HCSA warns NHS England on conflict of interest plans

HCSA has warned NHS England against plans to force Hospital Doctors to reveal private earnings in its submission to an NHSE consultation on Managing Conflicts of Interest in the NHS.

In a robust response to the group tasked with drafting national policy on the issue, the Association has underlined its fears that such a demand – not extended to other senior NHS staff – would risk exposing individuals to “unfair, speculative and unwarranted media and public focus.”

While agreeing with many of the proposals put forward in the consultation document, HCSA warned in its submission: “We do not believe that compelling doctors to list details to the level specified will assist in revealing true conflicts of interest, but it will serve to create another pressure point where the medical profession feels negatively singled out for ‘special treatment.’

“It will be hard for the minority of NHS doctors who carry out private practice to comprehend why the proposal to publish outside incomes and other minutiae (sessions and specialties) are not extended to other professions and trades within NHS who are deemed ‘senior staff’.”

HCSA also raised concerns over a loosely worded proposal to compel NHS staff to reveal and publish publicly “political affiliations” where they play an “active role” and has requested clarification of this potentially extremely intrusive clause.

The Association did, however, relay its agreement on a range of areas, including ensuring that NHS Hospital Doctors do not initiate conversations with patients about private practice during the course of their NHS work, and its belief that employers should be aware of the broad nature of private work that their employees may be undertaking – something, however, already covered by annual appraisals for medical staff.

“The key priority for HCSA is for senior clinical staff to fulfil their NHS contractual obligations which already include, as the consultation document notes, prioritising NHS work above all other,” the HCSA noted in its submission.

It added: “Given the increasingly complex shape of the NHS and commissioning, it is essential that any provisions agreed for NHS providers must automatically and immediately be extended to non-NHS providers in respect of NHS-funded services. The failure to commit in full to a transparency regime should lead to censure and the potential withdrawal or refusal of contracts.

“HCSA firmly believes that any alteration in declaration or perceived transparency should be automatically extended to all staff who hold NHS contracts from top to bottom, including the multitude of arm’s length organisations such as NHS Employers, NHS England, NHS improvement, NHS Providers and the Department of Health.”

HCSA President Professor Ross Welch said: “We remain concerned that this unfair approach of publicly posting earnings will see a few cases from one section of senior NHS staff being used in a sensationalist manner by the media, but the impact in terms of public perception will be felt by all Hospital Doctors.

“It is somewhat bizarre and completely unjustified that given the wide range of senior NHS staff covered by the consultation, it is only doctors who will be expected to reveal precise details of their private earnings.

“Details of private work, albeit not earnings, undertaken on their own time by Hospital Doctors are already discussed within the annual job planning process and any impact they could potentially have forms part of the annual whole of practice appraisal, disclosed to NHS employers. The Consultants Contract also enshrines the primacy of the National Health Service when it comes to arranging their workload.

“We fear that this proposed policy will merely serve to land another blow to morale for many doctors who already feel that they are being squeezed from every angle. We urge a rethink.”