DVLA / Bus Driver / Frustration

[heronaddict]

Hello everyone.

My wife registered me on this forum whilst I was having my cryo ablation Oct 2019 and it has been a great help to read other peoples journeys.

Thank you all and thank you Joanne !

I was ablated at Barts by Dr Malcolm Finlay end of last Oct and thankfully no problems (apart from a few ectopic beats and anxiety about it returning)

I'm on 20mg rivaroxaban & 2.5 bisoprolol.

My first bout of a/f was way back in 2011 & again in 2012 each time 6 or 7 days at Whipps Cross in east London

In 2011 I self reverted with meds and was discharged.

I am a 55 year old London bus driver.

Informed DVLA and was surprised to learn I needed to be in sinus rhythm for 3 months before being allowed to return to work. So, paperwork was sent, everything went ok, a quick company medical and conference call with DVLA and back to work I went.

In 2012 I had a follow up appointment approaching, so when a/f returned, I waited a few days to get their opinion instead of going to A&E. Of course, they kept me in ! By this time, I had developed a clot which needed thinning before a planned cardio-version. Again, as in 2011, three months, DVLA, medical & return to work.

My memory is fuzzy as this is so long ago, but there about !

Skip forward to June 2019.

I arrive for work, it is a hot ish day, but I feel sweatier than normal. I instantly know, having experienced it twice before that something is not right. A quick check of pulse tells me a/f has returned. I go sick before starting my shift and take myself to Whipps Cross. I am straight through to the recovery room and I am moved to the Acute assessment unit. After 4 days of meds I am still in a/f and it is decided I shall go to Barts morning of day 5 for cardio version.

Off to Barts where after 12 hours of nil by mouth I self reverted. To say I was furious with myself would be an understatement.

Back to Whipps for a night then discharged and put on waiting list for cryo ablation. I am now in sinus rhythm on my daily meds.

This is where the whole circus began again.

Back to DVLA , VOCH1 & D2 forms.

I filled them in using info from my discharge letter and waited. And waited.

Weeks passed and I regularly call DVLA but no response from Dr Wae Chong Chow.

Only after 6 weeks do I learn that the above Dr does not work at WX but at Barts.

Try again with new forms with correct consultant.

Better results this time, ball moves forward and company medical arranged.

I am now up to 3.5 months off work

The night before medical, you can guess, I went into a/f

Medical cancelled and back to A&E

Again, kept in for 6 days & cardio verted before discharge and waited for cryo appointment date. And waited..

After lots of phone calls to nurse specialist at Whipps discover I am not on any cryo ablation waiting list. Despair is setting in now.

After another couple of weeks, I get letters telling me my cryo date at Barts, end of Oct 2019. Yippee, excitement at last.

Cryo goes fantastically.

Brilliant team at Barts, nothing but praise for everyone.

Another round of paperwork for DVLA

VOCH1 & D2

Then wait.

Another medical required, which thankfully this time goes without any hitches. Then wait

What should have been a 6 week period of no driving has stretched into 6 months. I find this hard to believe myself as I type it.

My new licence arrived today and I am about explore returning to work.

Apologies for such a long post.

I have been frustrated for so long with the bureaucracy of DVLA paperwork and I am terrified if my A/F returns I will be in for another marathon wait.

My underlying question for any professional drivers on this forum is where I went wrong ?

Should I have been more demanding of DVLA ?

From experience, I know they read from a script when you call and just give an update of where they are at that moment and never answer any specific medical queries.

Are there any other bus drivers on this forum been through this too ?

Again, thank you all for showing me there are others with this condition. It is hugely encouraging to read the successful journeys of other sufferers

Many thanks

Trevor H

[BobD Volunteer]

Our long term member Carnueny is a bus driver in Cornwall so hopefully will answer very soon.

[heronaddict in reply to BobD]

Thank you BobD.

I realise it all water under the bridge now, but I would just appreciate clarification that I'm going about it the right way. ie is it a straight 3 months or is that a flexible amount of time.

I'm generally pessimistic that this will,at some point, return and would rather not have another saga !

Again, grateful of your interest

[jeanjeannie50]

Hidden - can you help here please?

[Hidden]

You can never find a bus driver when you want one.....😉

[jeanjeannie50 in reply to Hidden]

He's probably at work.

[Hidden in reply to jeanjeannie50]

Hold very tight please.....🛎🛎

[heronaddict]

Haha ! Then two will come along together

[heronaddict]

What a mess

I totally agree with the squirming !

It does make me think, if God forbid a next time, keep my mouth shut.

Call work, self cert for a week ( I'm usually right as rain within a week whatever the treatment) return to work tell them it was a stinking cold !

Of course I'd never do this, I'd worry myself to death.

Thanks

[heronaddict]

Thanks for that.

I never realised it was that ambiguous.

I always assumed I should stop until I'm told to resume. Next time (hopefully no next time) I will continue to drive until told to stop .

[heronaddict]

Agreed. Cheers

[Hidden]

G'day Trevor,

Apologies for my slow reply ........... as jean rightly said I've been out there in pixieland driving my bus.

At the outset I must say I've not read or heard of such a disaster as yours.

So, a bit of background .......... my AF mugged me at the age of 65 in Jan 2010, so my experiences with my Cardio consultant, GP and Medical Services at DVLA are now very dated. Yes I did have a problem with them, I now cannot recall the details.

I do recall my GP phoning up ( on what appeared to be a direct line to DVLA and going right off his brain). Several days later I received a letter authorising my return to work.

Now there is a key document you need to get hold of, my copy is now dated but you should be able to get it off DVLA website.The document is a DVLA publication ;

FOR MEDICAL PRACTITIONERS

AT A GLANCE GUIDE TO THE CURRENT MEDICAL STANDARDS OF FITNESS TO DRIVE

My copy is dated September 2009

Again, on my old copy there is page 20 and it lists cardiovacscular disorder and it discusses Atrial flutter/fibrillation ....................now I'll quote ..............

GROUP 2 ENTITLEMENT VOC - LGV/PCV

Disqualifies from driving if the arrythmia has caused or is likely to cause incapacity.

It then goes onto comment ..............

Driving maybe permitted when;

* the arrythmia is controlled for at least 3/12

* the LV ejection fraction is = to or greater than 0.4

* there is no other disqualifying condition.

This document may well give you some understanding of the system.

One thing ............ did you ever get a letter from DVLA asking you to agree to a search of your medical records ( held anywhere in UK ). I did and signed it off and this established a data protection link between DVLA Medical Services and my consultant and my GP.

Although reading your stuff again its a bit academic.

Where did you go wrong .......... dunno mate in all honesty, I rather think you have been an innocent victim of an ungodly bureaucracy. If I were able to, DVLA is a government instrumentality that I would hold of commission of inquiry as to the way it meets its charter ......... if it has one ! That place is a total mess and has been for years. And it gets worse each year.

In my view if you can prove in writing from a medical practitioner ( say your GP .... I would imagine your consultant has sent him a letter telling him he is finished with you and returning you back to his care. If this is the case your GP has to provide you with documentation answering the three asterisks I've listed above.

Another option is to lodge an appeal as to any decision they have made.

Finally, ( and I have done this in respect of my local NHS Hospital Trust on a non cardiac issue) Make a formal complaint about the performance of DVLA ( or your GP, or whoever) to your Member of Parliament and ask that as a matter of urgency he/she investigate the delays generated by this matter.

You would need to carefully document everything.

Mind you again , if you are exploring a return to work at the moment all of this may be irrelevant.

Are you still on sick leave from your bus company ? Do you plan to continue with bus

driving ? Have you ever involved the Union in this matter ?

How have your company HR Dept treated you ?

I don't suffer fools gladly I'm afraid and I would have kicked ass with my MP long before this ...... problem is though, it isn't a quick process .... but what it does do is expose the pure administrative bungling that DVLA itself manages to hide and squirrel away from a more wider and detailed scrutiny.

I am so sorry to read of all your troubles and I know that my comments now are very late in the day BUT if you want to ask any questions just fire away. No worries.

I do recall when I was fit to return to driving my company opted to put me on light duties for several weeks and this varied from undertaking route training with newbie drivers, then after that it was very much short fairly straightforward shifts ( no split shifts) and progressively working up to handling a full on shift.

At the time I was with First ( Surrey & Berks) based at Bracknell in those days, and they were excellent.

So, I'm no industrial expert but I think you have a right to a gradual, light duties, slow phased return to work. Indeed I think industrial law prohibits them from doing other wise.

anyway Trevor, the offer is there if you want to go over any questions on my experience.

Hope my ramblings above make some sort of sense.

Stay safe,

John

[heronaddict in reply to Hidden]

Hello John

Thank you for taking the time to reply, I can guess it is a very stressful time to be working.

My main reason for sharing my experience is to prevent a merry go round of bureaucracy

if God forbid it happens again ( being a glass half empty kind of person I'm sure it will !)

What bothers me most though, is the ambiguity of "official" advice and guidelines.

Below, I've put links to DVLA medical advice and another text copied from Patient.info which appears to be advice for medical professionals (this may be out-dated)

I am trying to put all the hospital admissions and cardio version behind me and focus on post op cryo-ablation. I had the cryo on Oct 31 2019

Patient.info suggests a two week period before resumption of driving "For arrhythmia not causing or likely to cause incapacity"

Mine has never caused any incapacity.

patient.info/doctor/cardiov... (not sure if you will be able to open this link without creating an account )

Where as on DVLA medical web page advice is :

"Bus, coach or lorry licence

You must tell DVLA if you’ve had a catheter ablation. You must not drive for 6 weeks after your treatment.

Fill in form VOCH1 and send it to DVLA. The address is on the form.

and also this from DVLA

gov.uk/arrhythmia-and-driving

Apologies if I have doubled up any info/links ! I'm even beginning to confuse myself !

I appreciate every case is different and mine is now hopefully resolved for some time at least.

It just bothers me that there appears to be no hard and fast official advice and frustrated that what should have been maximum 6 weeks post successful ablation turned into 6 months. *

* I need to remind myself that during this time, ejection fraction needed to be confirmed by my consultant which took 4 weeks.

Like my wife says, I have the wrong condition for the right job !

I don't expect anything to be resolved from this post. I think I am really just typing my thoughts and moans just to make myself and others to be more wary in future as to how letters being sent, forms being filled and waiting for replies and results can run into weeks/months !

Appreciate your advice everyone

Keep well

[Hidden]

Hi Trevor,

I have read of your litany of a disaster and still find it unbelievable.

I have also looked again at my reply.

I thought perhaps I would add my own experience.

My AF ‘bus route’ was quite different to yours. I started off feeling as if I were going down with a dose of ‘flu. During that day my BP chucked a wobbly and finally decided to fall. Back in the day (Jan 2010) my normal BP was around 136/80, with a heart rate of 85 to 90 bpm plus some. By late afternoon my BP had fallen to around 76/50, so I rang my GP.

Long story short I ended up in A & E at East Surrey hospital in Reigate and the duty Dr. there

diagnosed my AF where I was then incarcerated for 5 or 6 days. My HR then was around 156 bpm.

So, my AF was diagnosed, roughly in about 9 hours of onset of feeling like flu coming on.

Brilliant.

Over those few days I was subjected to a whole range of tests and eventually discharged back to the care of my GP and put on Warfarin and Bisoprolol. ( which I am still on and will be for life).

Between 2007 and Jan 2010 I was already put on statins and BP meds - these never, and still

haven’t changed).

I’d always reckoned I’d led a pretty healthy lifestyle ( oh! how many times have I read this on here from AF’ers) so all this blew my mind.

I joined the former AF forum ( but now defunct) hosted by Yahoo. This is where I met ( in a virtual sense ) BobD and MarkS and learned about the Vagus (Vagal) nerve. In my time at home

rehabilitating ( those dreaded 3/12 of a year) I read up as much as I could about this mongrel condition. This in turn made me look more closely at my lifestyle and my body behaviour. As the months went on and I returned to work I identified the ongoing short bursts of AF with food I’d eaten. Symptoms were, thank goodness not all at the same time, bloating, massive and painful bloating, diahorrea, burping and intestinal gurgling. GP had me checked out for both IBS and Coeliac Disease. All clear.

I then consulted an Nutritionist who put me on a course of Probiotics and suggested going

Gluten Free. I did and over time widened the scope of my diet. It was a long slow process taking from Sept 2011 to April 2015 but it eventually restored my gut and digestive system health and reduced progressively my AF events. I then managed to go through to February 2018 without any AF events at all. I had an AF event one night, about 2 am, it lasted about 4 or 5 hours and subsided. My BP took another 21 hours to return to normal.

No AF since Febraury 2018, although I have occasionally experienced rapid HR at times, usually when on a motoring trip and after eating at motorway services.

I am an old git now and my PCV licence is renewed each year, subject to a medical, on grounds of age. Thus far I have passed each medical each year.

Interestingly, a mate of mine decided to retire and handed in his PCV, but, retained his otherwise full licence categories, notably car, and they made him have a full blown medical before they’d reinstate his car licence. This DVLA mob are certainly weird. Personally, I loath them.

Nevertheless, disregarding my personal and disparaging views on DVLA it is wise to keep a

perspective on this. In the last 2 to 4 years there have been several serious accidents involving HGV and PCV licence holders which later police enquiries have found the drivers wanting for either making false declarations on their driving licence medical forms, or in some other way flouting the medical regulations. I think DVLA have had to at least appear to be tightening up. Its the process that is the problem ! Absolutely no consulation to you at all - Lol!

The key thing is get a copy of the document I referred to and carefully understand the wording the the bit about the 3 asterisks - noting the wording arrythmia disqualifies you from driving if it has caused or is likely to cause incapacity. This is where you nail your consultant and/or GP to the cross. You have to force them to make a committment to one or the other. They just cannot willy nilly dream on. The key feature here is .......... they have to state that you either were or still are incapacitated. This is the bit where following a DVLA ruling/judgement you have the right of appeal.

In a legalistic sense an appeal has to be about the process leading to a judgement and if that process involves so called ‘expert’ decisions which have been inadequately or improperly

applied/made then it becomes a whole new world. I used to be the local Unite Union rep when at First and I forget how many disciplinaries and appeals I was involved in and won simply because

management and/ or other authorities never followed the legal and correct process.

Hope that's of interest and of some help.

John

.

[john-boy-92]

As a Group 2 driver the requirements are higher. Secondly, if it''s like the vision section of the DVLA, the applications are reviewed by administration grade workers using detailed instructions, before going to a DVLA doctor who isn't a specialist (in other words medically the same as a GP). It then depends on the policy at the time. In 2016 I had a stroke that caused the loss of part of the right peripheral vision. I lost my Group 1 (car) licence because of the adopted EU requirement for a 120 degree horizontal visual field. Around 8,200 lose their Group 1 licence each year due to vision. There is a process called "exceptional case" where after a minimum of 12 months you have a cognitive, physical, and driving assessment to either have driving lessons, return of the licence, or in affect a lifetime driving ban. In 2017 the expert advisory panel said that exceptional case drivers should have pre-assessment driving lessons; the DVLA didn't implement it. I found out last week that because the DVLA believed pre and post-assessment driving tuition should be with an ADI in a dual control car, but could not require it in law, nobody received training. I have an FOI request in at the moment to find out how many regained their licences.

That's a long way to say that there was nothing you do. If you read the Parliamentary Ombudsman report of October 2016, "Driven to despair..." about the failings of the DVLA, you will understand what you're dealing with.

[heronaddict]

Thanks for that john-boy-92, I shall look into that

Cheers