Doctors were told yesterday they must report to police incidents involving gunshot wounds, to protect the public.
New guidance from the General Medical Council (GMC), which weakens the doctor's duty of confidentiality to patients, comes after a spate of incidents which left nine people dead or injured last week.
Jon Otsemobor, 20, a Liverpool footballer, was among three people shot in a bar in Liverpool in the early hours of Sunday morning. Andre Shepherd, a DJ, was hit in the arms and back in a shooting in Reading on Friday. The same day David King, who was known to police, was gunned down with an automatic weapon in the quiet market town of Hoddesdon, Hertfordshire. On Tuesday, Marian Bates, a 64-year-old jeweller, was shot dead by a robber during a raid on her shop in Arnold, Nottingham.
The outbreak of gun crime led to calls for urgent action. The GMC came under pressure from the Association of Chief Police Officers (Acpo) more than a year ago after police were outraged when a surgeon removed a bullet from a patient and gave it to him as a memento. The patient then sought revenge on his assailant.
Jane O'Brien, head of standards at the GMC, said: "Acpo were concerned about one or two incidents where they hadn't been told of gunshot victims in hospital. We had a bit of a dialogue about how far we wanted to go. Clearly we did not want to discourage people in need from coming forward for treatment. But there was also an issue about the need to protect the public interest. The question was how to balance those things."
Existing guidance from the GMC, which sets ethical standards, says confidentiality is central to the trust between doctors and patients, and that it may only be breached, in the public interest "where the benefits to an individual or to society of the disclosure outweigh the public and the patient's interest in keeping the information confidential".
Under the new guidance doctors must inform the police when a patient seeks treatment for a gunshot wound. The GMC said this would trigger a visit from the police who would discuss with the doctor the circumstances of the injury.
Consent should be sought by the doctor to disclose the patient's identity, but if it is refused it may be revealed, and the patient's trust breached, if the doctor judges that it would "help prevent, detect or prosecute a serious crime".
Ms O'Brien said it was important that doctors protected the confidentiality of patients in cases where, for example, there had been a failed suicide attempt and no crime had been committed or other people put at risk.
"Acpo would have liked us to have said doctors should immediately disclose everything they know. But we were also concerned to protect patient confidentiality and for doctors not to become a supplementary police force. We think the balance will be accepted."
John Heyworth, president of the British Association of Accident and Emergency Medicine, said: "Patients presenting to emergency departments with gunshot wounds require the highest standards of clinical care and this will remain the absolute priority. However, we also have a responsibility to protect the public in the community."
Alan Green, Deputy Chief Constable of Greater Manchester, said: "This guidance ... will not only assist in the detection of [gun offences] but may assist in the prevention of further offences."