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GPhC: Only 'trivial gifts' will avoid conflicts of interest

GPhC: Conflicts can arise when someone’s judgement may be influenced by a financial interest

The General Pharmaceutical Council (GPhC) is urging pharmacists to "refuse all but the most trivial gifts" in an effort to avoid "conflicts of interest" which may impact patient care.

In a joint statement signed by the GPhC and eight other health regulators – including the General Medical Council (GMC) and the Pharmaceutical Society Northern Ireland (PSNI) – the regulators outline what they "expect health and social care professionals" to do in order to "avoid, declare and manage conflicts of interest".

"Conflicts can arise in situations where someone’s judgement may be influenced – or perceived to be influenced – by a personal, financial or other interest," the regulators said in the statement, published yesterday (August 8).

As well as refusing "gifts, favours or hospitality if accepting them could be interpreted as an attempt to gain preferential treatment", the regulators urge health professionals to: "put the interest of people in their care before their own"; "maintain appropriate personal and professional boundaries"; and "ensure their professional judgement is not compromised by personal, financial or commercial interests, incentives or similar measures".

The joint statement will be promoted to "registrants, students and to the public, to ensure they all know what we expect", the regulators added.

Alongside the statement, the regulators published case studies illustrating how health professionals should deal with situations where a conflict of interest might arise.

A joint case study from the GPhC, GMC, and the PSNI on the GPhC’s website outlines a scenario where a GP is conflicted over prescription direction (see below).

Issues affecting patient care

Commenting on the joint statement, GPhC chief executive Duncan Rudkin said: "As health and care regulators, we share a commitment to collaborating on issues that affect patient safety and care."

The statement aims to "help give patients and the public the assurance that their interest will always be put above any other interest a health professional may have", he added.

A GPhC spokesperson told C+D that the "collaborative effort…[is] in recognition of the increasing move toward multi-disciplinary teams in health and care".

"The statement is intended to support – not supersede – our existing standards for pharmacy professionals," the spokesperson added.

Conflict of interest case study: prescription direction

The scenario

Dr Williams is a GP in a private practice. Her employer has recently bought a local pharmacy. Dr Williams has been told to encourage her patients to take their prescriptions there, as they will get better service and faster processing times.

What did Dr Williams consider?

Dr Williams considered whether her patients may think that her employers were influencing her judgement, as they have a financial interest in the pharmacy. Dr Williams knew she must always put the interests of her patients before her own or her employer’s, and that she must ensure her professional judgement is not compromised. She was aware that her patients could choose freely which pharmacy dispenses their prescriptions, and so she decided it wouldn’t be appropriate to make recommendations.

What did Dr Williams do?

Dr Williams decided to prioritise the interests of her patients and reminded her employer of her professional responsibilities.

She realised that directing patients to a pharmacy owned by her employer without being honest about this relationship would likely be, or be perceived to be, a conflict of interest. This could damage her patients’ trust in her and in the GP practice.

She decided to make sure her patients understood they can choose where to get their prescription from. Where patients had repeat prescriptions, Dr Williams continued to check with patients that they were happy with their nominated pharmacy, and would advise about a range of options if needed. Dr Williams decided that if any of her patients asked her about that particular pharmacy, she would be open and honest about her employer’s interest in it.

Source: GPhC website

Have you ever struggled with a conflict of interest at work?

IAN FRASER, Locum pharmacist

Pure joke

GPs expect everything 

So do care homes 

We are happy to get BFH (BUS FARE HOME)

Service a MDS tray making losses on tray costs and time for 4 years and you'll get the out of date meds when the patient dies - gifts lol

Jonny Johal, Pharmacy Area manager/ Operations Manager

The issue of prescription direction was around when I qualifield in 1979, it is still around now. All the 'regulatory bodies' (RPSGB and GPhC) in this period have failed to tackle it, as did the GMC (who allows doctors to be sponsored and entertained by drug companies and other things). As for gifts, I think pharmacists and doctors should harmonise on this issue.

Dave Downham, Manager

Would be nice to be offered anything to refuse!

Lucky Ex-Locum, Superintendent Pharmacist

We get boxes of chocs at Christmas. Have I got to start knocking them back now? That will look so good for customer service won't it? 'Sorry Mrs Smith, I can't accept this box of Roses in case you're trying to bribe me......'

Paul Dishman, Pharmaceutical Adviser

If "Dr Williams" worked for a dispensing GP practice would she be reminding patients that they could take their prescriptions to a pharmacy?

Leroy Jackson, Community pharmacist

Who's regulating the care home managers who demand gifts such as drug trolleys, staff discounts and new cd cabinets or fridges before threatening to move their business elsewhere??

Ilove Pharmacy, Non Pharmacist Branch Manager

They Would do NOTHING. Correction they would probably have the pharmacist sruck off. 

L H, Community pharmacist

Errr...pardon me, GPhC, but why is 2013 the last year you have a record of any gifts and hospitality accepted by council members?  Fair enough if nobody has accepted anything or been on any paid conferences since then, however I'd suggest adding a "2014 - Nothing to declare" etc to stop pessimists like myself jumping to conclusions.


Ilove Pharmacy, Non Pharmacist Branch Manager

Replace the GP with a pharmacist and her employer with Boots.

The pharmacist reminds Boots of her professional responsibilities after Boots insist on 400Murs no matter how spurious or un warranted.

What would the GPhC do on hearing that the pharmacist has subsequently been sacked. 

Answers on the back of a postcard.

A Hussain, Senior Management

So what would they do if they were given a scenario as above, but where the GP and pharmacy decide to ignore the clear conflict and plough ahead with a prescription direction scheme?

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