CONFLICTS OF INTEREST POLICY

Version 4

August 2017

Version Control

Version / Date / Author/Reviewer / Comments
1.0 / October 2013 / Governing Body / Approved by Governing Body on 3/10/13
1.1 / December 2014 / CCG Head of Corporate Services / Annual review and reflecting internal audit recommendations
1.2 / January 2015 / CCG Head of Corporate Services / Accountable Officer / Updated to reflect statutory guidance issued on 18/12/14
1.3 / January 2015 / CCG Head of Corporate Services / Accountable Officer / Updated references and appendices and feedback
1.4 / January 2015 / CCG Head of Corporate Services / Accountable Officer / Addition of procurement template. Draft approved for submission to NHS England
1.5 / February 2015 / Governing Body / Submitted for approval by Governing Body on 5/2/15
2.0 / February 2015 / Governing Body / Approved by Governing Body on 5/2/15
2.1 / September 2016 / CCG Head of Governance/ Accountable Officer / Updated to reflect statutory guidance issued on 28/6/16
3.0 / October 2016 / Governing Body / Approved by Governing Body on 6/10/16
3.1 / December 2016 / CCG Head of Governance/ Accountable Officer / Amended templates to reflect CCG branding and requirements
3.2 / July 2017 / CCG Head of Governance/ Chief Executive & CFO / Updated to reflect revised statutory guidance issued on 16/6/17
3.3 / August 2017 / Governing Body / Updated to reflect CE feedback. Submitted for approval by Governing Body on 5/2/15
Impact Assessed / July 2017 / Date of next review: June 2018

Contents

Page
1. / Introduction / 3
2. / Purpose / 3
3. / Legislative Requirements / 4
4. / Other Requirements / 4
5. / Scope / 5
6. / Principles of this Policy / 6
7. / Conflicts of Interest Covered by this Policy / 7
8. / Appointments / 10
9. / Roles and Responsibilities / 11
10. / Declaring an Interest / 13
11. / Declaring an Offer of Gifts, Hospitality and Sponsorship / 14
12. / Managing Conflicts of Interest in Meetings / 16
13. / Managing Conflicts of Interest throughout the Commissioning Cycle / 18
14. / Registers of Interests, Procurement Decisions, and Gifts, Hospitality and Sponsorship / 22
15. / Data Protection / 23
16. / Raising Concerns and Breaches / 23
17. / Monitoring Compliance & Effectiveness of this Policy / 24
18. / Equality & Diversity Statement / 24
Appendices
Appendix 1 –Guidance & Frequently Asked Questions / 25
Appendix 2 – Declaration of Financial & Other Interests for Members/Employees / 30
Appendix 3 – Declaration of Offers and Receipt of Gifts, Hospitality and Sponsorship / 35
37
Appendix 4 – Declaration of conflict of interests for bidders / contractors template / 43
Appendix 5 – Procurement Template / 46
Appendix 6 – Register of Interests Template / 49
Appendix 7 – Register of Gifts, Hospitality and Sponsorship Template / 50
Appendix 8 – Register of Procurement Decisions Template / 51
  1. Introduction

1.1Knowsley Clinical Commissioning Group (the CCG) is committed to ensuring public funds are used appropriately and efficiently and recognises that it is placed in a significant position of trust in relation to responsibilities for the commissioning of healthcare services. In order to inspire and retain patient and public confidence in the CCG’s decision making,the highest standards of probity, transparency and accountability will be applied when commissioning services for the population of Knowsley and when dealing with stakeholders, partners and suppliers.

1.2The CCG’s constitution requires that it make arrangements to manage conflicts and potential conflicts of interest to ensure that decisions made by the group will be taken and seen to be taken without any possibility of the influence of external or private interest.

1.3Conflicts of interest may arise when an individual’s personal, or a connected person’s interests and/or loyalties, conflict with those of the CCG. Identifying and managing conflicts of interest (real or perceived) is therefore essential in the promotion of transparency and maintaining public trust, demonstrating integrity and avoiding any potential or real situations of undue bias or influence in the CCG’s decision-making process.

1.4For a GP or any other individual involved in commissioning, a conflict of interest may arise when their own judgment as an NHS commissioner could be, or be perceived to be, influenced and impaired by their own concerns and obligations as a healthcare or related provider, as a member of a particular peer, professional or special interest group, or as a friend or family member.

1.5This policysets out theCCG’s arrangements for the management of conflicts of interest and potential conflicts of interest arising from the operation of the CCG’s commissioning activities and decisions, including any responsibilities for commissioning primary care delegated from NHS England.

  1. Purpose

2.1The purpose of the policy is to:

2.1.1Safeguard clinically led commissioning, whilst ensuring objective investment decisions;

2.1.2Demonstrate that the CCG acts fairly and transparently and in the best interests of patients and the local population;

2.1.3Uphold confidence and trust in the NHS locally;

2.1.4Support those who work on behalf of the CCG to understand when conflicts, whether actual or potential, may arise and how to manage them if they do; and

2.1.5Ensure that the CCG operates within the legal framework.

  1. Legislative Requirements

3.1Section 14O of the National Health Service Act 2006, inserted by the Health and Social Care Act 2012, sets out that each CCG must:

3.1.1Make arrangements to ensure individuals declare any conflict or potential conflict in relation to a decision to be made by the group as soon as they become aware of it, and in any event within 28 days. CCGs must record the interest in the registers as soon as they become aware of it;

3.1.2Maintain one or more registers of interest of the members of the group, members of its governing body, and its employees. CCGs must publish, and make arrangements to ensure that members of the public have access to, these registers on request;

3.1.3Make arrangements for managing conflicts of interest, and potential conflicts of interest, in such a way as to ensure that they do not, and do not appear to, affect the integrity of the group’s decision making.

3.2NHS England has issued statutory guidance under sections 14O and 14Z8 of the Act and expects all CCGs to fully implement the guidance. This includes annual and quarterly self-certification by CCGs confirming that they comply with specific elements of the guidance. Where CCGs have decided not to comply with one or more of the requirements, CCGs are required to discuss this with NHS England and include their reasons on the self-certification statement.

3.3The NHS (Procurement, Patient Choice and Competition) Regulations 2013 require that CCGs:

3.3.1Must not award a contract for the provision of NHS health care services where conflicts, or potential conflicts, between the interests involved in commissioning such services and the interests involved in providing them affect, or appear to affect, the integrity of the award of that contract; and

3.3.2Must keep a record of how it manages any such conflict in relation to NHS commissioning contracts it enters into.

4. Other Requirements

4.1In addition to the requirements in section 3 above, CCGs also need to adhere to guidance issued by professional bodies on conflicts of interest, procurement rules, and other relevant legislation as follows:

4.1.1British Medical Association guidance on conflicts of interest for GPs in their role as commissioners and providers at

4.1.2Royal College of General Practitioners – Managingconflicts of interest in clinical commissioning groups at

4.1.3General Medical Council good medical practice guidance at

4.1.4The Public Contract Regulations 2015 at

4.1.5The Bribery Act 2010 at

4.1.6The Fraud Act 2006 at

  1. Scope

5.1This policy applies to all CCG members, staff, and others working on its behalf, regardless of whether they are directly employed, seconded or working under a contract for services, or whether their remit is clinical or corporate. This includes the following, as reflected in NHS England statutory guidance:

5.1.1All CCG employees, including:

  • All full and part time staff;
  • Any staff on sessional or short term contracts;
  • Any students and trainees (including apprentices);
  • Agency staff; and
  • Seconded staff

In addition, any self-employed consultants or other individuals working for the CCG under a contract for services should make a declaration of interest in accordance with this guidance, as if they were CCG employees.

5.1.2Members of the governing body and all members of the CCG’s committees, sub-committees/sub-groups, including:

  • Co-opted members;
  • Appointed deputies; and
  • Any members of committees/groups from other organisations.

Where the CCG is participating in a joint committee alongside other CCGs, any interests which are declared by the committee members should be recorded on the register(s) of interest of each participating CCG.

5.1.3All members of the CCG (i.e., each practice). This includes each provider of primary medical services which is a member of the CCG under Section 14O (1) of the 2006 Act. Declarations should be made by the following groups:

  • GP partners (or where the practice is a company, each director);
  • Any individual directly involved with the business or decision-making of the CCG.

5.2Collectively, and for the purpose of this policy the above will generally be referred to as ‘CCG members and staff’ throughout the document.

6. Principles of this Policy

6.1The CCG will observe the principles of good governance in the way in which it conducts its business and manages conflicts of interest, including:

6.1.1The Nolan Principles at

6.1.2The Good Governance Standards for Public Services (2004), Office for Public Management (OPM) and Chartered Institute of Public Finance and Accountancy (CIPFA) at

6.1.3The seven key principles of the NHS Constitution at

6.1.4The Equality Act 2010 at

6.1.5The UK Corporate Governance Code at

6.1.6Standards for members of NHS boards and CCG governing bodies in England at

6.1.7The CCG’s Standards of Business Conduct at

6.2The main principle of this policy is to protect both the CCG and individuals involved in decision making from any appearance of impropriety and demonstrate transparency to the public and external interested parties. The general processes and safeguards contained within will equally apply across the full commissioning cycle.

6.3All CCG members and staff are required to:

6.3.1Ensure that the interests of patients remain paramount at all times;

6.3.2Be impartial and honest in the conduct of their official business;

6.3.3Use public funds entrusted to them to the best advantage of the service, always ensuring value for money;

6.3.4Ensure that they do not abuse their official position for personal gain or to the benefit of their family or friends; and

6.3.5Ensure that they do not seek to advantage or further, private or other interests, in the course of their official duties.

6.4The CCG will ensure that all members and staff are aware of the existence of this policy, and will include an introduction to the policy and related documents in induction packs for new staff. Anannualreminder to review and update declarations of interest will be sent to all CCG members and staff by the Chief Executive, with more frequent reminders for decision making members and staff. This is does not replace the requirement for all CCG members and staff to notify the Chief Executive of any changes within 28 days of becoming aware of such a change.

6.5The CCG will view any instances where this policy is not followed as serious and may take disciplinary action against individuals, which may ultimately result in dismissal. In the case of members of the Governing Body or its Committees and Sub-Committees this will result in removal from office.

6.6In cases where non-adherence to the policy also constitutes a breach of the Fraud Act 2006 or the Bribery Act 2010, individuals may also be subject to criminal sanctions, including a fine or up to 10 years imprisonment.

7. Conflicts of Interest covered by this Policy

7.1A conflict of interest is defined as any situation where the personal interests or responsibilities of CCG members and staff may influence, or appear to influence the CCG’s decision making. The 4 key types of interest covered by this policy are described below.

7.2Financial Interests

7.2.1This is where an individual may get direct financial benefits from the consequences of a commissioning decision. This could, for example, include being:

  • A director, including a non-executive director, or senior employee in a private company or public limited company or other organisation which is doing, or which is likely, or possibly seeking to do, business with health or social care organisations. This includes involvement with a potential provider of a new care model.
  • A shareholder (or similar ownership interests), a partner or owner of a private or not-for-profit company, business, partnership or consultancy which is doing, or which is likely, or possibly seeking to do, business with health or social care organisations.
  • A management consultant for a provider.
  • A provider of clinical private practice.

7.2.2This could also include an individual being:

  • In employment outside of the CCG;
  • In receipt of secondary income;
  • In receipt of a grant from a provider;
  • In receipt of any payments (for example honoraria, one-off payments, day allowances or travel or subsistence) from a provider;
  • In receipt of research funding, including grants that may be received by the individual or any organisation in which they have an interest or role; and
  • Having a pension that is funded by a provider (where the value of this might be affected by the success or failure of the provider).

7.3Non-financial professional interests

7.3.1This is where an individual may obtain a non-financial professional benefit from the consequences of a commissioning decision, such as increasing their professional reputation or status or promoting their professional career. This may, for example, include situations where the individual is:

  • An advocate for a particular group of patients;
  • A GP with special interests e.g., in dermatology, acupuncture etc.
  • An active member of a particular specialist professional body (although routine GP membership of the RCGP, British Medical Association (BMA) or a medical defence organisation would not usually by itself amount to an interest which needed to be declared);
  • An advisor for the Care Quality Commission (CQC) or the National Institute for Health and Care Excellence (NICE);
  • Engaged in a research role;
  • The development and holding of patents and other intellectual property rights which allow staff to protect something that they create, preventing unauthorised use of products or the copying of protected ideas.

7.3.2GPs and practice managers, who are members of the governing body or committees of the CCG, should declare details of their roles and responsibilities held within their GP practices.

7.4Non-financial personal interests

7.4.1This is where an individual may benefit personally in ways which are not directly linked to their professional career and do not give rise to a direct financial benefit. This could include, for example, where the individual is:

  • A voluntary sector champion for a provider;
  • A volunteer for a provider;
  • A member of a voluntary sector board or has any other position of authority in or connection with a voluntary sector organisation;
  • Suffering from a particular condition requiring individually funded treatment;
  • A member of a lobby or pressure group with an interest in health and care.

7.5Indirect interests

7.5.1This is where an individual has a close association with an individual who has a financial interest, a non-financial professional interest or a non-financial personal interest in a commissioning decision (as those categories are described above) for example, a:

  • Spouse / partner
  • Close family member or relative e.g., parent, grandparent, child, grandchild or sibling;
  • Close friend or associate;
  • Business partner.

7.5.2A declaration of interest for a “business partner” in a GP partnership should include all relevant collective interests of the partnership, and all interests of their fellow GP partners.

7.5.3Whether an interest held by another person gives rise to a conflict of interests will depend upon the nature of the relationship between that person and the individual, and the role of the individual within the CCG.

7.6The NHS Model Standing Orders, Reservation and Delegation of Powers and Standing Financial Instructions, page 23 Department of Health (2006) defines relevant and material interests as:

7.6.1Directorships, including non-executive directorships held in private companies or PLCs (with the exception of those of dormant companies);

7.6.2Ownership or part-ownership of private companies, businesses or consultancies likely or possibly seeking to do business with the NHS;

7.6.3Majority or controlling share holdings in organisations likely or possibly seeking to do business with the NHS;

7.6.4A position of authority in a charity or voluntary organisation in the field of health and social care;

7.6.5Any connection with a voluntary or other organisation contracting for NHS services;

7.6.6Research funding/grants that may be received by an individual or their department;

7.6.7Interests in pooled funds that are under separate management, and;

7.6.8Clause 7.15 of the Model Standing Orders, Reservation and Delegation of Powers and Standing Financial Instructions states that such directorships should be included in the organisation’s Annual Report.

7.6.9Interests “...must not exceed £5,000 in nominal value or one per cent of the total issued share capital of the company or of the relevant class of such capital, whichever is the less.”

7.7It is not possible to define or describe all instances in which an interest may be real or perceived conflict. It is therefore incumbent on each individual to exercise their judgement in deciding whether to register any interests that may be construed as a conflict. When in doubt, individuals should seek guidance from the Chief Executive but are advised to declare in the event of any doubt as to whether a conflict exists or not. A guidance document, which includes a selection of Frequently Asked Questions, is included as Appendix 1.

8. Appointments

8.1Applicants for senior appointments to the CCG, its Governing Body, Committees, or Sub-Committees will be asked to declare any relevant interestsprior to interview, and again on appointment when it will be recorded on the register of interests. For all other appointments, applicants will be asked to declare any relevant interest as part of the pre-employment checks.

8.2Where a relevant interest exists, the Chief Executive will consider whether the conflict, or potential conflict, is such that the applicant should be excluded from being appointed. This assessment will be made following the shortlisting process and will include a discussion with the candidate to confirm and clarify the nature of the interest and how it could be managed. In making this assessment, the Chief Executive will take into account:

8.2.1The materiality of the interest, in particular whether the individual (or a family member) could benefit from any decision the Governing Body, Committee, Sub-Committee or post-holder might make;

8.2.2The seniority and authority of the role to which appointment is being considered;

8.2.3The extent of the interest, and whether it is related to such a significant area of the CCG’s business in relation to the role to which appointment is being considered, that it wouldn’t be possible for the applicant to perform the majority of the role;

8.2.4The nature and degree of specialism of the role to which appointment is being considered, and whether it is reasonably practical to make alternative arrangements for performing those elements where a conflict, or potential conflict exists;