Managing conflicts of interest
One of the issues that GPs need to understand as they form statutory commissioning bodies and take on financial and contractual responsibilities as commissioners, is how they will manage real and perceived conflicts of interest facing the individuals involved in their governance and decision making.
What are conflicts of interest and why do they matter to clinical commissioners?
A conflict of interest can be defined as: “A set of conditions in which professional judgement concerning a primary interest (such as the welfare of patients or the validity of research) tends to be unduly influenced by a secondary interest (such as financial gain)” or a situation in which “one’s ability to exercise judgement in one role is impaired by one’s obligation in another.”
For a GP, or other clinical commissioner, a conflict of interest may arise when their own judgement as an NHS commissioner could be, or is perceived to be, influenced by their own concerns and obligations as a healthcare provider or as a member of a particular peer, professional or special interest group. This would also include a close family member.
The Conflicts of Interest (CoI) Guardian for the CCG is David Smith, Lay Member – Governance & Audit and Chair of the Audit Committee. David can be contacted via email - firstname.lastname@example.org or via the CCG office on 020 3668 1200.
Raising concerns and managing breaches:
- In order to report any breaches, employees, governing body members, committee/sub-committee members, GP practice members should follow the CCG's whistleblowing policy.
As a guide:
- CCG employees – should report to their line manager who in turn may refer to the CoI Guardian for Guardian. If the employees are unable to report to their line managers e.g. if line managers are suspected of breach, then they may contact the CoI Guardian directly.
- Committee members who are not CCG employees and GB members - should report direct to the CoI Guardian.
- GP Practice members – should report any concerns to the Chief Officer and Chief Financial Officer.
- Where the breach is reported by an employee or worker of another organisation, the individual should follow their organisation's policies for whistleblowing.
- The CCG's COI guardian is best placed to address any concerns and advise on COI matters and should be contacted in the first instance.
- All such notifications will be treated with appropriate confidentiality and in accordance with the CCG's policies and relevant laws.
- It must be ensured that the Chief Officer/ Chief Financial Officer are kept informed of any suspected breaches.
- Once reported, the CoI Guardian should investigate the report of the suspected breach with the help of the Risk and Assurance manager.
- The aims would be to determine if a material breach has occurred and if so to identify the reasons and propose remedial action (e.g. training issues, lack of clarity in policy or culpable non-compliance by one or more individuals).
- The conclusions of the investigation will be reported to the Governing Body.
- Failure to comply with this policy or failure to make a declaration, or making a false declaration could result in an investigation by the Local Counter Fraud Specialist which could result in a disciplinary, and/or criminal/civil action if fraud or bribery is discovered.
Remedying and Redressing:
- CoI Guardian's investigation should recommend remedial action which might range from clarifying the policy, augmenting the training or disciplinary action of the types set out in your black text from the current policy.
- If relevant, the appropriate professional body will be notified of the breach.
- The following CCG policies (as amended) will apply to breaches of this policy where appropriate:
- Whistleblowing Policy
- Disciplinary Policy
- As required by NHS England, the CCG will publish anonymised details of confirmed breaches, including remedial action on our website for the purpose of learning and development.