NHS England has published new guidelines on managing conflicts of interest applicable to clinical commissioning groups (CCGs), NHS trusts, NHS foundation trusts and NHS England. The guidance comes into force on 1 June 2017 and will be mandated through:
- inclusion in revised statutory guidance for CCGs issued by NHS England under the NHS Act 2006
- changes to the NHS Standard Contract, General Condition 27, for NHS trusts and NHS foundation trusts, and
- changes to the Standards of Business Conduct for NHS England.
Others working in the health sector, such as independent and private sector organisations, are also ‘invited to consider implementing the guidance as a means to effectively manage conflicts of interest and provide safeguards for their staff.’
The guidance is available on NHS England’s website and includes clarity over what is deemed acceptable and appropriate, as well as what might not be. For example:
- Staff receiving hospitality should always be prepared to justify why it has been accepted and principles as to when such offers may be accepted are set out, e.g. hospitality must only be accepted where there is a legitimate business reason and it is proportionate to the nature and purpose of the event.
- Gifts from patients and families valued at over £50 should be treated with caution; they should be declared and only accepted on behalf of an organisation. Modest gifts under £50 do not need to be declared. Gifts of cash or vouchers to individuals should always be declined.
- It should be standard practice for NHS commitments to take precedence over private practice and all members of staff must declare outside employment.
NHS England’s press release on the new guidance includes a comment from Sir Malcolm Grant, chairman of NHS England, that: ‘The public rightly expects NHS staff to behave appropriately and use the healthcare budget to achieve the best outcomes for patients. While behaviour is exemplary in virtually all instances, there are times when more could have been done to prevent standards slipping...This new guidance will bring a consistent approach to conflicts of interest and ensure that the public can have faith in the integrity of the NHS.’
As well as recognising the importance of such behaviours and practices, the guidance seeks to strike a balance, for example, recognising that ‘sponsorship of NHS events by external parties is valued. Offers to meet some or part of the costs of running an event secures their ability to take place, benefitting NHS staff and patients.’
The guidance will be accompanied by a model policy due to be published in March 2017. The model policy, which incorporates the guidance, can be adopted and adapted by organisations as they wish.
The guidance follows a consultation exercise in 2016 and should be welcomed for seeking to implement consistent and clear minimum standards and clear guidelines for staff and organisations. The model policy should also be helpful to assist with implementation. Organisations should note that they can introduce more stringent requirements locally if they wish, but, in our view, this guidance document will still be helpful to set a minimum benchmark that all those within the NHS should achieve.