If you drive a lorry, bus or coach for a living and you have had a heart problem, the DVLA will usually want to see the result of an exercise test before it gives your Group 2 licence back. For most drivers that test is the thing standing between them and their income, and the wait for one through the NHS can run to months. This guide explains who needs the test, what the DVLA actually asks for, what counts as a pass, and how to prepare so you give yourself the best chance.
Who this applies to
Group 2 means the licence categories for lorries and buses (C, CE, D and DE). The rules for ordinary car and motorbike licences (Group 1) are much lighter and mostly do not involve an exercise test at all. For Group 2 drivers, the DVLA's standards say an exercise or other functional test is needed after:
- A heart attack or acute coronary syndrome. You must stop driving and tell the DVLA. You may be relicensed after at least 6 weeks if your heart's pumping function (ejection fraction) is at least 40% and you meet the exercise test requirements.
- A stent (elective coronary angioplasty, PCI). The same: at least 6 weeks off, ejection fraction of at least 40%, and the exercise test requirements met.
- Bypass surgery (CABG). At least 3 months off, ejection fraction of at least 40%, and the exercise test done at least 3 months after the operation.
- Angina. You must not drive while you have symptoms. You may be relicensed once you have had no angina for at least 6 weeks and you meet the exercise test requirements.
- Established coronary heart disease more generally. The DVLA expects a repeat functional test at intervals of no more than 3 years while you hold a Group 2 licence.
Those are the DVLA's own words, from Assessing fitness to drive: a guide for medical professionals, last updated in November 2025. Other heart conditions have their own rules, and the DVLA, not the clinic, makes the licensing decision.
What the test involves
The DVLA's default test is a treadmill exercise test using the Bruce protocol. You walk on a treadmill that gets faster and steeper every three minutes, while a 12-lead ECG records your heart continuously and your blood pressure is taken at each stage. A cycle test is an acceptable alternative for people who cannot manage a treadmill.
The Bruce protocol starts gently and builds:
- Stage 1 (minutes 0 to 3): a slow walk, 1.7 mph, on a 10% slope.
- Stage 2 (minutes 3 to 6): 2.5 mph on a 12% slope.
- Stage 3 (minutes 6 to 9): a brisk walk, 3.4 mph on a 14% slope.
For the DVLA you need to complete those three stages, which is 9 minutes. Stage 3 is a genuinely brisk uphill walk, but you are not asked to run. The whole appointment, including setting up the electrodes and a recovery period afterwards, takes about an hour.
What counts as a pass
The DVLA's guidance sets out exactly what the test must show. You need to complete 3 stages (9 minutes) of the standard Bruce protocol without signs of cardiovascular dysfunction, which the DVLA defines as:
- no angina (chest pain or tightness) during the test,
- no fainting,
- no fall in the top blood pressure reading of 20 mmHg or more,
- no heart rhythm disturbance that needs treatment, and
- no ECG changes that a cardiologist interprets as a sign of reduced blood supply to the heart muscle, during the exercise or the recovery period. The usual threshold is a 2 mm ST-segment depression or elevation.
That last point is why the test needs to be reported by a cardiologist rather than simply printed out. The DVLA wants a doctor's interpretation of the trace against each of those criteria, and a good report states each one in turn.
Do I have to stop my heart medication?
No. This is a common worry because older advice said anti-anginal tablets had to be stopped for 48 hours before the test. The current DVLA guidance is clear that discontinuing anti-anginal medication is not required. That covers nitrates, beta-blockers, calcium channel blockers, nicorandil, ivabradine and ranolazine. Never stop a heart medicine for a test unless the cardiologist looking after you has specifically told you to.
How to prepare
- Wear trainers and loose, comfortable clothes you can walk briskly in.
- Eat a light meal at least two hours before. Avoid caffeine, alcohol, smoking and heavy exercise for three hours before.
- Bring a list of your medications and a note of your cardiac history, including the dates of any heart attack, stent or surgery and, if you know it, your most recent ejection fraction.
- Small patches of chest hair may need to be shaved for the electrodes to stick.
- Tell the clinic in advance if you have had chest pain at rest, a recent hospital admission, or any new symptoms. A treadmill test is the wrong test for someone who is currently unwell.
Book a DVLA exercise ECG
A symptom-limited Bruce protocol treadmill test with continuous 12-lead ECG, blood pressure and oxygen monitoring, supervised and reported by Prof Jawad Khan, Consultant Cardiologist. £250, appointments typically within days, no referral needed.
Book a DVLA exercise ECGWhat happens after the test
You receive a written report from the cardiologist that addresses each DVLA criterion, together with the ECG tracings. You, or your GP, send that to the DVLA as part of your medical questionnaire or D4 assessment. The DVLA makes the decision, not the clinic. Our job is to run the test to the standard and report it clearly.
If the test is not passed, that is not the end of the road. It usually means something needs looking at before you drive professionally again, and the cardiologist will say what: a review of your treatment, further investigation, or simply a repeat test once symptoms have settled. Finding that out on a treadmill in a clinic is far better than finding it out at the wheel of a 44-tonne lorry.
Why drivers come to us
NHS exercise tests are prioritised for people with new symptoms, so a licensing test can sit on a waiting list for a long time while you cannot work. At OneMedicine the test is £250, fixed, with no consultation fee on top, and appointments are typically available within days. It is supervised and reported by a consultant cardiologist on a hospital-grade GE stress-testing system, at our CQC-registered clinic in Kings Heath, Birmingham, opposite the railway station with on-site parking. You do not need a referral, though we are happy to work from one.
When to see a doctor first
If you are having chest pain now, at rest or on light exertion, or you have had a recent hospital admission, do not book a treadmill test to try to push through it. See your GP or cardiologist first. And if you have severe chest pain, breathlessness or collapse, call 999.
Book a DVLA exercise ECG
Book online with OneMedicine, a CQC-registered clinic in Kings Heath, Birmingham. Supervised and reported by Prof Jawad Khan, Consultant Cardiologist, on a hospital-grade GE stress-testing system. £250, no consultation fee, no referral needed. Read about the test.
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Specialist interest: Cardiovascular Medicine · OneMedicine, CQC-registered clinic