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NHS nursing staff face crackdown on perceived conflicts of interest


Nursing and midwifery staff should not accept patient gifts in excess of £50 or promotional gifts from drug or device manufacturers worth more than £6, under proposals set out by NHS England.

Meanwhile, nursing directors earning money from consultancy, advisory positions or honorariums will be expected to publicly declare them as interests in the new crackdown by the national body.

“There is a risk that current arrangements are not effective at delivering transparency”

Consultation document

In a consultation document, published last week, NHS England set out proposals to increase transparency around potential conflicts of interest.

These include declarations around an individual’s shareholdings, hospitality in excess of £25, family relationships and “loyalty interests” that may have an impact on their NHS employer.

However, while NHS England’s proposals include a plan to force doctors to reveal their earnings from any private practice work, the document makes no similar demand on non-medical staff – who will need to declare their interests but not necessarily specific earnings.

A review led by NHS England chair Sir Malcolm Grant developed the proposals NHS organisations could be expected to meet, in a bid to increase transparency across the service.

NHS England said anonymised information about breaches and how they were dealt with “must be published in a prominent place on the organisation’s website”.

Ideas in the consultation document affecting all nursing and other NHS staff include:

  • Gifts from patients up to the value of £50 may be accepted and need not be declared but gifts over the value of £50 should be declined.
  • Gifts connected with procurement and/or service supply should be declined. However, where low cost branded promotional aids are offered these may be accepted where they are under the value of £6 in total. In these circumstances they need not be declared
  • Hospitality – meals, refreshments, travel and accommodation offers – should only be accepted where there is a legitimate business interest and declared when it exceeds the £25, though there will be no requirement to declare the actual value.

Ideas in the consultation document affecting nursing directors and other senior staff include:

  • Declaring outside employment and engagements including directorships, non-executive roles, self-employment, consultancy work, paid advisory positions and paid honorariums related to organisations likely to do business with the NHS.
  • Declaring shares or other ownership interests that could give rise to a conflict of interest, except for those held in blind trusts. There is no proposal to reveal the size or earnings from the shareholding.
  • Declaration of loyalty interests including family and other relationships that could create a conflict including positions with charity and voluntary organisations, and political affiliations.

The review group, which assessed existing practices, said: “Our evidence review found that publication regimes across the NHS differ.

“Some organisations do not publish any information on interests, and where organisations do the information often only covers only a small subset of very senior staff, and is often old or out of date,” it said. “So there is a risk that current arrangements are not effective at delivering transparency.

It added: “Transparency is an important safeguard to ensure the probity of decision making in public service.

“Successive governments have pursued a transparency agenda in an attempt to make available more information about how public service organisations are performing, and how they are making use of taxpayers’ money,” it noted.

Malcolm Grant

Malcolm Grant

Malcolm Grant

The six-week consultation on the proposals will close on 31 October, after which guidance will be finalised and issued to NHS organisations.

Sir Malcolm said: “The public expect the highest standards of behaviour in the NHS, but we know there are times when the NHS has failed to meet this expectation.

“Spending decisions in healthcare should never be influenced by thoughts of private gain,” he noted.

He added: “We want to hear from as wide a range of people and organisations as possible so they can help us bring greater transparency, and clearer guidelines for staff in a way that will benefit taxpayers, patients and the health service.”


Would you accept a gift from a patient or their family?

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Readers' comments (12)

  • I think a value of up to £10 is reasonable

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  • Is this applicable to doctors? Because the same rules should ski trips to France paid for by drug companies. Surely this is a greater breach than any nurse receives ?
    I agree with the proposed legislation... I just think it should apply to any healthcare professional

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  • Oh aye! Regularly get gifts to the value of £50. Pen and a butty from reps.

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  • next stop we we have to show our pay slips to themedia ans patient- don't get any gifts these days

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  • I would never accept cash. But anything as a token should accepted, I would be offended if the role was reversed and someone didn't accept a gift that I wanted to give.

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  • I think the NHS management should mind it's own business. Gifts are given in many industries why the NHS. Go to any healthcare around the world gifts are given. This sick country is getting worse.

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  • The NHS management are getting their own house in order and as with MPs expenses this affects everyone in public service. I think that £50 is normally a reasonable limit but take someone caring long term may bequeath something more significant when they die. Especially if they have no family and view the carer as 'family'.

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  • There is a difference between a 'Please' and a 'Thank you' gift. A member of my family gave a bottle of wine to each of the surgeons that had removed his brain tumour, as a token of gratitude and appreciation. They were happy to receive it but told him "Our greatest reward is to see you well again".

    Ambrose Kingston, Nojerm Infection Control.

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  • Here in New Zealand, our District Health Board brought in an edict that all gifts, no matter how small must be declared. Since it is a cultural thing to offer small gifts, generally of food, as a token to thanks, they were inundated with declarations of pieces of fish, chocolate, fruit and the like. They soon changed the policy to gifts over $100 (currently about £50).

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  • Unfortunately they are not looking at the right places. NHS bank offices employees, Tender issuers are getting BIG payouts from Agency Bosses to secure contracts to supply in the hospital. This is an open secret. Up to today no one has ever demanded that Agencies declare how much they charge the NHS before they pay the nurses, doctors, PT, OT. Cut the middle man and save money.

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