Focus on conflicts of interest
Conflicts of interest can arise in situations where someone’s judgement may be influenced, or perceived to be influenced, by a personal, financial or other interest.
A joint statement on managing conflicts of interest has been signed by the chief executives of the nine regulators of healthcare professionals in the UK, and social workers in England.
The joint statement sets out what is expected of health and care professionals in relation to avoiding, declaring and managing conflicts of interest that may arise across different healthcare settings.
The increasing move towards multi-disciplinary teams means that a joint and consistent approach from the regulators is crucial to ensure the interests of patients and the public are put first.
The statement is intended to support each regulator’s professional standards, codes and guidance, which the statement says “should be the overriding consideration for professionals.”
Our standards for pharmacy professionals state that registrants must use their professional judgement. This includes pharmacy professionals declaring any personal or professional interests and managing these professionally, as well as considering and appropriately managing any personal or organisational goals, incentives or targets.
The joint statement from the regulators says that health and social care professionals are expected to:
- Put the interests of people in their care before their own interests, or those of any colleague, business, organisation, close family member or friend.
- Maintain appropriate personal and professional boundaries with the people they provide care to and with others.
- Consider carefully where conflicts of interest may arise – or be perceived to arise – and seek advice if they are unsure how to handle this.
- Be open about any conflict of interest they face, declaring it formally when appropriate and as early as possible, in line with the policies of their employer or the organisation contracting their services.
- Ensure their professional judgement is not compromised by personal, financial or commercial interests, incentives, targets or similar measures.
- Refuse all but the most trivial gifts, favours or hospitality if accepting them could be interpreted as an attempt to gain preferential treatment or would contravene your professional code of practice.
- Where appropriate, ensure that patients have access to visible and easy-to-understand information on any fees and charging policies for which you are responsible.
To further assist healthcare professionals and the public in understanding what the joint statement means in practice and to illustrate where it might be relevant, some case studies have also been published. The case studies set out various different scenarios that may occur in practice particularly so that healthcare professionals can consider what they would do if faced with that situation. The suggestions given are examples and not an exhaustive list of all the possible solutions or courses of action.
We have included one of the case studies, about prescription direction by a GP, below. The other case studies are available on our website.
Conflicts of Interest case study: Dr Williams and prescription direction
Note: While this scenario focusses on a doctor who had commercial interests in a pharmacy, it could also apply to a range of healthcare professionals who may have a direct or indirect financial interest in another business, regardless of the ownership model
Dr Williams is a GP in a private practice. Her employer has recently bought a local pharmacy. Dr Williams has been told to encourage her patients to take their prescriptions there as they will get better service and faster processing times.
What did Dr Williams consider?
Dr Williams considered whether her patients may think that her employers were influencing her judgement as they had a financial interest in the pharmacy. Dr Williams knew she must always put the interests of her patients before her own or her employer’s interests, and that she must ensure her professional judgement was not compromised. She was aware that her patients could choose freely which pharmacy dispenses their prescriptions and so she decided it wouldn’t be appropriate to make recommendations.
What did Dr Williams do?
Dr Williams decided to prioritise the interests of her patients and reminded her employer of her professional responsibilities.
She realised that directing patients to a pharmacy owned by her employer without being honest about this relationship would likely be, or be perceived to be, a conflict of interest. This could damage her patients’ trust in her and in the GP practice.
She decided to make sure her patients understood that they know they can choose where to get their prescription from. Where patients had repeat prescriptions, Dr Williams continued to check with patients that they were happy with their nominated pharmacy, and would advise about a range of options if needed. Dr Williams decided that if any of her patients asked her about that particular pharmacy, she would be open and honest about her employer’s interest in it.
Other useful resources for you
- Joint statement from the chief executives of statutory regulators of healthcare professionals
- GMC, Financial and commercial arrangements and conflicts of interest, 2013
- GPhC, Standards for pharmacy professionals
- GPhC, Standards for registered pharmacies
- PSNI Code (Professional standards of conduct, ethics and performance for pharmacists in Northern Ireland)
- NHS Constitution for England – under this, patients in England have the right to choose their pharmacy
- For pharmacists working in Northern Ireland, the NHS Constitution doesn’t apply, and pharmacists should follow the BMA guidance on this issue
- The 7 principles of public life (‘Nolan principles’ May 1995) – apply to anyone who works in health, education, social and care services and give guidance on transparency and declaring any interests.
- NHS England has published guidance for staff and organisations organisation on managing conflicts of interest in the NHS