The scene
A GP with a special interest in diabetes contacted the MDU advisory helpline. He was a member of the local clinical commissioning group (CCG) and had been offered a new device for GPs in the area to try out for a year. The device recorded blood sugars taken by patients in their homes and sent the results directly to the GP system which automatically alerted the GP to any abnormalities.
Patients and staff would need to be trained in their use and the GP's best friend's wife was the director of the company which would provide the devices and the training. The member was concerned about whether this was a conflict of interest. He stressed that he would derive no financial benefit from the situation.
MDU advice
The medico-legal adviser said that sometimes conflicts of interest are unavoidable. She explained to the member that there are several types of conflict of interest. These include:
- direct financial interest, for instance if the individual is a director of the company being commissioned
- indirect financial interest where a family member may obtain financial gain from the situation
- non-financial or personal interest where the individual may gain recognition from research or where friends of the individual gain
- conflicts of loyalty between the CCG and other bodies that the individual belongs to, such as colleges
- perceived conflict between professional duties to the whole population when acting as a commissioner and to individual patients as a primary care provider.1
The adviser also explained that the GMC says that if a doctor is in doubt about whether there is a conflict of interest, he or she should act as if there is one. The GMC also says that doctors should declare a conflict of interest to anyone affected as soon as possible and follow established procedures for managing a conflict.2
Possible outcomes included, on the one hand, that the CCG would welcome his input into discussions given his expertise in diabetes, but on the other he could be accused of a personal interest due to his friend's wife's potential future financial gain. This could lead to accusations of lack of probity on his part, complaints about the CCG, adverse publicity and loss of public confidence in the organisation.
The adviser also explained that the GMC says that if a doctor is in doubt about whether there is a conflict of interest, he or she should act as if there is one.
The adviser suggested that the doctor may wish to declare his interest in line with the guidance from NHS England (formerly the National Commissioning Board)3 but that the CCG would need to decide how to manage the conflict in a balanced and proportionate manner.4
Outcome
The doctor thanked the adviser and said that he would certainly declare the non-financial personal interest so that it could be properly documented.
References
1 Managing Conflicts of Interest in clinical commissioning groups, RCGP Centre for Commissioning, 2011
2 Financial and commercial arrangements and conflicts of interest, GMC, 2013
3 Towards establishment: Creating responsive and accountable CCGs, NCB, 2012
4 Making difficult choices: RCGP ethical commissioning guidance, RCGP, 2011
This page was correct at publication on 04/12/2013. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.