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NHS England vows to tackle conflicts of interest

Guidance proposes that consultants will have to publish their private practice earnings

Louise Prime

Tuesday, 20 September 2016

NHS England has vowed to tackle conflicts of interest and inappropriate behaviour in the NHS, and ensure that the NHS leads the world in tackling these problems. One of the most controversial proposals in its “long overdue” guidance is for doctors to have to publish their income from private practice.

NHS England’s major consultation, which closes on 31st October, will cover areas as diverse as gifts, hospitality, employment, sponsorship and other interests. This follows on from its establishment in March of a group to investigate developing a stronger approach to managing both real and perceived conflicts of interest. The group, led by NHS England chair Sir Malcolm Grant, also includes representatives from the British Medical Journal, the National Institute for Health and Care Excellence, the Care Quality Commission, the Local Government Association and the Association of the British Pharmaceutical Industry.

Having explored best practice in health and other sectors in the UK and globally, the group has proposed several measures to strengthen conflict of interest identification and management. These include:

  • setting out what is and is not acceptable in relation to individual types of interest such as the need to seek prior approval from the employing NHS organisation for any outside employment.
  • the processes by which interests should be identified and conflicts of interest managed appropriately, for example ensuring all senior staff complete an annual declaration of interest.
  • information which NHS organisations must publish in relation to the interests of their staff
  • ensuring that staff and others understand what constitutes both interests and conflicts of interest as well as the circumstances in which they can occur.
  • the processes which organisations should have in place to ensure they appropriately manage any breaches of conflicts of interest policy.

The Royal College of Surgeons welcomed the “long overdue” guidance. Its president Miss Clare Marx said: “Patients rightly have a huge amount of trust in the medical profession and this guidance will help doctors to think about any potential conflicts of interest and help them to act appropriately at all times.”

But in response to NHS England’s proposal that hospital consultants’ private practice earnings should be published, the BMA pointed out that they are already obliged to offer the NHS their extra time, before taking on private work.

BMA consultant committee chair Dr Keith Brent said: “All consultants are dedicated professionals who in the vast majority of cases work beyond their contractual hours to deliver NHS care to patients at all times, including at night and at the weekends. Under the terms of the consultant contract, if a doctor wishes to undertake private work, they have to first offer extra time to the health service on top of any working hours they already perform.

“Consultants, like all other senior NHS staff, are also required to make an annual declaration of substantial conflicts of interest in accordance with legislation.”

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