Doctors could be asked to declare private income, NHS England says

BMJ 2016; 354 doi: (Published 20 September 2016) Cite this as: BMJ 2016;354:i5101
  1. Abi Rimmer
  1. BMJ Careers
  1. arimmer{at}

Doctors could be asked to declare how much they have earnt from private practice, under proposals set out by NHS England.

The plans were included in a wider NHS England consultation on proposals designed to strengthen the management of conflicts of interest, which was published on 19 September.1

Under the proposals, clinical staff would be required to declare their earnings from private practice and state whether they earnt less than £50 000, less than £100 000, or more than £100 000. This information would then be included on their employers’ register of interests.

The proposals also said that clinical staff should not initiate conversations about private work with patients when they were undertaking NHS work, or accept financial incentives from private providers.

The consultation also included proposals requiring doctors to refuse all gifts from patients and foreign dignitaries that were worth more than £50, and to decline all gifts from suppliers except when they were “low cost branded promotional aids” worth less than £6. All NHS staff who received hospitality from the pharmaceutical or other industries worth more than £25 must declare it, the proposals said.

Malcolm Grant, chair of NHS England, who led the group that worked on the proposals, said, “We have a responsibility to use the £110 billion (€128bn; $143bn) healthcare budget provided by the taxpayer to the best effect possible for patients, with integrity, and free from undue influence. Spending decisions in healthcare should never be influenced by thoughts of private gain.”

Speaking to the Times newspaper about doctors’ payments for private work, Grant said, “It’s not an attempt to curb private work by consultants . . . Let’s have some transparency here. Much of what goes on in these communities is almost under the radar.”

Commenting on the consultation, Clare Marx, president of the Royal College of Surgeons, said that clear guidance for NHS staff on managing potential conflicts of interest was long overdue. “Patients rightly have a huge amount of trust in the medical profession and this guidance will help doctors to think about any potential conflicts of interest and help them to act appropriately at all times,” Marx said.

Keith Brent, BMA consultant committee chair, said: “All consultants are dedicated professionals who in the vast majority of cases work beyond their contractual hours. Under the terms of the consultant contract, if a doctor wishes to undertake private work, they have to first offer extra time to the NHS. Consultants, like all other senior NHS staff, are also required to make an annual declaration of substantial conflicts of interest in accordance with legislation.”


  • Competing interests: The BMJ’s editor, Fiona Godlee, is a member of the conflicts of interest taskforce.


View Abstract