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Independents' Day

LMC issues template letter for GPs to refuse firearms licence requests

An LMC has issued a template letter for practices to turn down police requests for information on firearms licence applicants, pointing out that most GPs are not suitably qualified.

The template, from Devon LMC, states that GPs do not have the expertise to diagnose a personality disorder, which is the ’major clinical issue giving rise to the improper use of firearms’.

The process for issuing firearms licences was changed on 1 April after negotiations between the BMA Professional Fees Committee and the Home Office. 

It means that after a licence is issued, the police will now contact the applicant’s GP to determine whether there are any issues relating to gun ownership (such as a history of depression) and for the GP to place a firearms reminder code on the patient record.

But Dr Mark Sanford-Wood, who drafted the Devon LMC letter, told Pulse that they produced this letter because ‘our members are at really significant risk if they try to offer an opinion that they’re not qualified to offer’.

He added: ‘I understand that if that letter is used in any kind of widespread way across the country that this system that was introduced on 1 April will collapse… but that doesn’t mean we shouldn’t do it.’

The letter, addressed to the firearms licencing department, states: ‘You have asked me if I have any concerns regarding the issuing of a firearms licence to this individual, and you therefore seek my professional opinion rather than a simple report of the medical facts.’

It goes onto say: ‘It is widely accepted that the major clinical issue giving rise to the improper use of firearms is the presence of a personality disorder. To give a professional opinion on such a diagnosis one would need to conduct a specific examination for personality disorder and have special expertise. Such expertise would, at a minimum, require approval under section 12 of the Mental Health Act 1983 (as amended 2007).’

The letter concludes ’I am therefore not qualified to offer the expert professional opinion you seek and would suggest that you approach an appropriately qualified psychiatrist who may be able to help you in this regard.’

The LMCs conference last month overwhelmingly passed a motion urging the GPC to work with the BMA Professional Fees Committee to revise the system and ‘actively support GPs refusing to participate in this process’ until it is changed so that certificates are only approved after GP involvement and there is clarification regarding payment and ‘the medico-legal validity of the process’.

Current BMA guidance states that this system is not part of the GP contract and GPs can choose to charge a fee to the patient (though not police) for responding to the request, or refuse the request by notifying the police as soon as possible if the practice ’does not have the capacity to undertake the work within the 21 days’.

Devon LMC has also produced template letters for GPs who were willing to produce a firearms certificate with options to send it back, charge the patient or charge the police.

Dr Sanford-Wood told Pulse that they included these options because some GPs may be happy to offer their opinion and that since the police requests the GP’s opinion, it would be unusual for someone else - the patient - to pay the charge.

Readers' comments (12)

  • Excellent! hope you dont mind if I use this in our practice

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  • Ed: A slightly misleading photograph used at the head of this item. Handguns are illegal in the UK. By contrast approximately 1.5 million shotguns are legally held and used responsibly for sport - principally clay pigeon shooting - and for vermin control.

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  • Took Early Retirement

    Hmmmm....shame Pulse has used a picture of handguns: illegal in the UK for a long time now. (Except in the very rarest of circumstances.)

    I wonder what will happen if the police start writing to failed applicants by saying, "As a result of the failure of your GP to respond to our questions about your license/certificate application, it has been refused."? If already a holder of a certificate it will mean storage of, or selling of, the guns, and therefore rapidly generate a letter from our learned legal colleagues suing the GP for damages.

    I do worry if some of this is generated by doctors who basically don't approve of shotguns/firearms, even though it is perfectly legal to possess them in the UK, providing certain requirements are met.

    DOI- holder of both, and used for vermin control on my land.

    I await the first test case with interest.

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  • It would be helpful if GPC were able to rid of the free ESA forms which on an average I have around 6-10 per month. If I am correct, these ESAs were supposed to be replaced by PIP forms which were chargeable. However, in the last financial year only two paid PIPs were done at this Practice.
    BTW, the shotgun licensing form does not need a reply if the patient has no psychiatric background. Of course, it is unfunded work and we should.t have to waste precious time having to deal with these.
    BTW, even if the person has severe depression, the decision not to issue a license can be challenged as the one odd case where a patient on benefits due to severe agoraphobia contended that shooting was his only past time and his family took him out for this once a week:) But he couldn't be bothered to work.

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  • It says a lot of bad things about the BMA that they negotiate a system which an LMC thinks puts "our members are at really significant risk".

    yet again disappointed but not surprised at BMA failure

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  • Our LMC (Lincolnshire) currently promotes a letter as below

    "Thank you for informing us that the above named patient has applied for or been granted a firearms/shotgun licence. We have made a note of this in their patient record, but have not checked their medical records to see whether they are suffering from a condition which would preclude them holding such a licence."

    and is likely to be updated to include the recommendation as below:

    I would additionally advise that the letter should contain the sentiment that an independent medical advisor should make the assessment of fitness to hold a firearms licence, and that if this independent medical advisor requires information from the GP this could be provided with a fee for providing the report.

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  • Excellent idea! We should all do this. Why on earth would we want to offer a medical opinion free of charge with only limited information on a patient. How the BMA ever let this through is beyond me. It should be a report of facts. Not an opinion. The decision to license should be down to the police not GPs

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  • in our Practice, we make sure that i is clear that we simply providing police with information available from patient's record. We charge patients/clients for the service.

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  • Hi, my concern is whether the patient is aware of the implication of sharing this information with the police. Does it get onto a national database? Do other police have access to it? Would it then prejudice the way the patient may be dealt with by the police in other matters? We are all aware of the stigma of having any mental health issue label and how it is viewed by non-medical people.

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  • I know I am an idiot. But why should we refuse to issue a certificate to a person to hold a firearm? We will be pad for this certificate,Cwl know the patient, we have the medical history, we have our personal impressions about the applicant, we have a personal history, we can obtain a psychiatric report ( even on a normal person), so what are we frightened of?
    If we let the BMA run our professional lives , we will find ourselves as disliked as the BMA is, by doctors. If anyone wants particulars of how the BMA is interested in only itself,contact me. I have experience ot the BMA, the LMC, the MDU or MPS, deserting you, when needed. Remember my adage, if you support your patient, legally, he or she, will always support you. Ultimately, you represent your patient. I f he or she is happy no one can touch you.
    In many of my reviews and comments I have tried to explain that the patient is king.
    This is in our contract. If the patient is happy , both you,and the patient is king.
    Summary: try to help, not hinder, our patients.

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