Being told you need an HRO medical can feel overwhelming. The letters from the DVLA are formal, the process is unfamiliar, and the stakes feel high. But the process itself is straightforward when you know what to expect. This guide explains what an HRO (High Risk Offender) medical involves, what the DVLA is looking for, what tests may be required, and how Medica Universal can support you — whether you are preparing in advance or booking your final medical appointment.
An HRO medical is a structured assessment carried out by a DVLA-approved doctor. It is a documented medical review, which includes either blood or urine testing, with the outcome decision resting entirely with the DVLA, not with the examining doctor.
Key takeaways at a glance:
| What you need to know | Detail |
| What HRO stands for | High Risk Offender |
| Who HRO medicals are for | Drivers disqualified for certain alcohol or drug-related offences |
| Where appointments take place | Heyward Road Surgery, Southsea |
| Who makes the final licensing decision | The DVLA — not the examining doctor |
| Expected timescale | Allow around 21 days from the date of the medical |
| Pre-assessment available | Yes — consultation, CDT blood testing, and advice |
If you have been asked to complete an HRO medical and want support before or during the process, Medica Universal offers both pre-assessment appointments and final HRO medical appointments. Contact us to find out more.
What is an HRO medical?
HRO stands for High Risk Offender. This is a category the DVLA uses for certain drivers who have been disqualified from driving, most commonly following alcohol-related offences. Before a licence can be restored, the DVLA requires these drivers to undergo a formal medical assessment carried out by an approved doctor.
The medical is not about judging you. It is a process the DVLA uses to gather clinical information before making a licensing decision.
Common reasons a driver may be classified as HRO include:
- A blood alcohol reading of 87.5 micrograms per 100ml of breath or above at the time of the offence
- Two or more drink driving offences within a ten-year period
- Failing to provide a specimen for analysis
- A medical condition related to alcohol or drug use identified during a previous DVLA review
Why has the DVLA asked me to have an HRO medical?
The DVLA requires an HRO medical as part of its licence restoration process. It is how the DVLA gathers the clinical evidence it needs before making a decision on your application. This is standard procedure for drivers who fall into the HRO category — it does not mean the DVLA has already made a decision against you.
The medical forms part of a broader assessment. The DVLA will review the completed paperwork, any test results, and relevant medical history before reaching its conclusion.
Who makes the final decision after an HRO medical?
The DVLA makes the final licensing decision — not the examining doctor.
Dr Sethi’s role is to carry out the medical assessment accurately and thoroughly, complete the required DVLA documentation, plus testing, and submit the relevant paperwork. He does not determine whether your licence is restored. That decision sits entirely with the DVLA, which reviews all submitted information as part of its own process.
It is a formal step in the DVLA’s review process.
What happens during an HRO medical?
The appointment is structured and methodical. Here is what to expect:
Review of medical and relevant history. Dr Sethi will go through your medical background, any previous or current health conditions, and the circumstances relevant to your DVLA case. This is a fact-finding review, not a cross-examination.
Physical examination. A clinical examination will be carried out as part of the standard assessment. This follows the format required by the DVLA.
Completion of DVLA paperwork. The relevant DVLA forms will be completed during or immediately following the appointment. These are submitted directly as part of the process.
Testing where required. Either blood or urine testing may be requested depending on your case. The most relevant blood test in HRO pathways is the CDT (carbohydrate-deficient transferrin) test, which is covered in detail below.
What to bring to your appointment:
- Your DVLA letter requesting the medical
- A valid form of photo ID (passport or driving licence)
- A signed photograph and declaration are accepted for those without standard photo ID (see your DVLA letter for this)
- Details of any current medications
- Relevant medical records if you have them to hand
- Your GP’s contact details
Where does the appointment take place?
HRO medical appointments with Dr Sethi take place at Heyward Road Surgery, Southsea.
This address may be different from the one shown on your DVLA letter. This is normal. Your DVLA letter refers to the doctor assigned to carry out your assessment. The actual appointment location is confirmed in the booking details provided by Medica Universal. Always follow the appointment confirmation you receive from us rather than the address on the DVLA letter.
If you are unsure where to go, contact us before your appointment and we will confirm everything clearly.
What is the CDT blood test?
CDT stands for carbohydrate-deficient transferrin. It is a blood marker that reflects alcohol consumption over a period of weeks rather than days.
In alcohol-related DVLA pathways, the CDT test provides clinical evidence about drinking patterns over time. It is not a test of what you drank the night before. It gives a picture of recent drinking behaviour over the preceding two to four weeks.
A raised CDT result does not automatically determine the outcome of your DVLA application. The DVLA reviews the full clinical picture as part of its decision-making process.
The CDT test may be required as part of your HRO medical. Some patients also choose to have CDT testing done in advance as part of a pre-assessment, so they can understand where their levels stand before the formal appointment.
At a glance: CDT testing CDT reflects alcohol intake over the preceding 2 to 4 weeks. A raised level suggests heavy regular alcohol use during that period. The test is a standard part of many HRO pathways and can also be arranged in advance through a pre-assessment with Medica Universal.
Can I have a pre-assessment before my final HRO medical?
Yes. Medica Universal offers a pre-assessment service for patients preparing for an HRO medical.
A pre-assessment can include:
- A consultation to go through what the HRO process involves and what to expect
- CDT blood testing, arranged locally through Portsmouth phlebotomy services
- A review of your results and what they may indicate
- General guidance on preparation
A pre-assessment does not guarantee any particular outcome at your final HRO medical. It also does not influence the DVLA’s decision. What it does is give you a clearer picture of where you stand before the formal appointment, so you can attend with greater confidence and without unnecessary surprises.
Medica Universal’s pre-assessment service is available to patients preparing for an HRO medical. To find out what is involved and whether it is right for you, contact us to discuss your situation.
How long does the process take?
As a general guide, patients are advised to allow around 21 days from the date of the medical for the process to move forward. This accounts for the time needed for any testing, completion and submission of paperwork, and the DVLA’s own review period.
Timescales can vary depending on the complexity of your case, whether additional information is requested by the DVLA, and how quickly test results are returned. The 21-day figure is a guide, not a guarantee.
If you are working towards a specific deadline, raise this when you book so we can advise you accordingly.
Can I request Dr Sethi for my final HRO medical?
If you have already attended a pre-assessment with Dr Sethi, you are welcome to request him for your final HRO medical where this is available. Dr Sethi has been carrying out HRO medicals since 2017 and is experienced in the DVLA’s requirements for this pathway.
Please note that Medica Universal does not control DVLA assignment. The DVLA may have assigned a specific doctor to your case based on their own processes. If Dr Sethi has been named in your DVLA correspondence, your appointment will be with him. If not, please contact us and we will advise you on the options available.
Frequently Asked Questions
What does HRO stand for?
HRO stands for High Risk Offender. This is a DVLA classification applied to certain drivers who have been disqualified, most commonly following alcohol or drug related offences. The DVLA uses this classification to determine when a formal medical assessment is required before a licence can be restored.
Who decides whether I get my licence back?
The DVLA makes the final decision on licence restoration, not the examining doctor. Dr Sethi’s role is to carry out the medical assessment, complete the required paperwork, and submit it to the DVLA. The DVLA then reviews all the information and reaches its own conclusion.
What is the CDT blood test?
CDT stands for carbohydrate-deficient transferrin. It is a blood test that reflects alcohol consumption over the preceding two to four weeks. It is commonly used in HRO pathways to provide clinical evidence of recent drinking behaviour. It can be arranged as part of a pre-assessment or may be required at your formal HRO medical.
Will I need a urine sample?
A urine sample may be requested as part of your HRO medical. This is not always required but can form part of the DVLA’s assessment process depending on the nature of your case. Your appointment confirmation will give you more detail, and you are welcome to ask when you book.
What should I bring to the appointment?
Bring your DVLA letter, a valid photo ID (passport or driving licence), or signed photograph and declaration if you do not have standard photo ID, details of any current medications, and your GP’s contact details. Having these ready helps the appointment run smoothly.
Where is the clinic?
HRO medical appointments with Dr Sethi take place at Heyward Road Surgery, Southsea, which is one of the sites of the Practice Group. This may be a different address from the one shown on your DVLA letter. Always follow the appointment confirmation sent by Medica Universal for the correct location.
Why is the address different from my letter?
Your DVLA letter names the doctor assigned to carry out your assessment and is sent to one of the main surgeries in the Practice Group. The appointment location is one of the quieter clinics with less footfall. These are not the same address. The booking confirmation from Medica Universal will always show the correct location for your appointment.
How long should I allow for the process?
As a general guide, allow around 21 days from the date of your HRO medical for the process to progress. Timescales can vary depending on test results, DVLA workload, and case complexity. If you have time-sensitive circumstances, mention this when you book.
Can I book a pre-assessment first?
Yes. Medica Universal offers pre-assessment appointments that can include a consultation, CDT blood testing through Portsmouth / local phlebotomy services, and a review of results. A pre-assessment does not influence the DVLA’s decision but can help you understand the process and feel better prepared.
Can I request Dr Sethi?
If Dr Sethi has been named in your DVLA letter, your appointment will be with him. If not, you can contact Medica Universal to ask about availability. Patients who have attended a pre-assessment with Dr Sethi are welcome to request him for their final HRO medical where this is possible.
Book an HRO appointment
Medica Universal offers two routes for patients going through the HRO process:
HRO Pre-Assessment — A consultation with Dr Sethi, CDT blood testing, Portsmouth phlebotomy, and a results review to help you understand your position before the formal medical.
HRO Medical — The formal DVLA-required appointment, carried out by Dr Sethi at Heyward Road Surgery, Southsea. Paperwork is completed and submitted as part of the appointment.
To book either appointment or to ask a question about the process, Contact Medica Universal today. We will confirm which appointment suits your situation and get you booked in as quickly as possible.