Jonathan Davies

The Driver and Vehicle Licensing Agency (DVLA) aims to make a licensing decision within 90 working days in 90% of cases where a medical condition(s) must be investigated before a licence can be issued. During this financial year the average time to make a licensing decision in such cases is 44 working days.

The DVLA’s online services are the quickest way to apply for a driving licence and drivers with diabetes, epilepsy, Parkinson’s disease, visual impairments, sleep conditions, or heart conditions can apply online. However, the DVLA is very often reliant on receiving information from third parties, including doctors, other healthcare professionals or the applicant themselves, before a decision can be made on whether to issue a driving licence. To help with this, the DVLA has introduced a simplified licence renewal process for drivers with glaucoma and some mental health conditions. This has significantly reduced the need for the DVLA to seek further information from medical professionals and enabled more licensing decisions to be made based on the information provided by the driver. The DVLA will consider including more medical conditions in this simplified process, as well as adding more medical conditions to its online channels.

Screening for prostate cancer is currently not recommended by the UK National Screening Committee (UK NSC). This is because of the inaccuracy of the current best test, called the Prostate Specific Antigen (PSA). A PSA-based screening programme could harm some men, as many would be diagnosed with a cancer that would not have caused them problems during their life.  This would lead to additional tests and treatments which can also have harmful side effects, for example sexual dysfunction and incontinence.

The UK NSC regularly reviews its recommendations. The evidence review for prostate cancer screening is underway and will conclude at the end of 2025.

The Department has been working hard with industry and NHS England to help resolve supply issues with some attention deficit hyperactivity disorder (ADHD) medicines, which are affecting the United Kingdom and other countries around the world. As a result of intensive work, some issues have been resolved and all strengths of lisdexamfetamine, atomoxetine capsules, and guanfacine prolonged-release tablets are now available.

We are continuing to work to resolve supply issues, where they remain, for methylphenidate prolonged-release tablets. We are engaging with all suppliers of methylphenidate prolonged-release tablets to assess the challenges faced and their actions to address them. We are also directing suppliers to secure additional stocks, expedite deliveries where possible, and review plans to further build capacity to support continued growth in demand for the short and long-term. We expect supply to improve in the UK throughout the rest of 2024. However, we anticipate supply to be limited for some strengths, and we continue to work with all suppliers to ensure the remaining issues are resolved as soon as possible. To improve supply chain resiliency, we are also working with prospective new suppliers of methylphenidate prolonged-release tablets to expand the UK supplier base.

We are supporting an ADHD taskforce that NHS England is establishing to examine ADHD service provision. The taskforce will bring together expertise from across a broad range of sectors, including the National Health Service, education, and justice, to help provide a joined-up approach in response to concerns around rising demand. In collaboration with NHS England’s national ADHD data improvement plan, we plan to combine modelling for future growth forecasts, which will be shared with industry to improve demand forecasting for ADHD medicines.

To minimise the impact of the shortages on patients, the Department has worked with specialist clinicians, including those within the NHS, to develop management advice for NHS clinicians to consider prescribing available alternative brands of methylphenidate prolonged release tablets or available alternative ADHD medicines. We would expect ADHD service providers and specialists to follow our guidance, which includes offering rapid response to primary care teams seeking urgent advice or opinions for the management of patients, including those known to be at a higher risk of adverse impact because of these shortages.

To aid ADHD service providers and prescribers further we have widely disseminated our communications and continually update a list of currently available and unavailable ADHD products on the Specialist Pharmacy Service website, helping ensure that those involved in the prescribing and dispensing of ADHD medications can make informed decisions with patients.

Decisions on the routine availability of licensed medicines for National Health Service patients in England are made on the basis of recommendations by the National Institute for Health and Care Excellence (NICE). NICE plays an important role in ensuring that medicines represent a clinically and cost-effective use of NHS resources before they are routinely funded. The NHS is legally required to fund medicines recommended by NICE, normally within three months of final guidance.

NICE aims wherever possible to issue recommendations on new medicines close to the point of licensing and started its appraisal of the medicine sipavibart for preventing COVID-19 ahead of the Medicines and Healthcare products Regulatory Agency’s decision. NICE’s appraisal process is however currently suspended as the manufacturer, AstraZeneca, has been unable to provide an evidence submission as planned. NICE is currently awaiting notification from AstraZeneca on when it can make a submission and will update stakeholders in due course.