Intended for healthcare professionals


More than a third of GPs on commissioning groups have conflicts of interest, BMJ investigation shows

BMJ 2013; 346 doi: (Published 14 March 2013) Cite this as: BMJ 2013;346:f1569

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  1. Gareth Iacobucci
  1. 1BMJ

On the eve of one of the biggest upheavals in the history of the NHS, Gareth Iacobucci looks at the conflicts at the heart of clinical commissioning groups

More than a third of GPs on the boards of the new clinical commissioning groups (CCGs) in England have a conflict of interest resulting from directorships or shares held in private companies, a new analysis by the BMJ has shown.

An examination of the registered interests of almost 2500 board members across 176 CCGs provides the clearest evidence to date of the conflicts that many doctors will have to manage from 1 April, when the GP led groups are handed statutory responsibility for commissioning around £60bn (€70bn; $90bn) of NHS healthcare services.

Our investigation shows that conflicts of interest are rife on CCG governing bodies, with 426 (36%) of the 1179 GPs in executive positions having a financial interest in a for-profit private provider beyond their own general practice—a provider from which their CCG could potentially commission services.

The interests range from senior directorships in local for-profit firms set up to provide services such as diagnostics, minor surgery, out of hours GP services, and pharmacy to shareholdings in large private sector health firms that provide care in conjunction with local doctors, such as Harmoni and Circle Health.

In some cases most of the GPs on the CCG governing body have financial interests in the same private healthcare provider.

Some doctors have relinquished interests in private enterprises because of their new roles as commissioners. These include GPs linked to Richard Branson’s Virgin Care, which announced in October 2012 that it planned to end its joint venture partnerships with over 300 GPs in England,1 after admitting that many were becoming “increasingly worried about the perception of potential conflicts of interest.”

Calls for doctors with interests to step down

But our analysis …

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