Why HGV Drivers Have Stricter Medical Standards
Professional HGV drivers are subject to Group 2 medical standards set by the DVLA, which are considerably more stringent than the Group 1 standards that apply to ordinary car drivers. This reflects the greater responsibility that comes with operating a vehicle that can weigh up to 44 tonnes and cause catastrophic consequences in the event of a medical episode at the wheel. The Group 2 standards are set out in the DVLA's guidance document "Assessing Fitness to Drive — A Guide for Medical Professionals" (commonly known as the "At a Glance" guide), which is updated periodically and is the definitive reference for both drivers and their doctors.
All professional HGV drivers must hold a valid medical certificate (the D4 form) and must notify the DVLA of any medical condition that may affect their fitness to drive. Failure to notify the DVLA of a relevant condition is a criminal offence under the Road Traffic Act 1988 and can result in prosecution, a fine, and the loss of the driving licence.
The D4 Medical Examination
The D4 medical examination is the formal assessment of fitness to drive for professional drivers. It is conducted by a doctor registered with the DVLA and consists of a physical examination, an eyesight test, and a review of the driver's medical history. The doctor completes the D4 form, which is submitted to the DVLA as part of the licence application or renewal process.
The cost of a D4 medical is not covered by the NHS and must be paid by the driver or their employer. In 2026, the typical cost ranges from £50 to £120, depending on the doctor and the location. GS Driver Training can recommend local doctors who offer D4 medicals efficiently and at competitive rates — contact us on 01252 447808 for a referral.
Medical Renewal Frequency
| Age | Medical Renewal Frequency |
|---|---|
| Under 45 | Every 5 years |
| 45 to 65 | Every 5 years (some conditions require more frequent review) |
| 65 and over | Annually |
Vision Requirements
Vision standards for Group 2 drivers are more demanding than for Group 1. The key requirements are as follows. The driver must be able to read a number plate at 20 metres (with glasses or contact lenses if worn). The visual acuity in the better eye must be at least 6/7.5 (Snellen) and in the worse eye at least 6/60. The horizontal visual field must be at least 160 degrees, with 70 degrees on each side and 30 degrees above and below the horizontal. Monocular vision (sight in one eye only) is generally disqualifying for Group 2 driving, though there are limited exceptions for drivers who had monocular vision before 1 January 1997.
Cardiovascular Conditions
Cardiovascular disease is one of the most common reasons for licence refusal or revocation in professional drivers. The DVLA's standards for Group 2 drivers are as follows for the most common conditions.
| Condition | Group 2 Standard |
|---|---|
| Hypertension (high blood pressure) | Must be controlled to below 180/100 mmHg. Driving may continue if well-controlled on medication. |
| Angina | Must be free of symptoms at rest and during ordinary activity. Driving must cease if symptoms occur at the wheel. |
| Heart attack (myocardial infarction) | 6-week off-driving period minimum. Return subject to satisfactory exercise test and no disqualifying arrhythmia. |
| Coronary artery bypass graft | 3-month off-driving period. Return subject to satisfactory exercise test. |
| Pacemaker insertion | 6-week off-driving period. Return subject to satisfactory pacemaker check. |
| Atrial fibrillation | Driving may continue if rate is controlled and no disqualifying symptoms. Annual review required. |
Diabetes
Diabetes is a notifiable condition for Group 2 drivers. The standards differ depending on whether the diabetes is managed by diet alone, oral medication, or insulin.
Drivers with diet-controlled or tablet-controlled diabetes may generally continue to drive professionally, provided their condition is stable and they are not experiencing hypoglycaemic episodes. Drivers on insulin were previously barred from Group 2 driving, but this was changed in 2011. Insulin-treated drivers may now hold a Group 2 licence subject to annual medical review, no severe hypoglycaemic episodes in the preceding 12 months, and compliance with blood glucose monitoring requirements before and during driving.
Neurological Conditions and Epilepsy
Epilepsy is one of the most strictly regulated conditions for professional drivers. A driver who has had an epileptic seizure must cease driving immediately and notify the DVLA. To regain a Group 2 licence, the driver must have been seizure-free for 10 years without anti-epileptic medication. This is a significantly more demanding standard than the 1-year seizure-free period required for Group 1 (car) driving.
Other neurological conditions — including stroke, TIA (transient ischaemic attack), and brain tumours — are also notifiable and subject to specific DVLA standards. Drivers who have had a stroke or TIA must cease driving and notify the DVLA. Return to Group 2 driving is subject to a minimum off-driving period and satisfactory medical assessment.
Mental Health
Mental health conditions are notifiable if they are likely to affect safe driving. The DVLA's approach to mental health has become more nuanced in recent years, with a greater emphasis on individual assessment rather than blanket restrictions. Conditions such as depression and anxiety are generally compatible with continued Group 2 driving if they are well-managed and the driver is not taking medication that impairs driving ability. Psychotic conditions, severe personality disorders, and conditions requiring sedating medication are more likely to result in licence revocation or refusal.
Sleep Disorders and Obstructive Sleep Apnoea
Obstructive sleep apnoea (OSA) is a notifiable condition for Group 2 drivers. OSA causes repeated interruptions to breathing during sleep, resulting in poor sleep quality and excessive daytime sleepiness — a significant road safety risk. Drivers with OSA must notify the DVLA and cease driving until the condition is assessed and treated. Drivers who are compliant with CPAP (continuous positive airway pressure) treatment and are no longer experiencing excessive daytime sleepiness may be able to return to Group 2 driving subject to medical review.
Notifying the DVLA
Drivers must notify the DVLA of any medical condition that may affect their fitness to drive. Notification can be made online at gov.uk/health-conditions-and-driving or by completing a paper notification form. The DVLA will then assess the condition and advise whether the driver can continue to drive, must cease driving, or requires further medical assessment. Drivers who are uncertain whether their condition is notifiable should seek advice from their GP or the DVLA's medical enquiries team.
For drivers who are starting their HGV training journey and want to understand the medical requirements before investing in a course, GS Driver Training is happy to provide guidance. Contact us on 01252 447808 or visit our HGV Class 2 training page for more information.
