get it right. As I understand you are having your entitlement to drive category D vehicles revoked, you are not having your driving licence revoked.

Thanks again. I've been looking at things, and it appears that my driving for what is classed as a charity/not-for-profit/community transport organisation is one thing in my favour, but it seems I cannot be paid to do so, and I'm a paid driver. But then again, the document you linked me to says D1 101 pre-97 licence passes can drive for S19 and s22 without additional restrictions, so this seems to contradict other information, and I feel is unclear as to payment as wages. Thanks, it's so complicated you need a PhD in licensing to understand it all!

In my experience take any blood pressure medication first thing, dont eat any breakfast or drink anything at all gets the lowest readings.

Thanks for that. After some googling, I have found information saying don't take medication before a reading, you can take medication before a reading, don't take reading when you wake up and you can take reading when you wake up!!

"White coat hypertension" is very common indeed. Usually it is dealt with by having the patient take 2 readings per day at home, or, if the doctor is concerned these may be falsified, by way of a 24 hour blood pressure monitor.

thanks. DVLA will not accept home readings, only those at the GP surgery. They aren't even accepting my hospital initiated 24-hour monitoring where the averages for waking time, sleeping time and overall average are all within limits! They're a law unto themselves. I've been told any legal action to appeal the licence revoking could be £5k to 10k, so no recourse to justice.

 

[Busaholic]

In my experience take any blood pressure medication first thing, dont eat any breakfast or drink anything at all gets the lowest readings.

Absolutely agree. Read in a paper last week though that 'trials show' that it makes no difference what time of day you take it in relation to outcomes e.g. suffering stroke or heart attack. I have loads of medication to take, mostly once per day, and I always choose soon after getting up.

 

[Cumberlandkev]

What sort of permit / operators licence is on your minibus?
You can be paid for driving a minibus under a Section 19 permit.

 

[Typhoon]

When I was first diagnosed with blood pressure tablets, the (specialist hypertension) nurse took three readings at intervals. Left arm, right arm, left arm.

Some months later she explained why. She disregarded the first as that was always going to be highest ('white coat' syndrome - anxious about the tests; maybe rushing into the surgery), she averaged the other two as there is usually a difference between the two (higher blood pressure in the right arm). When I had my blood pressure taken in hospital by a doctor, he only took it from the left arm. If the medics are taking it from the right rm and soon after arriving that could make all the difference (getting to the surgery before time and, say, reading a paper may reduce stress levels prior to blood pressure being taken. I am now with a different surgery, many miles away, and I can't get them to take blood pressure more than once or from the left arm (the consulting room is set up for right arm tests).

Also if you are diagnosed statins

Take them at the same time every day. Your doctor or nurse might suggest you take your statins at night, before you go to bed. That’s because the liver is more active in making cholesterol at night.

From https://www.heartuk.org.uk/getting-treatment/statins

 

[Bletchleyite]

thanks. DVLA will not accept home readings, only those at the GP surgery. They aren't even accepting my hospital initiated 24-hour monitoring where the averages for waking time, sleeping time and overall average are all within limits! They're a law unto themselves. I've been told any legal action to appeal the licence revoking could be £5k to 10k, so no recourse to justice.

I am surprised they will not accept the hospital readings. Will your GP willingly write to effectively diagnose white coat? I get that really badly as I am always stressed when I go to the doctor's. I actually ended up on meds to make sure it was low enough for an operation (as that's really stressful!) and am back off now.

 

[MarkMini]

Absolutely agree. Read in a paper last week though that 'trials show' that it makes no difference what time of day you take it in relation to outcomes e.g. suffering stroke or heart attack. I have loads of medication to take, mostly once per day, and I always choose soon after getting up.

I read a medical study that said taking blood pressure meds at night had a very large and significant effect on its effectiveness and in reducing cardiovascular events. I'm sure one event was reduced in the group that took nighttime meds by 46%.

I am surprised they will not accept the hospital readings. Will your GP willingly write to effectively diagnose white coat? I get that really badly as I am always stressed when I go to the doctor's. I actually ended up on meds to make sure it was low enough for an operation (as that's really stressful!) and am back off now.

What sort of permit / operators licence is on your minibus?
You can be paid for driving a minibus under a Section 19 permit.

I think its s22

 

[Cumberlandkev]

Section 22 - prior to 2008 only volunteers could drive Section 22 minibuses ( community buses) but this was amended by the Local Transport Act 2008, Section 59, to allow paid drivers. Hope this helps
(This assumes that DVLA leave you with at least D1 - not for hire or reward. Good luck with it all!)

 

[Titfield]

I appreciate your desire for anonymity hence you will not wish to reply to this post.

May I suggest that you ascertain with absolute certainty what licencing regime or permit type the organisation you are driving for is operating under and that the type of work being carried out falls within the scope of whatever licence or permit the organisation holds.

If you were stopped by the police or dvsa you could find yourself in legal difficulty if the correct permit / operating licence isnt held.

Apologies for adding to your anxiety.

 

[philthetube]

Slightly off topic but what are the required numbers which blood pressure has to be below?

 

[MarkMini]

I appreciate your desire for anonymity hence you will not wish to reply to this post.

May I suggest that you ascertain with absolute certainty what licencing regime or permit type the organisation you are driving for is operating under and that the type of work being carried out falls within the scope of whatever licence or permit the organisation holds.

If you were stopped by the police or dvsa you could find yourself in legal difficulty if the correct permit / operating licence isnt held.

Apologies for adding to your anxiety.

Its community transport, charitable status, not-for-profit organisation. We do Dial-A-Ride, special needs schools' contracts, etc. but I do only schools runs am and pm. Its section 22 permits. The council awards us some grant per year, and they award us the contracts, so the students/pupils do not pay.

 

[MarkMini]

Slightly off topic but what are the required numbers which blood pressure has to be below?

179/99 consistently below. The nurse was surprised as 179 is high. My typical numbers are 125-145/80-100. It's the 100 bottom number that's the problem.

 

[Busaholic]

Slightly off topic but what are the required numbers which blood pressure has to be below?

My G.P. told me last week that 140 over 90 was the standard, but that doesn't mean to say it applies in all circumstances. It may just be a general 'rule of thumb.' I'd just expressed concern at my 140 over 80 reading, because over recent years I'd been more like 125-130 over 70-75, but she didn't find cause for alarm.

 

[Bletchleyite]

179/99 consistently below. The nurse was surprised as 179 is high. My typical numbers are 125-145/80-100. It's the 100 bottom number that's the problem.

From experience getting diastolic down with medication is VERY difficult indeed. Most medication affects systolic, and while vasodilators do slightly impact diastolic they cause all manner of other issues. Lifestyle changes are the best way to fix that, but it takes time.

On the other hand very high systolic is a major stroke risk, whereas very high diastolic isn't, but is a risk of heart disease and other long term complications, so it taking a time to fix it is less of an issue in normal circumstances.