Managing Conflicts of Interest in the NHS Consultation

What the proposed changes of the recent ‘Managing Conflicts of Interest in the NHS Consultation’ mean for Consultants in private practice

NHS consultants that are also involved with private practices have a number of new considerations to make after the publication of Managing Conflicts of Interest in the NHS Consultation.

For the purpose of transparency and avoiding conflicts of interest, NHS consultants that undertake private work will now have to declare their income as part of the new guidance. Under the proposals of NHS England Chairman Sir Malcolm Grant, the details would be published in hospital registers from April next year.

The government has been keen to stress that this isn’t meant to perturb consultants from seeking private work. If you are an NHS consultant, the details of your private income will now be viewable, but only as a part of a bracket. The register will state whether an NHS consultant is earning less than £50,000 from private sources, between £50,000 and £100,000, or over £100,000.

To be clear on what is meant by the term “private medical practice”, it refers to any work that is conducted outside the terms and conditions of employment by the NHS. For those that are involved in private medical practice under the preceding definition, the information required from them will be; the name of the private facility where they work, the timing of their private practice, and what they practice in terms of their speciality, as well as their earnings in accordance with the brackets detailed in the last paragraph.

Gifts and hospitality

Other areas of the guidance that warrant consideration by NHS consultants include a section on gifts and hospitality. Among the key proposals are that gifts which exceed the value of £50 should be declined, and that gifts received in relation to procurement, be they from a service provider or supplier, should also be declined. Where it is deemed rude to refuse a gift, the proposals suggest that the gift is given to charity so as not to cause offence to the giver of the gift.

Outside employment and sponsored research

In terms of outside employment with organisations that might have some NHS involvement, the new guidance asks that senior staff seek the approval of their employer before taking up a position, be it paid or unpaid. In the case of NHS research products that are sponsored, while the review does not wish to discourage valuable funding, it asks consultants to ensure that sponsors do not have any influence over “the content of an event, meeting, seminar, publication or training event”.

Shareholdings and patents + political activity

Where any potential for conflict of interest is present, consultants must declare their ownership or financial interests in the relevant organisations, the new guidance states. Where a consultant is politically active or has loyalties to an organisation that could throw up a conflict of interests, the review asks that they also make this activity known.

The new guidance means that NHS consultants will have to divulge more information about their involvement with private practices, as well as outside interests that relate to the NHS, and while they do not have to give specific salary details, they should be prepared to give an indication of their earnings.