Changes to funded brands of Epilepsy Medication, effective 1 October 2019
Pharmac have recently announced there will be changes to funded brands of Epilepsy Medication, effective 1 October 2019. The Transport Agency’s primary concern is road safety, and while we will not be enforcing a mandatory stand-down period from driving as we do when licence holders undergo a withdrawal of treatment, as a precaution we will be recommending that health practitioners whose patients have or will be transferring brands consider a voluntary stand down from driving during the eight-week early transition period after switching medications, should they have any concerns when considering an individual patient’s medical history and other relevant factors.
Additionally, we encourage anyone with concerns about the potential side effects as a consequence of changing brands to consult with their health practitioner or specialist before continuing to drive. Health professionals are often best placed to make a determination in respect of a person’s driving ability, by considering the patient’s medical history and other relevant factors that may only be known by their health practitioner.
Who must have a medical certificate?
Some drivers must have a medical or eyesight certificate to apply for or renew a driver licence or endorsement – drivers who:
- are applying for or renewing a heavy vehicle licence (class 2,3,4,5) and who’ve not provided a certificate within the last five years
- are applying for or renewing endorsements for passengers (P), vehicle recovery services (V), driving instruction (I) or testing (O) and who’ve not provided a certificate within the last five years
- have a medical condition that may affect their ability to drive safely
- are 75 years old or more and applying for or renewing any licence or endorsement
- we have asked to provide one.
The evidence we require is a medical or eyesight certificate:
- supplied by New Zealand registered health practitioner(optometrists, ophthalmologists, general practitioners, registered nurses, nurse practitioners, neurologists and occupational therapist driving assessors)
- not more than 60 days old.
Use the guide for medical assessments
Placing licensing restrictions on a driver is a serious matter. But so are the consequences of allowing someone to continue to drive if they are unfit to do so.
We’ve produced Medical aspects of fitness to drive: a guide for health practitioners [PDF, 1.1 MB] to set out your responsibilities and guide you in assessing a person’s fitness to drive.
Have concerns about an older driver?
If you’re satisfied that an older person (75 years+) is medically fit but have concerns about their ability to drive safely, you can recommend that they sit an On-road Safety Test.
Simply tick the box for this recommendation on the NZ Transport Agency pre-printed medical form. The driver licensing agent will then arrange the test when the person presents their medical certificate.
Conditions you can recommend
You can recommend conditions to be imposed on a driver’s licence to improve their driving safety. Commonly imposed conditions include:
- Correcting lenses must be worn at all times while driving.
- Only vehicles with an automatic transmission may be driven.
- Vehicle must have rear view mirrors on both sides.
- Must not drive during the hours of darkness.
We’re here to help
While you have a responsibility for making recommendations about licence conditions, we have the responsibility of imposing them. If you have any concerns about a particular case, please write to our Chief Medical Adviser at the Transport Agency's Palmerston North Office
The Land Transport Act 1998 and associated Driver Licensing Rule previously limited fitness to drive assessments to general practitioners, optometrists and occupational therapists.
Under law changes that came into effect on 8 November 2018 appropriately qualified nurse practitioners and registered nurses, working within their scope of practice, will also be able to carry out a fitness to drive assessment.
These changes were enacted by the Land Transport Amendment Act 2016. For example, references in section 18 of the Land Transport Act to a 'medical practitioner or optometrist' are replaced by 'health practitioner'.
This change reflects New Zealand's changing health care environment and recognises that, for example, appropriately qualified and competent nurse practitioners and specialist registered nurses have the expert clinical knowledge and skills to assess fitness to drive.
Scope of practice is defined in the Health Practitioners Competence Assurance Act 2003.
Section 8 of that Act makes it clear that health practitioners must:
- have a current practising certificate issued by the responsible authority (such as the Nursing Council of New Zealand)
- not practise outside their scope of practice unless permitted to do so by the scope of practice
- perform that service in accordance with any conditions stated in the scope of practice.
Responsible authorities are responsible for defining scopes of practice, which can include a description of tasks commonly performed by that profession (section 11 of that Act).