Reports for the police

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Reports of injuries following e.g. an assault or accident

It is seldom necessary for GPs to provide detailed reports to the police.[1]

A letter from the then chairman of the Association of Chief Police Officers (ACPO), referring to the Making a Difference report,[2] stated:

An issue that features in the report, which was raised by GPs themselves, is the practice of some police forces directing people (who require no medical treatment) from police stations to their GP in order for evidence of an assault or injury to be recorded, by the GP, on that person's medical record. The Cabinet Office has agreed with GPs and ACPO that the documentation of injuries in these circumstances is not an appropriate use of GPs time. [3]

One reason for GPs to decline to do this work is that they are not usually trained to do so. One reason why prosecutions are unsuccessful is that the evidence was not collected properly, according to the rules. For this reason alone it may be more appropriate for GPs to decline to provide a report, referring the patient (and the police officer requesting the report) to the forensic medical examiner (aka police surgeon).

Where reports are provided, they should be short and factual. Opinions are to be avoided - at least by Professional witnesses. (Expert witnesses are different.)

A letter along the following lines is used by some GPs:[4]

TO WHOM IT MAY CONCERN.
Re:
This Patient has told me that she/he has been referred by the Police to consult her GP in order to have injuries recorded. Could I draw your attention to the following extract:
Making a Difference - Reducing General Practitioner (GP) Paperwork estimated that by removing the obligation to record injuries for police purposes 87,000 appointments plus 2,000 hours would be saved annually. GPs are therefore no longer required to record injuries for police purposes.[5]
The Chairman of the Association of Chief Police Officers (ACPO) wrote to all Chief Constables in June 2001 stating that ACPO had agreed with the Cabinet Office and with GPs that the documentation of minor injuries for police purposes was not an appropriate use of GPs' time. In the past patients required this evidence in order to initiate their own prosecution, since the police did not prosecute for common assault. However, this policy has now changed and the police do prosecute in cases of common assault. Therefore the rationale for requiring the GP's evidence no longer exists.
Home Office circular 24/1998 suggested that a statement should be made describing the injuries and, if possible, the injuries should be photographed by a scene of crime officer. The patient should be examined by a forensic medical examiner where the injury is not of a minor nature.
The following is the relevant extract from Home Office Circular 24/1998[6]
Prosecuting offences of ABH without medical reports
10. A number of offences where ABH is charged can be prosecuted without the need for a medical report. Such reports are costly and often cause significant delay. Guidance, agreed by the Trials Issues Group is being issued to all agencies on the need to question whether such a report is necessary. The guidance has been drawn to the notice of the Law Society and the Bar Council. The guidance also applies to cases of common assault where, under the Offences Against the Persons Charging Standard, the degree of harm envisaged is likely to be of a more minor nature.
11. A medical report may be unnecessary if the injury is, by any common sense judgement, of a minor nature, is apparently uncomplicated and likely to be temporary. It should be adequately described in a statement from the victim and, if practicable, a police officer. A quality coloured photograph should be provided wherever possible. If an officer has any remaining doubts, a guilty plea, or likely guilty plea, may tip the balance against ordering a medical report.
12. Otherwise a medical report is likely to be required and should be obtained as soon as possible. Nothing should be done to discourage a victim from obtaining proper medical treatment. This guidance is solely concerned as to whether a medical report is required for criminal proceedings.
Referral for the documentation of minor injuries is therefore no longer necessary or acceptable. However, if the patient requires medical treatment of the kind that a GP would normally provide under the Terms of Service, it would be reasonable for the police to refer the patient to the GP.
I would be grateful if this could be borne in mind in the future
Yours sincerely, etc.

Scotland

In Scotland the police may request a report for the Procurator Fiscal in a case of sudden death.

The fiscal (a legally qualified crown officer similar here to the English coroner) has the statutory duty to enquire into any unexplained, accidental or suspicious death[7]. The fiscal in an area will ask the local police to question witnesses about the death and provide a report.

The report will usually consist of statements from interested parties such as relatives, those present, a hospital doctor and/or GP.

Unless there is any suggestion of the doctor being involved legally (in which case the relevant Defence Body should be consulted) a simple list from records of diagnoses and treatments is usually all that is required. If the fiscal considers the medical report incomplete or doubtful in any way, he (or she) may require the doctor to come to the local fiscal's office for an interview. This is rare but again advice from a defence organisation may be appropriate. The visit is not optional and no fee is paid though travelling expenses may be reimbursed.

Other requests for information from the police

(Update - please note the statement from the BMA below.)

Sometimes police officer approach doctors and ask for information about their patients.

In most occasions the usual rules of confidentiality will apply. Under section 29(3) of the Data Protection Act 1998 (DPA) information may be released to the police without prior consent from the patient; but this does not waive the duty of confidentiality altogether, and does not compel the release of information. The GMC has clear guidance on confidentiality. There is a section on disclosures required by statute, which emphasises that: "You must not disclose personal information to a third party such as a solicitor, police officer or officer of a court without the patient’s express consent, unless it is required by law or can be justified in the public interest". Disclosures that may be in the public interest are discussed at this page on the GMC web site. See also ganfyd confidentiality page.

NB Revised GMC guidance on the reporting of intentional injuries (focusing on gun and knife wounds) was published in 2017. There is a helpful commentary on it from Dr Adrian Boyle.[8][9]

Information may be released to the police if it is formally requested by a court (a court order), or if all of the following apply:

  • It is needed for investigation or prevention of a serious arrestable offence, such as armed robbery, murder or terrorism, or child abuse.
  • It is requested by a senior officer.

In all such circumstances, only the minimum information necessary to help the police should be released: they should not, for example, be given access to the medical notes (unless this is essential). In nearly all circumstances it will be possible - and highly desirable - to discuss this with your defence organisation first.

There is a useful scenario described by one of the medical defence organisations (the MDU) here. This also points out that it might be in the patient's interests to disclose information (e.g. to a police surgeon - properly known as a forensic physician - so that appropriate care can be provided); but without the patient's consent such disclosure should be limited to the information that is needed for the purpose, and ideally should be given directly to the person to whom it is most relevant, such as a police surgeon or other appropriate healthcare professional.

Message from the BMA Professional Fees Committee, 20 June 2017

The following message information was posted at the BMA's website in June 2017:[10]

"The BMA professional fees committee has received new legal advice regarding medical note requests received from the police, which are detailed below.
"There is clear guidance regarding the obligations that GPs have with respect to copying and/or release of the GP record. For your reference, these circumstances are:
  • "If the police do not have a court order or warrant they may request voluntary disclosure of a patient’s health records under section 29 of the Data Protection Act 1998.
  • "However, while health professionals have the power to disclose the records to the police where section 29 applies, there is no obligation to do so.
  • "In such cases health professionals remain bound by the long-established common law duty of confidentiality and may only disclose information where the patient has given consent, or there is an overriding public interest. They may also be required to defend their decision to disclose before the GMC which is a statutory tribunal.
  • "Disclosures in the public interest based on common law are made where disclosure is essential to prevent a serious threat to public health, national security, the life of the individual or a third party, or to prevent or detect serious crime. This includes crimes such as murder, manslaughter, rape, treason, kidnapping and abuse of children or other vulnerable people. Serious harm to the security of the state or to public order and serious fraud will also fall into this category.
"Your practice is entitled to a fee for producing the notes for the police.
"There is no set fee for producing these notes, as they are not considered a subject access request that you may receive from a patient. Therefore the practice is able to set its own fee.
"In order for you to proceed with the police request, please find attached a pro forma that we recommend you complete and send to the police authority. We recommend that you obtain each of the following:
1. "Provide written patient consent to release of their records OR provide written confirmation as to the nature of the serious crime allegedly committed by the patient and an explanation as to why the patient’s records, or other information requested, are considered necessary for the specific purpose you are pursuing. You will require one of these in order to fulfil your responsibilities as the Caldicott Guardian.
2. "Confirmation in writing that the fee of £xx will be paid within 28 days of the police receiving the record. This fee is due to the disproportionate effort placed on an already overburdened GP practice to provide these notes which recognises the need to support the police in their investigation of a crime, where appropriate to do so.
3. "Written confirmation from a senior police officer – ranked Superintendent or above – that he or she considers that the crime being investigated is a serious crime in line with the examples provided above.
"Once you are in receipt of both of these at the practice, and have checked the appropriateness of release of the records, you should respond to the police authority as soon as possible.
"Alternatively, should it be appropriate for the police to view the record (based on their answer to requirement 1 above), then there is the option for them to view the record in the practice in the presence of a practice staff member. In this situation there is no fee chargeable.
"There is no set fee for providing records in this manner. Therefore it is the responsibility of individual practices to set their own fee for this work. When completing the attached pro forma you must enter the fee you choose to charge.
"GPs should, in all cases where there is no patient consent, consider whether the benefits to an individual or to society of disclosing the records outweigh both the public and the patient’s interest in keeping the information confidential before agreeing to disclose the records."

Guns and firearms

See Firearms page.

References

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