A 10th of GPs on consortium boards are also on boards of private firms

A survey of almost half of all primary care trusts in England has shown that one in 10 GPs on the boards of the new commissioning consortiums are on boards of private firms.

Doctors’ leaders are concerned about possible conflicts of interests that GPs in consortiums might have over commissioning care for patients through services that might be on offer from private companies in which they have a role.

A survey by Pulse magazine collected data under the Freedom of Information Act, which included results from 73 primary care trusts about the pathfinder consortiums in their areas that are piloting the NHS reforms that will give consortiums control of most of the NHS budget.

Although 56 trusts said that they could not provide information because boards had not yet been set up or information on conflicts of interest had not been collected, there was evidence among the others of potential conflicts.

Pulse’s analysis looked at the additional roles held by 132 consortium board members across the 17 trusts that were able to provide information and found that 15 people held board level positions in addition to their role in the pathfinder consortiums.

An additional 15 consortium board members were linked to private firms in non-executive capacities, being either a shareholder or holding an advisory role.

Chaand Nagpaul, a negotiator with the BMA’s General Practitioners Committee, told Pulse: “There are real concerns about GPs with a senior-level interest in a private provider and we would suggest as far as possible to avoid such doctors sitting on commissioning boards because of perceived or actual conflict of interest.”

Some of the additional roles held by consortium board members included board membership of the private firm Assura Medical’s local GP provider companies and medical directorships of out of hours’ companies.

A spokesman for Assura Medical said that members of the boards of its GP provider companies who were elected to consortiums would have to step down before the consortiums took any commissioning decisions. He told the BMJ: “As a provider of NHS services, Assura Medical is not involved in commissioning. However, as our GPCo [GP provider company] boards are run by highly talented and experienced GPs, it is likely that some GPCo board members may be approached by consortia boards.

“Even though commissioning consortia are not yet statutory bodies, and no conflict of interest currently exists, we are keen to ensure that clear daylight exists between the provision and commissioning of services.

“Where our GPCo board members opt to become elected to consortia boards we require that they step down from our GPCo board before the consortium becomes a statutory body or starts to take commissioning decisions, even when in shadow format.”

The spokesman said that the situation had happened more than once since the pathfinder consortiums came into being.

Pulse also quoted James Kingsland, the national clinical commissioning network lead at the Department of Health, as saying it was a “possibility” that private firms might have a seat on the NHS Commissioning Board that will oversee the GP consortiums, although its make-up had not yet been determined.

A health department spokeswoman said there was no truth to this.