How to ride safely, by cyclist doctors who save lives


It is with tremendous sadness that we have seen three more cyclists die on the streets of London in the last three weeks.

These unfortunate people are the tip of the iceberg of patients and families that we see who have suffered as a result of cycling collisions.

We work in London’s major trauma centres and as part of the Air Ambulance team. All too often we have seen cyclists killed or severely injured on London’s roads but all three of us continue to cycle.

Cycling remains a wonderful way to commute and travel cheaply and remain fit and healthy in the process and so should continue to be encouraged.  However, it is naïve to think that it is completely without its risks. 

There have been numerous calls for changes to the infrastructure of roads and for cycle lanes to accommodate the growing number of cyclists on our roads.  As a critical mass is being reached there was a thought that the sheer number of cyclists would in itself provide a protection from injury. 

This has sadly not been the case as more and more cyclists are battling to share space with other vehicles.  Comparisons continue to be made with previous years and months, and London continues to be compared with other European countries.  Changing infrastructure and road design takes time.  We are falling behind and something needs to be done sooner rather than later to prevent more tragedies.

So what are the answers?  Road design, segregation and education are obvious but take time, money, political will and strong leadership.  What are we to do in the meantime?  How can we prevent another child this summer holiday being killed, how can we prevent another lorry turning left and running over a woman, how can we prevent a father, wife, son or daughter not returning home and a family being told the news that their loved one has been killed or seriously injured.

1. Avoid sharing roads with buses and HGV’s . Plan a route that uses smaller roads and safe cycle routes whenever possible. These routes may not be as direct as the major roads but they are so much safer. Maps, websites will help you plan your route. There seem to always be calls for compulsory helmet use after a cycling death. Whilst helmets are important our experience in pre hospital care suggests many of the cycling deaths occur when a vehicle has driven over the chest or pelvis causing terrible injuries. 

2. When you have to share a road with large vehicles remember they are bigger than you and you will definitely come off worse - so give them a wide berth. Keep another vehicle between you and an HGV. Undertaking large vehicles whilst at traffic lights and placing oneself in their blind spot runs obvious risks. Advanced Stop Lanes can place cyclists in the blind spot of lorry drivers high up in their cabs. Allow these lorries to pull away first.

3. Defensive riding. This places the cyclist in a position where they can be seen by all on the road.  Motorcyclists are taught to look over their shoulder before changing lanes and cyclists should do the same.

4. Be visible. Reflective clothing and lights at night are an obvious way of improving visibility. Eye contact helps to break down the barriers of the windshield and ‘humanises’ we commuters both cyclist and driver.

5. Wear a helmet. The issue of helmet use remains controversial but for obvious reasons they go some way to minimise brain injury. 

6. Use all your senses. It is always best to hear your enemy when they are close and headphones may not permit you to hear a vehicle close behind. 

7. Make your own decision about how ‘safe’ a cycle route is.  Cycle scheme routes are not yet dedicated cycle lanes and are far from exclusive. They are often shared and after 7pm some are filled with parked cars that then force cyclists to join the main carriageway at night.  Roads that have a simple white bicycle painted on the road are even worse.  The designers of these routes should consider cycling them daily and run the gauntlet along with the rest of us.   Some have termed the cycle scheme as little more than expensive blue paint and so treat them with caution.  The Cycle Scheme 2 route that runs along the Whitechapel road on which a young girl from France was killed is far from fit for purpose.  It may be wise to avoid them and take an alternative route where there is less traffic.  London has many parks and canals that make for far more picturesque cycling.

We wait with baited breath for the changes to our roads that that will allow HGVs to deliver much needed supplies, pedestrians to talk and be heard and children to be able to cycle to school without fear of injury.  This ‘Nirvana’ would win many political votes but actions have to speak louder than words.  In the meantime we ask that all road users make efforts to share the roads sensibly this summer so that we don’t have to continue to witness these terrible injuries that are entirely preventable but continue to needlessly cause suffering and death.

Mr Tom Konig-Trauma Surgeon and Pre Hospital care doctor

Dr Ali Sanders-Emergency Medicine Consultant and Pre Hospital care doctor

Mr Mark Wilson- Neurosurgeon and Pre Hospital care doctor