What do I do if one of my patients applies for a firearms licence?
Iona Twaddell explains what to do if the police ask you for advice
What is the system?
Previously (before 1 April 2016), the licence holder’s GP was only contacted if the applicant disclosed a relevant condition on their application. But now, before the police grant a firearms licence, they will contact the applicant’s GP to ask if there are any recorded medical facts that may give rise to concern if the patient had a firearms or shotgun certificate. Only a yes or no answer is needed. The GP is also asked if there is a record of any relevant medical conditions (see below), in the past five years. Again, you tick yes or no. If there is something relevant, the police may request a detailed factual medical report.
Should patients pay for these checks?
Yes. This is not contractual work, so GPs can seek a fee from the patient, both for responding to the police letter and for producing a medical report.
What if the patient refuses to pay?
The British Association of Shooting and Conservation (BASC) has advised members to not pay fees to the GP for responding to the initial police letter, saying it is ‘disappointed that some doctors are now demanding payment for a matter that affects public safety and is in opposition to the agreement reached by the BMA’. In fact, the BMA never agreed that there would not be fees, rather that fees were at the discretion of the practice.
BMA advice changed in July in reaction to the BASC’s advice to its members not to pay fees charged by GP practices. The BMA now advises that, if the patient will not pay, GPs return the initial letter to the police without delay ‘explaining they are unable to undertake the work due to a lack of funding or a conscientious objection to gun ownership.’
However, if you do have information that may suggest the patient could pose a danger, the BMA advises that you ask the patient to reconsider their application. If they refuse, you can breach their confidentiality and inform the police. The BASC does advise applicants to pay if police ask for a medical report as part of the application.
What if the patient does agree to pay?
If the applicant agrees to pay despite the BASC advice, you must get confirmation from them and agree a fee before carrying out the work. Then you must respond to the police’s request within 21 days. If you cannot do this, you must let the police know as soon as possible. The level of the fee is at the discretion of the practice although the BMA has guidance on setting a fee for work from government departments.
What if I don’t have time?
You can turn down this work if you do not have the capacity to undertake it or you have an objection to gun ownership. However, make sure you tell the police promptly. If you decide you will not be involved in the firearms licence process at all, have a system to turn down all requests.
If you delay your reply or ignore the letter you could put yourself at professional risk, as the police may assume you hold no relevant facts.
Do GPs have to give a medical opinion? What if I’m not qualified to do this?
Do not give an opinion unless you are an appropriately qualified expert able to defend the position to a court or the GMC. Only give the factual material from the patient’s record – for example if there is an incident of depression. You do not need to have had the relevant consultation with the patient.
What is the GP involvement after the licence is granted?
You should – at the time you are informed by the police – enter a shotgun or firearm reminder code in the patient’s record. If during the tenure of the licence the police become aware of a matter they believe requires medical information, they will seek a factual report and they will pay. The fee is agreed between the police and the doctor.
Relevant medical conditions
- Acute stress reaction or an acute reaction to the stress caused by a trauma
- Suicidal thoughts or self-harm
- Depression or anxiety
- Mania, bipolar disorder or a psychotic illness
- Personality disorder
- Neurological condition, for example multiple sclerosis, Parkinson’s or Huntington’s diseases, or epilepsy
- Alcohol or drug misuse
Written with advice from Dr John Canning, chair of the BMA professional fees committee