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All GPs must help patients obtain firearms licences if requested, BMA says

GPs who refuse to deal with firearms licensing requests because of conscientious objection have to help patients find another doctor, says updated BMA guidance.

The new guidance says GPs ‘must engage in the process of firearms licensing when requested to do so’ and if GPs refuse to engage with the process based on conscientious objection they have to put in place alternative options for the patient.

Since April this year, GPs have been expected to keep a record of all patients who own a gun – and to inform police if anybody develops a mental health problem such as depression.

Previous BMA advice said that GPs may be able to refuse based on conscientious objection to gun ownership but the updated guidance says this refusal would have to be undertaken in line with GMC guidance.

This requires GPs to notify patients of this objection in advance, and if the service is not easily available from another doctor, ‘the GP that objects has a professional duty to put in place alternative arrangements for the provision of the relevant services or procedures without delay'.

The new guidance replaces previous guidance that stated that GPs should refuse all firearms requests after the British Association for Shooting and Conservation (BASC) advised its members to refuse to pay a fee to the GP for this process.

But after discussions with the BASC, the Home Office and taking external legal advice, the BMA has now said that the new guidance ‘takes account of the regulatory obligations on the part of GPs and specifically the requirement to “comply with all relevant legislation”’.

The advice goes onto say that this ‘obliges GPs to cooperate with and agree to facilitate statutory processes in which they have a prescribed role or function’.

The guidance still allows for GPs to charge for firearms licences, saying: ‘However, it is also clear that where a fee for the relevant services has not been provided within the terms of the GMS contract, it may be demanded and that the GP can withhold such services until such time as the fee has been paid.‘

It later says: 'The demand for a fee may form a condition, which if not fulfilled, means the GP can refuse to engage in the firearms certification process.’

The guidance re-emphasises that GPs cannot simply ignore the letter from the police or delay a reply as this places them at professional risk.

This advice only applies to the initial letter from the police, which asks if GPs have any concerns about the patient applying for the firearms licence. BASC still advises any licence applicants to pay if a medical report is requested as part of the licensing process.

Dr John Canning, GPC professional fees and regulation subcommittee chair, said it is 'unacceptable' for GPs 'to take no action at all' when they receive a request.

He told Pulse: 'If someone comes in and says, "I’m a gamekeeper, I’m very depressed and I’ve got a gun and I’m thinking of using it" and I do nothing about it then I’m in grave danger of having to explain myself.'

It comes as GPs received letters from firearms licensing bodies suggesting they could not refuse requests.

The Firearms and Explosives Licensing Department of Hampshire Constabulary wrote that it 'will regard you as having a part to play in the duty of care to prevent harm and loss of life and the management of risk around licence holders'.

Tony Hill, firearms licensing manager at the constabulary, said they 'regard the GP as having shared responsibility with us for the prevention of harm through the use, or threat of use, of licensed firearms'.

He said that if GPs don't engage with the process 'there is a danger that medical conditions that might affect the suitability of a person to possess firearms may go unreported to us'.

He added: 'The possible consequences of this for the patient or others are clearly severe, and it is for this reason that we point out the potential ramifications for these doctors.'

 

 

 

Readers' comments (57)

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  • So when I receive a notification I have to rely on the accuracy of my practice coding and any previous practice the patient may have been registered with (as notes transferred via GP2GP). I then need a failsafe method of flagging up any concerns to the police if my patient develops a condition that I deem to be a risk. If something dreadful happens then I can be blamed for not noticing or notifying something that in retrospect is deemed pertinent. And I'm doing this work when in my day? And for free (as how are we going to invoice, be paid and guarantee a response to the police within 14 days).

    Thanks BMA.

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  • I am none the wiser as to what I am to do???

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  • Damned if we do damned if we dont.Are we qualified to diagnose a personality disorder.Do the police inform the patient there may be a charge involved with this service.There are two many firearms around anyway,It about time the police stopped trying to infer that the gp IS IDEALLY PLACED AGAIN!

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  • For goodness sake - this is an absolutely ridiculous "GPs must". Use of firearms is largely shotguns and is a leisure activity.Having to do things (a la GMC and BMA) to facilitate a patients hobby is outrageously directive and quite frankly none of my damm business. If patients want to spend their days killing pheasants than society can take a view on the safeguards required and sort it out. Compelling GPs to do this is a step too far.What next - forcing us to take patients blood pressure before they play tiddlywinks?

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  • Has the BMA actually reduced any unfunded GP workload???

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  • This is not a health matter. This is not a contractual matter.This is not a court matter. I cannot be compelled to compile a report if I do not wish to.

    The answer then is NO. A letter, a templates of which has done the rounds, should be sent to the local Chief Constable. That is the end of it. It then becomes the Police's duty to find another doctor to 'certify', not yours.

    Seriously BMA support your members don't shaft them!

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  • Dear All,
    Certainly there does appear to be a significant difference from this BMA guidance and the Home Office's own guidance which can be found at;

    https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/518193/Guidance_on_Firearms_Licensing_Law_April_2016_v20.pdf

    You only need to read the last 10 of the 270 pages, the annexes that detail the new process.

    Regards
    Paul C

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  • Dear 5.52pm, could I just mention as a legal firearms owner and a 'retired' doctor and firearms owner, fire arms owners too are being caught up in the middle of all these politics.
    My husband shoots for Scotland (as do I) and he is the captain of a successful Scottish rifle team. He previously competed in the Commonweath games.
    He also is regularly called upon to put severly road injured animals out of their misery.
    He also occasionally uses shotgun. He also uses rifles for stalking deer or rabbits due to the rural nature of his job.
    Please don't forget some have to have firearms licences as part of their work as well as part of their leisure activities.

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  • This requires GPs to notify patients of this objection in advance, and if the service is not easily available from another doctor, ‘the GP that objects has a professional duty to put in place alternative arrangements for the provision of the relevant services or procedures without delay'.
    Would someone at the BMA like to clarify what this aspect of the new guidance means? Assuming all partners at a practice wish to conscientiously object, what alternative is being recommended? I need to have an alternative course of action that I can invoke otherwise I am being forced to engage in a process which I disagree with, which presumably infringes on my human rights.

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  • Tell the patient to piss off and register elsewhere. Problem sorted.

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  • Dear 6.58, Shooting for Scotland and the Commonwealth games are both leisure activities. I can just about accept putting roadkill out of its misery but the numbers of licences required for this activity would be very small and could be covered by a specialised unit.
    Love from 5.52
    PS Stalking rabbits sounds intense!

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  • Great work from the BMA again. Dr Canning should resign.

    It's simple. Non-contractual work I can choose to do. Or not. On receipt of the letter from the police, we send a letter informing them we are declining to participate in a process that would place legal responsibity for us to create a de facto firearms register. We are happy to supply any medical notes to the police with th patients consent and either they or the patient can pay to process this work.

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  • Clear as mud.

    Righto, since I'm now (sort of) told I must participate due to some vague clause in the NHS regulations, and yet at the same time told I can refuse to do this until my fee is paid, that's no problem.

    Given I'm being asked to be the fall guy for anyone with a shotgun who then uses it to kill themselves or someone else, I view that is particularly risky private work. For which my fee to process each licence is £2000. I will be waiting until payment arrives before processing, as per GPC guidance.

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  • Dear fire arms people. I can confirm that I am a practicing GP at Mr Shooty's surgery and have access to most of his notes at least most of the notes that has been placed upon his computer records, most of the paper records are falling apart and look like they've washed up ashore and have been pulled out of a wine bottle. I don't know for a fact that he is a psychopath at least its not coded on our system. I heard through the grapevine that he did a lot of shouting and swearing when his football team lost an important game i'm not what that says about his temperament. Anywhoo's I have no idea as to whether he'd be safe to own a gun or not but my basic understanding of the matter is that generally they can be pretty dangerous and if in the wrong hands can lead to a pretty nasty case of death and I'd prefer it if nobody owned a gun or kept one in their homes. Here is a bunch of his notes for you to read through at your leisure most of it if not all is completely irrelevant. . Just to be clear I have no opinion on the patients ability to safely manage firearms now or in the future. My invoice for this report is listed below

    Many thanks Dr P Acifist

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  • Pity women requesting an abortion are not protected as much as people wanting to own a gun.

    Powerful lobbies and BMA covering their own backsides......yet again

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  • Your headline is plainly wrong and misleading. GPs are being advised that they must not just ignore letters regarding firearms cerificates, but it is reasonable to make a charge and not to reply until it is paid, or to refuse on concientious gounds (as long as you have notified your patients in advance).

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  • Took Early Retirement

    GP Partner15 Nov 2016 5:52pm

    I am retired as a GP. I have a modest land holding. I use my shotgun and small-bore rifle exclusively for vermin control. It's not really a leisure activity.

    I can't think of anything much more pointless than standing in a cold, muddy, field waiting to pop at pheasants as they fly past. Many people would disagree with me on that, of course, but I feel the same way about fishing when you can buy trout for a few quid a kilo in Tesco.

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  • This is a responsibility we need like a hole in the head.
    Ummm....

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  • Vinci Ho

    You see
    In my long comment a few days ago about Brexit on GP recruitment , I referred to the possibility to challenge this betrayal to NHS and hence GP by this post Brexit government for the money promised during the referendum ,
    ''......Perhaps , this opportunity of going through the parliament to lay down all conditions for Brexit is the last chance to ensure NHS will not be sacrificed as a price for the final destination. Our representatives will have to go furthest, by any imaginable means , to ensure NHS survival is one of these conditions to be laid down in House of Commons debate.......I am pessimistic. ''
    Interesting , some of the usually pro-government organisation like King's Fund is 'relatively militant' in criticising the government ......
    We are where we are , who am I to judge these people ?

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