Managing Conflicts Of Interest

Dealing properly with conflicts of interest is vital to securing public confidence in GP commissioning.  The consequences of failing to do so could have significant implications for clinical commissioning groups. The Conflicts of Interest Policy (COI) for Harrow sets out the issues to think about.

The key stages of dealing with conflicts of interest are:

Recognising when conflicts of interest arise

Conflicts of interest may arise where an individual’s (or a connected person’s) personal interests and/or loyalties conflict with those of the clinical commissioning group.  It is for each individual to exercise their judgement in deciding whether to declare any interests that may be construed as a conflict.  Individuals can seek guidance from the Company Secretary about when to do so, but it is always best to declare an interest if in doubt.

Declaring conflicts of interest

All Governing Body members and Senior Managers are required to declare any relevant and material interests, using this form. Interests to be declared include:

  • Any directorships of companies likely to be engaged with the business of the clinical commissioning group
  • Previous or current employment or consultancy positions
  • Voluntary or remunerated positions, such as trusteeship, local authority positions, other public positions
  • Membership of professional bodies or mutual support organisations
  • Investments in unlisted companies, partnerships and other forms of business, major shareholdings and beneficial interests
  • Gifts or hospitality offered by external bodies and whether this was declined or accepted in the last twelve months

The declaration of interests form must be completed prior to appointment, then updated at least annually and when any material changes occur.

Each CCG maintains a register of interests which is available here.

Acting appropriately in response to conflicts of interest

Visibility of interests is vital.  Once an interest is out in the open others can give a perspective to the significance of the issue.  Declaration by itself shows good faith and therefore serves to protect the person declaring it.  However declaring an interest either by entering it on the register or announcing it in a meeting will often not be sufficient.  There remains an on-going responsibility for any decision-maker to consider issues as they come up and to decide whether they present them with a conflict.  Details of how to respond to conflicts are included in the policy.

Gifts, Hospitality and the Bribery Act

The CCG’s policy is that any gift or offer of a gift/hospitality which is perceived to exceed £25 must be declared and entered onto the Gifts and Hospitality Register.  Any gift or offer of a gift which is perceived to exceed £100 can only be accepted if prior authorisation has been received from the Chair or the Accountable Officer.

Gifts or hospitality can be perceived as being a bribe.  Under the Bribery Act it is a criminal offence to pay or to receive bribes. Gifts or hospitality are unlikely to breach the Act if they are:

  • Reasonable and proportionate
  • Have a bona fide business purpose
  • Are not intended to influence

However, unduly lavish hospitality could give rise to inference of impropriety.

For more information about Conflicts of Interest or Gifts/Hospitality, please contact David Triggs, Head of Governance at david.triggs1@nhs.net 

The role and responsibilities of the CCG Procurement Panel 

The Harrow CCG Governance structure clearly defines the role of the Procurement Panel: the Governing Body fully delegates decision-making authority to the procurement panel where it is unable to undertake decision(s) due to real or potential conflicts of interest. If requested by the Governing Body, the Panel may make decisions on a range of purposes, and if authority has been specifically delegated to it in any particular case, it may make decisions on behalf of the Governing Body. The Procurement Panel reports on its business to the next meeting of the Governing Body. Thus the role of the Procurement Panel is integral to the CCG’s process in managing conflicts of interest where they may arise.