Firearms Licensing Medical Process

Effective immediately, Bedfordshire, Cambridgeshire & Hertfordshire Police, in collaboration with
Cambs LMC and Beds & Herts LMCs, will be changing the way they process applications for Shotgun
Certificates (SGC) and Firearm Certificates (FAC). The LMC has been working closely with the police
in recent months to agree a new, standardised medical process which both satisfies the police’s
requirements for public safety whilst also minimising workload and medico-legal risk upon GPs.

Why is the system changing?
Under the old system, the police have written to a patients GP asking whether the applicant has a
history of any of a list of diagnoses of concern. A lack of reply from the GP after 21 days results in
assumption by the police of no concerning history and consequent grant of the certificate. The
police are concerned this system risks important medical history being missed if the GP fails to
respond at all. Furthermore, the LMC is concerned that there is a presumption that a lack of
response equates to the absence of any given diagnoses places GPs at unacceptable medicolegal
risk. BMA guidance also makes it clear that failing to respond at all to the letter places the GP at
professional risk.

What is changing?
Bedfordshire, Cambridgeshire & Hertfordshire Police will no longer accept any SGC/FAC application
unless it is accompanied by a completed standardised proforma which the applicant will ask their
GP to complete. Therefore, from the GP’s perspective the only change is that the applicant will now
be asking them to confirm/deny the presence of any diagnoses of concern rather than the police.
What will the proforma contain?

The proforma has been designed to have tick boxes to confirm the presence of any of the listed
diagnoses of concern. There will be a separate section for the GP to write pertinent factual
information such as the onset time, symptoms, treatment and any referrals as well as when the
patient was last seen with the problem. It should be noted that the form asks for factual information
only, GPs should not give an opinion on the fitness of the applicant to possess a firearm – that is a
matter for the police to decide.

Fees
The medical process of firearms applications falls outside of core GMS contractual obligations and
therefore attracts a private fee. It is not the role of the LMC to prescribe a set fee for such work. It
should be noted that it is up to practices to set their own fee, and make these clear to patients in
advance. Also, practices are free to charge more or less than the advised fee range depending on
the workload and complexity of each individual case, considering the following:

  • GP time – This could be anything from 30 mins to 1 hour on average, depending on whether it is
    a grant (new) or renewal (subsequent) application, and on the complexity of the patient’s medical
    history
  • Admin costs including audit
  • Indemnity costs – The CNSGP indemnity scheme does not cover firearms applications and
    individual personal indemnity is needed to cover the medicolegal risk of this work, this cost should
    be considered
  • Overheads

Conscientious Objection
The LMC reminds GPs that they have a right to conscientiously object to the firearms medical
process where they have a genuine ethical and/or religious reason for doing so in line with GMC and
BMA guidance. In such cases, the practice should consider using the template letter that we have
formulated and make it clear to patients in advance which GPs conscientiously object and where an
applicant requests completion of a medical proforma a conscientiously objecting GP should either:

  • Direct the applicant to another GP in the practice who is able to complete the form, or
  • If no such GP is available, complete the attached conscientious objection letter and hand it to the
    applicant in lieu of the medical proforma

The LMC reminds GPs that to refuse to engage with the medical process of firearms licensing for
any reason other than genuine ethical/religious conscientious objection places you at medicolegal
and professional risk.

Review
Bedfordshire, Cambridgeshire & Hertfordshire Police and the LMC will continue to review and
monitor the local firearms medical process and encourage GPs to contact the LMC on the email
below with any concerns, queries or other issues that arise. We continue to work closely with the
Police locally to ensure a system which does not place excess workload or risk on practices.

What to do now?
If you are unsure on how to respond to these letters, guidance can be found at
https://www.bma.org.uk/advice/employment/ethics/ethics-a-to-z/firearms

Please also refer to the attached guidance documents which we have tired to make as
comprehensive as possible.

Cambs LMC

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