Fitness requirements

The health rules for black cab drivers are being ever more strictly applied. In this article I am going to restrict myself to writing about my own speciality cardiology.

I am a senior cardiologist looking after all aspects of adult heart disease. I work in North London so I have many London cabbies as patients. They have encouraged me to develop a range of services specially aimed at the taxi trade.

Introduction

The health rules for black cab drivers are being ever more strictly applied. In this article I am going to restrict myself to writing about my own speciality cardiology.

I am a senior cardiologist looking after all aspects of adult heart disease. I work in North London so I have many London cabbies as patients. They have encouraged me to develop a range of services specially aimed at the taxi trade.

The Background

The DVLA set the health standards for all types of driving licence in this country. To drive a black cab you hold a Group 1 licence. This has much lower health standards than the Group 2 licences needed for lorry and bus drivers. In the last few years the government has instructed the taxi licensing authorities to apply the Group 2 health requirements to Taxi drivers even though they still hold Group 1 licences. The practical effect is that all taxi drivers need to demonstrate much higher levels of fitness than previously.

Read more: The Background

General Exercise Tests

The treadmill exercise (stress) test using the Bruce protocol

This is a test where you walk on a treadmill. The treadmill speeds up every three minutes and also becomes steeper. During the test your heart rate and rhythm and blood pressure are recorded. In addition the electrical signals from your heart are recorded on an ECG recorder.

Read more: General Exercise Tests

The Echocardiogram

This is an ultrasound scan used to measure the overall function of your heart muscle. The technical term for this is "LVEF" unfortunately TFL often use this without explanation in their correspondence. LVEF is simply a measure of the completeness of your heart emptying with each beat. In the normal heat this is in the range 50 – 70 %. To be able to drive a cab it needs to be at least 40 %.

Read more: The Echocardiogram

Rules for specific heart problems

1. Drivers who have had a heart attack:

  • At least 6 weeks after the attack
  • Free of angina for 6 weeks
  • Pass a treadmill exercise test (Bruce protocol)
  • May also need an echocardiogram

2. Drivers who have had an angioplasty / stent:

  • At least 6 weeks after the angioplasty / stent
  • Free of angina for 6 weeks
  • Pass a treadmill exercise test (Bruce protocol)
  • Echocardiogram to show LVEF is at least 40%

Read more: Rules for specific heart problems

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