Fit to drive

Driving involves a complex and rapidly repeating cycle that requires a level of skill and the ability to interact simultaneously with both the vehicle and the external environment.

Information about the environment is via the visual and auditory senses and is operated on by many cognitive processes to effect decisions for the driving task in hand. These decisions are enacted by the musculoskeletal system, which acts on the controls of the vehicle and its relation to the road and other users.

The whole process is co-ordinated by complex interactions involving behaviour, strategic and tactical abilities, and personality. In the face of illness or disability, adaptive strategies are important for maintaining safe driving.

Safe driving requires, among other elements, the involvement of:

  • vision
  • visuospatial perception
  • hearing
  • attention and concentration
  • memory
  • insight and understanding
  • judgement
  • adaptive strategies
  • good reaction time
  • planning and organisation
  • ability to self-monitor
  • sensation
  • muscle power and control
  • co-ordination

Given these requirements, it follows that many body systems need to be functional for safe driving – and injury or disease may affect any one or more of these abilities for safe driving.




All drivers, regardless of vehicle category, MUST be able to read a car number place, 20 metres. If glasses or contact lenses are needed to do this, then, they MUST be worn when driving.

Remember – If you have an accident, caused by poor eyesight, your vehicle insurance may be voided.


  • It is estimated that 2,00 casualties are caused by poor driver vision each year. Poor vision is only recorded as a contributory factor in less than 1% of reported crashes, although some studies estimate that approximately 1.8 million drivers have vision below the minimum legal standards.
  • The general recommendation is have an eyesight check every two years, although your optician may advise an annual check. Having an eyesight test will be usually identify the majority of common eyesight conditions, and may also give clues about other less common diseases. It will also ensure that you meet minimum eyesight standards for driving.
  • If you are finding it difficult to read road signs, especially those with writing on as quickly as you used to, it could indicate that your long distance has deteriorated and require corrective lenses.
  • Poor vision causes more significant driving impairment at night. This may make it more difficult to spot pedestrians, especially if wearing dark clothing. You may also be affected by glare from oncoming vehicle headlights. Reducing night time driving can help in this instance; you may also wish to consider voluntary training.
  • Tinted lenses reduce the amount of light available to the eye, as such they are not recommended for driving at night or in conditions of poor visibility. The Highway Code advises against their use.
  • If you drive with eyesight below the minimum legal standard you could face a fine of up to £1,000, 3 penalty points or discretionary disqualification. If you cause death by dangerous driving you could face up to 14 years in prison.
  • 2017-79

Visuospatial perception

The way the brain functions when anticipating the threat from developing hazards may be responsible for the difference in risk between an experienced driver and a novice driver.

Imagine you’ve driving and you suddenly notice a pedestrian stepping out in front of you. Even with just a hint of movement in your peripheral vision, your full attention is guided towards the hazard. Your brain doesn’t waste time telling its ‘thinking part’ that the pedestrian is about to step into the path of your vehicle and that you should brake.

Your visual cortex (visuospatical perception) feeds the information to the brainstem. This information is then sent on to the brain controls movement. At this point, your foot moves to touch the brake. This is an automatic response based on past experience. It’s thought that our brain leaves a ‘marker’ whenever it encounters a threat, allowing it to respond more quickly than the same kind of scenario occurs again.

Why is the important? Well, there’s evidence to suggest that this ‘automated response’ allows experienced drivers to react earlier to hazards. The process only seems to develop with repeated exposure to different hazards and road situations. This could explain why experienced drivers are better able to avoid risky situations than inexperienced drivers.



Hearing loss is one of the most common conditions affecting older adults. Nearly 9 million adults in the UK suffer from some form of hearing difficulty from total deafness to slightly hard of hearing. Over a third of those affected are yet to seek help. Hearing loss tends to creep up on you, rarely is it sudden, although sadly it does happen. More often it is a slow and gradual loss and this can be difficult to recognise, especially if you are over 50 years old.

What are the signs?

  • Television or Radio up very loud.
  • Strain to hear family and friends.
  • Miss the odd word in conversation.
  • Certain sounds appear muted and dull.
  • Can’t hear car hooting.

1 in 4 people over 50 have a hearing loss. It is important to heed the signs and help as soon as you can. The longer you leave getting a hearing aid the more likely your hearing loss will increase. Your hearing nerve needs to be kept stimulated to maintain hearing health.

Does it matter, when I’m driving?

Yes, because you have an increased risk of an accident.

Deaf people often have great difficulty detecting any outside warning sounds because of the noise of the engine and the sound proofing in modern vehicles.

Slight or medium hearing loss, do present a hazard to themselves and other road users. Unlike total deafness, hard of hearing drivers without the help of a hearing aid are unlikely to be able to apply 100% concentration to the task of driving.

So what I can I do about it?

  • Read the latest copy of the highway code (book or online)
  • Get a hearing test
  • Wear hearing aids if necessary
  • Take an advanced driver course to learn other techniques and aids that can help you drive

Attention and concentration

The way you think and feel affects how well you drive. Your thoughts and feelings have an impact on how vulnerable you are to internal and external sources of distraction while driving. For example, feeling stressed about being late might make you more prone to mental distraction. Your thoughts and feelings also have an impact on your hazard perception skills. For example, driving too fast because you think you’re not at risk will mean that you’re less able to perceived hazards, given the increased information flow.

What are you thinking?

Your beliefs or ways of thinking are fairly consistent patterns of thoughts or ‘attitudes’ that determine the way you interpret or make sense of what’s going on around you and the behaviour of other road users. To become a safer and more confident driver, you need to understand the beliefs and thought patterns that underpin the way you drive.

You may not be aware of the perceptions and expectations you hold or have even questioned whether the way you think about other road users is valid.  These ‘hazards in the mind’ can lead to intentional or unintentional risk raking.

How are you feeling?

While you may not be consciously aware of the way you think and how this influences your driving behaviour, you can be consciously aware of how you feel when driving. You may find yourself acting on your feelings and expressing them behind the wheel without linking these feelings with your thought processes. Your feelings are an essential part of your decision making as a driver.

Assess your way of thinking and feeling

There’s a clear link between your thought processes, your feelings and your behaviour. In order to discover this link, you need to reflect and gain insight into the way your mind works when you’ve driving.

Driver beliefs and feelings can take many forms. It’s impossible to list them all, but you can ask yourself what some of your beliefs might be and how they affect the way you feel.

Sometimes the way you feel as a driver can affect your thought processes. At the same time, the way you feel in response to driving-related events helps to develop your beliefs.

Once you’ve identified the way that your thought processes are affecting the way you feel, you can take action to change the way you look at different road and traffic situations.

You can also try to separate your thoughts and feelings from your driving skills.


Memory, Insight and Understanding

Some driving tasks create a greater mental workload than others, Junctions can be particularly challenging in terms of the amount of information you have to process. At a junction you need to make a solid assessment of the speed and distance of oncoming vehicles, sometimes in both directions.

Driver behaviour is influenced by motives, attitudes, emotional responses to traffic, personality traits, lifestyle, etc, whereas driver skill is related to your ability behind the wheel. This includes your knowledge of the Highway Code and your technical skills in manoeuvring the vehicle. It’s possible to have excellent driving skills but very poor driving behaviour.

Driving is an activity that provides you with a large element of control over how you interact with your vehicle and other road users. This primary goal in driving is to reach a destination, but this ultimate goal comprises many other associated goals, such as reading the destination quickly, comfortably, enjoyably and safely. In order to fulfil these goals, a wide range of tasks must be performed by you the driver. To perform these tasks well, you need to have the right mental skills.

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