Conflicts of interest could “badly undermine confidence” in GPs, warn professional bodies

Failure of clinical commissioning groups to manage conflicts of interest could badly undermine the confidence of regulators, providers, and patients both in clinical commissioning itself and in the medical profession, the Royal College of General Practitioners and the NHS Confederation have said.

“There have been considerable concerns raised by MPs and professional bodies alike about this issue since the health bill was introduced and commissioning pathfinders were established,” said Mike Farrar, chief executive of the NHS Confederation. “It’s a fundamental issue for clinical commissioning groups to get to grips with.”

GPs are facing a tremendous range of new challenges with clinically led commissioning, said Clare Gerada, chair of the Royal College of General Practitioners, at the launch the college and the NHS Confederation’s joint guidance on conflicts of interest. “For all GPs, maintaining the highest ethical standards in all their activities is fundamental, and this applies to the commissioning of healthcare services through their role in clinical commissioning groups,” she added.

The publication Managing Conflicts of Interest in Clinical Commissioning Groups states that a conflict of interest can occur “when an individual’s ability to exercise judgement in one role is impaired by their obligation in another by the existence of competing interests.” For example, a clinical commissioner might experience a conflict of interest if their judgment as a commissioner could be, or be perceived to be, influenced by their own financial or non-financial concerns as an owner or shareholder in an organisation doing business with the NHS.

The guidance sets out ways to mitigate the risk of conflicts of interest, such as doing business transparently; being proactive rather than reactive when it comes to identifying potential competing interests; and setting out proportional rules for transparent and fair decision making.

However, the document states that there is “nothing inherently wrong” in having conflicts of interest and that seeking to avoid or eliminate them entirely is “unlikely to be possible or desirable.”

“While some conflicts of interest are inevitable, our publication makes it clear that in most cases it is possible to address them by ensuring that they are identified and managed in the right way,” clarified Mr Farrar. “No one wants confidence in their healthcare professionals undermined. That’s why tacking the issue head on now, and providing clarity for clinical commissioners about what are unacceptable conflicts of interest, will help minimise the impact on the commissioning model.”

• The guidance Managing Conflicts of Interest in Clinical Commissioning Groups is available online at: http://commissioning.rcgp.org.uk/2011/07/managing-conflicts-of-interest-in-clinical-commissioning-groups/.