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GPs must avoid conflicts of interest on CCGs

Business After more than 300 GPs ended their partnerships with Virgin Care on ethical grounds, healthcare experts have issued fresh warnings to commissioners to be “careful” of getting involved in commercial interests.

Healthcare experts have raised fresh concerns over potential conflicts of interest in clinical commissioning groups (CCGs), after more than 300 GPs ended their partnerships with Virgin Care on ethical grounds.

Pharmacists and doctor organisations urged GP commissioners to be "careful" of getting involved in commercial interests, following news last week that GPs had begun to sever ties with Virgin Care more than 18 months ago – citing fears over the "perception of potential conflicts of interest" with commissioning duties.

The comments came after a poll of C+D readers revealed concerns over the role of CCGs. Of the 45 readers polled, more than three quarters thought CCGs would have a commercial conflict of interest.

"The whole new landscape is fraught with problems... I can't see a clear path that isn't coloured in some way by some influence" Andrew McCoig, Croydon LPC

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GPs were becoming increasingly concerned about conflict of interest as they took on commissioning responsibilities, Virgin Care told C+D. But it said the new NHS did not make a partnership "unworkable", because it had "robust policies and procedures in place" and was continuing work with some GPs.

Croydon LPC secretary Andrew McCoig said conflict of interest was "inevitable" under the new NHS structure.

"I think the whole new landscape is fraught with problems over the [any qualified] provider model and I can't see a clear path that isn't coloured in some way by some influence," he argued. "It's impossible to sidestep that the CCG managers will be providing services themselves, or know people providing services."

The BMA agreed that GPs would have to be "even more careful" with conflict issues under the reforms and said commissioners would have to "ask themselves questions" as to whether they should be in a partnership with a service provider. But it stressed that there was also a responsibility on other providers to act ethically.

"Commercial companies have to be careful as well and make sure their contracts don't place any professional in a position where there might be a conflict of interest," a BMA spokesperson told C+D.

Meanwhile, PSNC called for tight regulation of CCGs to ensure decisions were made on a strictly clinical basis, in its response last week to the Department of Health's consultation on Securing best value for NHS patients.

"Where commissioners are also providers of services, there is clearly a risk that decisions will be clouded by commissioners' personal and business interests," said PSNC head of regulation Steve Lutener.

The new NHS must have "robust governance" and "proactive disclosure of self interest by commissioners", PSNC stressed. It called for watchdog Monitor to have powers to ban individuals from commissioning bodies, paying particular attention to commissioners who had interests as providers.

GPs' decision to sever ties with Virgin Care has meant that they will no longer have 50/50 control over the provider companies, known as GPCos, which are contracted to provide local primary care and community services.

Virgin Care said it was going to focus on providing services directly.



How can commissioners avoid conflicts of interest?

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