Guidance

New statutory guidance around firearms licensing for chief officers of Police that was issued on 1^st November 2021. Following the publication of this guidance applicants are now required, at their own expense, to obtain a medical report as part of this new application process.

It is now the responsibility of the applicant for both grant, renewal, or variation to complete a medical proforma (usually downloaded from the local Police firearms licensing website) and submit this to their GP.

GUIDANCE TO THE POLICE – FITNESS TO BE ENTRUSTED WITH A FIREARM (publishing.service.gov.uk)

We welcome the fact that here is now standardised national guidance in place to ensure more consistent processes for the police, medical professionals and applicants. It ensures that no one is granted a firearms certificate unless their regular GP, or a suitably qualified alternative doctor with access to the full medical record, has confirmed to the police whether they have any relevant medical conditions. This includes any mental health conditions.

Wessex LMCs believes that GPs have a professional and moral duty to protect the public by facilitating the Police with the firearms licensing process, as existing health issues have been implicated in several fatal shootings involving individuals holding firearms certificates. The Plymouth shootings have crystalised this view.

The 2021 statutory guidance and the arrangements for medical checks for applications reflects the BMA’s significant contribution to its development.

Practices are entitled to follow the guidance issued by the BMA (which has been updated in light of the new Statutory guidance for Police officers issued on 1^st November 2021), and as this work falls outside of their NHS contractual obligations, practices may charge a reasonable fee for providing medical information to support an application.

The BMA also advises that practices may decline to provide a report. “GPs can refuse to engage in the firearms certification process on grounds of conscientious objection because of religious or ethical beliefs. They must inform the police.

Legal opinion is that a GP who refuses to engage on these grounds should have due regard to the GMC guidance. Although, this guidance is primarily written for the purposes of referral for procedures, treatments and interventions rather than the compilation of a medical report.

GPs need to take reasonable steps to notify their patients of their conscientious objection in advance. We would advise doctors to put a clear statement on their website and on notices in the practice.

In the BMA’s view, conscientious objectors do not need to arrange for alternative provision of a report.

Where access to a firearm is a professional requirement, we would encourage doctors to assist applicants in finding a colleague who is a GMC-registered doctor to help.”

When a patient applies for or is granted a firearms licence, practices are asked to place a Digital Firearms Marker ‘flag’ in the patient record to identify the patient as the holder of a firearms license. Adding the appropriate SNOWMED code to the patient record will create a Digital Firearms Marker. Once the Digital Firearms Marker is applied it will automatically trigger an alert to the GP when a triggering condition is added from the Digital Firearms Marker reference set. The Home Office has signed an agreement with the BMA to provide greater legal protection for GPs who place a firearms flag on the medical record, noting that the legal liability to monitor suitability for certificate holding rests with the constabulary and not with the GP holding a medical record with a flag on it.

DHSC has confirmed that although the act of a GP giving a medical report to the police in response to a firearms certificate application is private work, which would not be covered by CNSGP, they have reviewed the position and have agreed that the liability for actions or omissions to act following this initial report, in connection to monitoring the flag and notifying the police, can be covered by CNSGP. They are clear that there is no legal duty for a GP to act, as noted in the Memorandum of Understanding between the BMA, the Home Office and the National Police Chiefs Council, but the position on CNSGP cover is that should such a claim arise in relation to an act or an omission to act, it could be considered to be ‘in connection with the diagnosis of an illness or the provision of care or treatment’ under regulation 5(1)(b). If such a claim also results in personal injury or loss to the third party and meets the other criteria set out in regulation 5(1) of the CNSGP Regulations 2019, it would be in scope of the scheme.

The new statutory guidance for chief officers of Police issued on 1^st November 2021 addresses concerns that Wessex LMCs have been raising for a while in that it is now clear that Police cant issue firearms certificates without a completed medical form (whereas some forces have always assumed no returned form means no medical reason not to issue). The new guidance also clearly states that a suitably qualified GMC registered private clinician can complete the form for the patient (by requesting a copy of the patients GP record on behalf of the patient) so there is room for conscientious objectors and you can decline to complete the form and signpost to a private GP service or similar. When the medical information is being provided to the police by a doctor who is not the GP of the applicant, the doctor must receive the applicant’s full medical record direct from the GP practice and not via the applicant.

(Note that a patient can authorise their solicitor, or another third party acting in their interests, to make a SAR on their behalf. It follows therefore, that they may authorise their private clinician to make a SAR (with signed consent) for the purpose of accessing the full medical record in order to complete the firearms report)

The statutory guidance reaffirms that GPs can charge prior to completing the firearms report report. It is up to you to decide what a ‘reasonable’ charge is. It is also clear that the GP isn’t giving an opinion as to whether a licence should be issued, this responsibility remains entirely with the police.

Where there is a reasonable belief that an individual holding a firearms licence may represent a danger to themselves or others, doctors should ask them to give up their licence.

Where a new condition of concern is added to the records of someone with an existing licence or with an application in progress, the GP should contact the patient to advise them that they must contact the police to update them with the new information.

If there is sufficient cause for concern, or if the GP believes that the patient has not informed the police then they (the GP) should inform the police directly who will take any necessary further action. Consent for the GP to do so has already been provided on the original firearms licence application.

The medical records should be annotated (using a code from the FTCSRS) to indicate that the police have been informed or that the patient has been asked to inform the police.

It is open to a GP to approach the police at any time in order to pass on information of possible concern about an individual.

Where possible, GPs should alert the police if they become aware that a firearm certificate holder has died.

Medical conditions that could be relevant include:

• acute stress reaction or an acute reaction to the stress caused by a trauma, including post-traumatic stress disorder
• suicidal thoughts or self-harm or harm to others
• depression or anxiety
• dementia
• mania, bipolar disorder or a psychotic illness
• a personality disorder
• a neurological condition: for example, multiple sclerosis, Parkinson’s or Huntington’s diseases, or epilepsy
• alcohol or drug abuse
• any other mental or physical condition, or combination of conditions, which may affect the safe possession of firearms or shotguns

The list above is not intended to be exhaustive

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