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Digital firearms alert system relaunched for EMIS practices

by Beth Gault
9 February 2023

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The digital firearms marker has been reactivated this week for GP practices using the EMIS system in England in order to ‘streamline’ GP involvement in the firearms application and licensing process.

The marker, which acts as a way to help better monitor the physical and mental health of those who have a firearms licence or have applied for one, was initially launched in July last year. However, it was paused on EMIS a week after its start because of concerns about its accuracy.  

It has now been reenabled for practices using EMIS and went live on 6 February. It will be deployed for those on the Cegedim/Vision systems by early March 2023. For SystmOne/TPP users, the marker system continues to be in place as has been the case since the scheme began last year.

The marker means that when practices are notified that a patient has either applied for a firearms license or been granted one, GP practices will need to add the appropriate SNOMED code to the patient’s record. This will create a digital firearms marker on the medical record.

After the marker is applied, if a ‘condition of concern’ (examples include dementia, suicidal thoughts, PTSD, alcohol and drug abuse) is added to the patient’s medical record, an alert will automatically be generated and sent to the GP. The GP will then determine if the police need to be informed of the new condition.

However, this only applies to future notifications of applications or certificates, as NHS Digital has said there is no requirement to go through historic records to add the code and generate the marker.

When the tool was paused last year, the BMA said it was ‘causing too much trouble’ for GPs after practices spoke of issues regarding the accuracy and completeness of the alerts.

This week, a BMA spokesperson told Management in Practice that it was ‘essential’ to monitor feedback on this new marker to ensure it is ‘fit for purpose’.

It added: ‘For public safety it is important that there is a flagging mechanism within patients’ records, that is robust, clear and standardised across the country, and the BMA has worked in consultation with NHS England and the Home Officeon the new digital firearms marker to improve the contribution GPs make to the licensing process.’

NHS Digital (which has now merged with  NHS England) previously advised that there may be a ‘significant number of false positive conditions’ that trigger the alert and do not need to be reported. The conditions of concern are named and coded within the Digital Firearms Marker reference set, which it says, contains many terms and was designed to be ‘highly sensitive.’

It added that it would monitor the performance of the tool and that codes contained in the reference set would ‘continue to be refined’.

A Home Office spokesperson said: ‘The digital marker system has been reenabled after a temporary pause and will streamline the way doctors can keep track of patients who have applied for, or been granted, a firearms certificate.’

The BMA has issued and updated its own guidance explaining GP involvement in the firearms licensing process.

What action to take when an alert goes off

A pop up can appear in two different situations:

  1. When a new firearms license application has been recorded in the electronic records of a person who has a condition from the Digital Firearms Marker reference set in their records.
  2. When a new, potentially relevant, medical condition from the trigger reference set is added to the records of someone who has a current licence or has had a licence application recorded in the past six months.

In either situation, NHS Digital guidance says: ‘If the GP considers all of the relevant information is known to the police, or that the information triggering the alert is not sufficiently relevant to require notification to the police, they should record that they have reviewed the record using the appropriate code, and record that no action is required on clinical grounds.

‘Where a new condition of concern is added to the records of someone with an existing licence or with an application in progress, the GP should contact the patient to advise them that they must contact the police to update them with the new information. If there is a public safety concern, or if the GP believes that the patient has not or will not inform the police, then the GP should contact the local police firearms branch themselves (or telephone 101) to report the new diagnosis. They should inform the patient that they (the GP) will be doing this.’

It adds that consent for information to be shared with the police will have been granted by the patient on their firearms application.

Source: Digital Firearms Marker, NHS Digital