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Commissioning dilemma: Half the board members at your CCG have financial links with local private providers

Half of the board members at your clinical commissioning group have some financial links with local private providers, although none are at director level. You have no reason to mistrust your colleagues' integrity, but are concerned about the message it could send out. What should you do? Dr Tony Grewal advises GPs on the best course of action.

GPs are good at handling conflicts of interest; this happens on a daily basis when we consider what is best for our patients while navigating relationships with the cluster amid the financial restraints being put in place.

The main issue here is one of transparency. Many of us wear several hats whether it is that of an LMC committee member, a board member on our clinical commissioning group or as a partner in a private healthcare provider. Disclosing your interests and being seen to be transparent is pivotal in avoiding a perceived conflict of interest, as is the case at LMC meetings. If a member has an interest in another company or organisation they are must declare that interest and it is recorded within the minutes of the meeting.

Maybe the real question should be: is it GPs conflicts of interest that we really need to be worried about? Ask yourself the question, how many management consultants are already involved in the decision making processes within the NHS and Department of Health? And how many of these organisations may subsequently be bidding to provide the services that they are making commissioning decision about?

If you are a GP who wears many hats you may be excluded from decision making or receiving information about commissioning of services where a conflict of interest does exist. Should this be inadvertently breached, the company involved must be precluded from any subsequent invitations to tender for the service in question.

Summing up, all GPs sitting on a CCG should declare all interests and the CCG should maintain a public register of such interests.  A statutory constitution for CCGs is imminent from the Department of Health which is expected to include guidance on conflict of interest; watch this space.

Dr Tony Grewal is a Medical Director at Londonwide LMCs.