Honesty in financial dealings
77. You must be honest in financial and commercial dealings with patients, employers, insurers and other organisations or individuals.22.
78. You must not allow any interests you have to affect the way you prescribe for, treat, refer or commission services for patients.
79. If you are faced with a conflict of interest, you must be open about the conflict, declaring your interest formally, and you should be prepared to exclude yourself from decision making.
Extracts from ‘Financial and Commercial Arrangements and Conflicts of Interest’ (2013))
Trust [between you and your patients] may be damaged if your interests affect, or are seen to affect, your professional judgement. Conflicts of interest may arise in a range of situations. They are not confined to financial interests, and may also include other personal interests. Conflicts of interest are not always avoidable, and whether a particular conflict creates a serious concern will depend on the circumstances and what steps have been taken to mitigate the risk… You should use your professional judgement to identify when conflicts of interest arise; avoid conflicts of interest wherever possible; declare any conflict to anyone affected, formally and as early as possible, in line with the policies of your employer or the organisation contracting your services; get advice about the implications of any potential conflict of interest; [and] make sure that the conflict does not affect your decisions about patient care. If you are in doubt about whether there is a conflict of interest, act as though there is.
If you, or someone close to you, or your employer, has a financial or commercial interest in an organisation … you must not allow that interest to affect the way you prescribe for, advise, treat, refer or commission services for patients. You must be open and honest with your patients about any such interests that could be seen to affect the way you prescribe for, advise, treat, refer or commission services for them. You must not try to influence patients’ choice of healthcare services to benefit you, someone close to you, or your employer….
The commissioning of services in the NHS can lead to conflicts of interest for the individual doctors involved. If you have responsibility for, or are involved in, commissioning services, you must: satisfy yourself that all decisions made are fair, transparent and comply with the law; keep up to date with and follow the guidance and codes of practice that govern the commissioning of services where you work; formally declare any financial interest that you, or someone close to you, or your employer has in a provider company, in accordance with the governance arrangements in the jurisdiction where you work; take steps to manage any conflict between your duties as a doctor and your commissioning responsibilities, for example by excluding yourself from the decision making process and any subsequent monitoring arrangements…. Health service financial incentives and similar schemes to improve the cost-effective use of medicines have a legitimate role to play in helping to make good use of available resources. Such schemes can also benefit the wider community of patients. But you must consider the safety and needs of the individual patient for whom you prescribe… Some organisations providing services outside healthcare (such as insurance companies or solicitors) run schemes where payment is offered according to the number of customers referred. Generally, doctors will not have the professional expertise to make recommendations or refer to a particular organisation; their chief interest in such schemes is financial. You should not accept fees for referring patients to, or recommending the services of, particular organisations or individuals.