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The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2015-11-17.

To ask Her Majesty’s Government what is their assessment of whether NHS England’s audit of conflict of interest is sufficiently comprehensive to govern circumstances in which Clinical Commissioning Groups enter into contracts with companies in which one or more of their board members has a financial interest.

Lord Prior of Brampton

NHS England has commissioned an independent audit of conflicts of interest management in 10 primary care co-commissioning arrangements. The audit fieldwork commenced in September 2015, with the final report due to be shared in January 2016. It is therefore too early to make an assessment of their findings.

The audit has been asked to examine and evaluate:

– arrangements to manage conflicts of interest;

– audit compliance with the statutory guidance on managing conflicts of interest and identify any areas of the guidance which need to be strengthened;

– identify and share good practices in managing conflicts of interest;

– identify future improvement opportunities; and

– share learning with commissioners in support of their development.

Each audit includes 360 degree interviews with representatives from:

– the clinical commissioning group (including the Chair of the primary care commissioning committee, Audit Chair, Accountable Officer, Finance Director, Clinical Chair/GP member of the primary care commissioning committee);

– NHS England (including the Director of Commissioning Operations, Head of Primary care and a Primary care commissioning manager for the locality);

– local Healthwatch;

– local Medical Committees (LMCs);

– Local Authorities; and

– Local Pharmaceutical Committees (LPCs).

The audit also comprises a detailed review of key governance documentation including:

– registers of interest, declarations of interest and registers of procurement decisions;

– co-commissioning governance arrangements;

– commissioning contracts that were entered into since 1 April 2015;

– guidance for CCG employees on managing COIs;

– guidance on dealing with breaches and details of any breaches; and

– minutes of primary care commissioning committee meetings since 1 April 2015 etc.

Each audit site will receive an individual report, detailing the findings for their specific arrangement. In addition, NHS England will receive a consolidated report, highlighting key themes, examples of good practice and recommendations to assist in the management of conflicts of interest.

Key learning from the audit will be shared with commissioners in January 2016 in support of their development and the findings will help inform the refresh of the statutory guidance on managing conflicts of interest.

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2015-11-17.

To ask Her Majesty’s Government, in the light of the investigation General practice commissioning: in whose interests? by The Times and the British Medical Journal, whether they have plans to require that the boards of Clinical Commissioning Groups cannot enter into contracts with companies in which one or more of their board members has a financial interest.

Lord Prior of Brampton

We do not have any such plans.

However, in all circumstances a clinical commissioning group must manage any actual or perceived conflicts in a way that is transparent, fair, and protects the integrity of their decision making.

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2015-11-17.

To ask Her Majesty’s Government, in the light of the investigation General practice commissioning: in whose interests? by The Times and the British Medical Journal, what assessment they have made of whether the conflict of interest guidelines are fulfilled by asking board members with a conflict of interest in an item under discussion during a board meeting to remain silent or leave the room.

Lord Prior of Brampton

NHS England is responsible for providing guidance to clinical commissioning groups on how to manage conflicts of interest.

The current guidance states that:

“Where certain members of a decision-making body have a material interest, they should either be excluded from relevant parts of meetings, or join in the discussion but not participate in the decision-making itself (i.e., not have a vote)….The chair of the meeting has responsibility for deciding whether there is a conflict of interest and the appropriate course of corresponding action.”

NHS England has commenced a review of the Conflicts of Interest Guidance, as part of a wider governance project to strengthen conflicts of interest management across the National Health Service, and this is expected to be published next year. NHS England will formally consult with a number of regulators and national partners in the development of this guidance.

The below Parliamentary question was asked by Lord Hunt of Kings Heath on 2015-11-17.

To ask Her Majesty’s Government what is their assessment of the finding by The Times and the British Medical Journal that the board of a Clinical Commissioning Group in Birmingham awarded a £1.7 million contract to a company in which a number of its board members were shareholders or held a senior position.

Lord Prior of Brampton

We are aware of the reports in The Times and The British Medical Journal.

Birmingham South Central CCG has provided assurances that it has robust and transparent governance arrangements in place that are in line with NHS England guidelines.