The new guidance for firearms licensing, including arrangements for medical checks for firearm certificates, came into effect in November last year in England and Wales, and on 31 January this year in Scotland. Ceylan Simsek, Case Manager, and Dr Karen Ellison, Medicolegal Consultant at Medical Protection, discuss the key considerations for GPs
The new statutory guidance on firearms licensing processes has been produced to reform and streamline the firearm and shotgun licensing processes to ensure that these are consistent for police, medical professionals and applicants.
From 1 November, individuals wishing to apply for a firearms licence are now required to provide a completed medical proforma alongside their application to the police firearms licensing department.
The form should be completed and signed by the applicant’s GP or another GMC-registered doctor and while in England and Wales the applicant may then provide the form to the police themselves, it is preferred that the doctor provides it to the police directly[1]. In Scotland, the doctor must provide the form to the police and this must be done within 21 days of receiving the form from the applicant.[2]
An applicant will not be granted a firearms licence without a signed medical proforma. It is the responsibility of the applicant to ensure they provide evidence of all relevant medical suitability to possess a firearm. The guidance states that if the medical information provided to police is from a private practice, the private doctor must receive the applicant’s medical information direct from the individual’s usual NHS GP and not via the applicant.
If the applicant does not have a UK-registered GP, they will not be able to fulfil the criteria to be issued with a firearm or shotgun certificate.
The new guidance suggests that no-one is granted a firearms certificate unless their doctor has confirmed to the police whether or not they have any relevant medical conditions, including in relation to their mental health. The relevant medical history that should be disclosed and assessed may include, but is not limited to:
- Acute Stress Reaction or an acute reaction to the stress caused by a trauma, including post-traumatic stress disorder
- suicidal thoughts, 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; and
- any other mental or physical condition, or combination of conditions, which may affect the safe possession of firearms or shotguns.
As the list above is not exhaustive, GPs should consider any other mental or physical condition which may affect the individual’s safe possession of a firearm or shotgun, currently or in the future. GPs are advised to also refer to sections 3.34 and 3.35 of the new guidance in relation to when a patient has been subject to the provisions of the Mental Health Act 1983 and/or the Mental Health (Care and Treatment) (Scotland) Act 2003.
The police may ask the practice to provide general access to the applicants’ medical records, however providing this may result in a breach of the Data Protection Act 2018. It is also not the doctor’s duty to endorse or oppose an application as the guidance suggests that this is the responsibility of police, not the doctor.
The police may also approach the applicant’s GP to obtain relevant medical information both during the application process and at any time during the validity of the certificate if there are continued concerns about an individual’s fitness to possess firearms safely.
If any new information comes to light as a result of background checks, more extensive enquiries may be necessary. Such enquiries could be required if, for example, the applicant’s circumstances have changed materially since the original grant or last renewal, or if they are otherwise considered higher risk. For example, if there is new relevant information about behaviour or a medical condition, it is likely that more extensive enquiries will be necessary.
Patient confidentiality
While GPs owe a duty of confidentiality towards their patients, there is also a wider duty to protect and promote the health of patients and the public. Whether the firearm applicant or licence holder has capacity or not, the new guidance suggests that if they pose a risk or potential risk to themselves and/or others, the GPs may – depending on individual circumstances – share relevant information with police on the following grounds:
- With the individual’s consent
- On public interest grounds; or
- In some rare circumstances, if it is legally required.
Medicolegal risks and considerations
When filling out a medical proforma, it is essential to have access to the applicant’s medical record to determine the level of risk to public safety arising from the grant of a firearm or shotgun certificate. The certificate should not, therefore, be granted or renewed if this information is not available.
When a certificate is granted, or a person is registered as a firearms dealer, the police will contact the applicant’s GP and ask them to place a firearms marker on their medical record. When reviewing patients, it is important to be aware of this marker and be reminded that you may need to notify the police should the patients begin to suffer from a relevant medical condition, or a relevant condition worsens significantly.
There is no requirement for GPs to monitor and assess a patient who currently holds a firearm certificate. However, the GP should notify the police if they become aware that relevant aspects of the licence holder’s circumstances have changed.
Doctors owe a duty of confidentiality to their patient but also owe a duty to promote and protect the wider public health. Any relevant information may, however, be shared with police if the individual has consented, on public interest grounds or where legally required.
Fees
According to the guidance, GPs can decide on whether a fee is charged for this service. You can contact Medical Protection for more advice on this.