A Cross-Sectional Study of All Clinicians’ Conflict of Interest Disclosures to NHS Hospital Employers in England 2015-2016

Harriet Ruth Feldman, Nicholas J. DeVito, Jonathan Mendel, David E. Carroll, Ben Goldacre (Lead / Corresponding author)

Research output: Contribution to journalArticle

Abstract

Objective: We set out to document how NHS trusts in the UK record and share disclosures of conflict of interest by their employees.

Design: Cross-sectional study of responses to a Freedom of Information Act request for Gifts and Hospitality Registers.

Setting: NHS Trusts (secondary/tertiary care organisations) in England.

Participants: 236 Trusts were contacted, of which 217 responded.

Main Outcome Measures: We assessed all disclosures for completeness and openness, scoring them for achieving each of five measures of transparency.

Results: 185 Trusts (78%) provided a register. 71 Trusts did not respond within the 28 day time limit required by the FoIA. Most COI registers were incomplete by design, and did not contain the information necessary to assess conflicts of interest. 126/185 (68%) did not record the names of recipients. 47/185 (25%) did not record the cash value of the gift or hospitality. Only 31/185 registers (16%) contained the names of recipients, the names of donors, and the cash amounts received. 18/185 (10%) contained none of: recipient name, donor name, and cash amount. Only 15 Trusts had their disclosure register publicly available online (6%). We generated a transparency index assessing whether each Trust met the following criteria: responded on time; provided a register; had a register with fields identifying donor, recipient, and cash amount; provided a register in a format that allowed further analysis; and had their register publicly available online. Mean attainment was 1.9/5; no NHS trust met all five criteria.

Conclusion: Overall, recording of employees’ conflicts of interest by NHS trusts is poor. None of the NHS Trusts in England met all transparency criteria. 19 did not respond to our FoIA requests, 51 did not provide a Gifts and Hospitality Register and only 31 of the registers provided contained enough information to assess employees’ conflicts of interest. Despite obligations on healthcare professionals to disclose conflicts of interest, and on organisations to record these, the current system for logging and tracking such disclosures is not functioning adequately. We propose a simple national template for reporting conflicts of interest, modelled on the US “Sunshine Act”.
LanguageEnglish
Article numbere019952
Pages1-7
Number of pages7
JournalBMJ Open
Volume8
Issue number3
DOIs
Publication statusPublished - 5 Mar 2018

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Conflict of Interest
Disclosure
England
Cross-Sectional Studies
Names
Gift Giving
Organizations
Secondary Care
Access to Information
Sunlight
Tertiary Healthcare
Outcome Assessment (Health Care)
Delivery of Health Care

Keywords

  • conflict of interest
  • freedom of information act (foia)
  • gifts and hospitality
  • nhs trusts
  • pharmaceutical industry

Cite this

Feldman, Harriet Ruth ; DeVito, Nicholas J. ; Mendel, Jonathan ; Carroll, David E. ; Goldacre, Ben. / A Cross-Sectional Study of All Clinicians’ Conflict of Interest Disclosures to NHS Hospital Employers in England 2015-2016. In: BMJ Open. 2018 ; Vol. 8, No. 3. pp. 1-7.
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abstract = "Objective: We set out to document how NHS trusts in the UK record and share disclosures of conflict of interest by their employees.Design: Cross-sectional study of responses to a Freedom of Information Act request for Gifts and Hospitality Registers.Setting: NHS Trusts (secondary/tertiary care organisations) in England.Participants: 236 Trusts were contacted, of which 217 responded.Main Outcome Measures: We assessed all disclosures for completeness and openness, scoring them for achieving each of five measures of transparency.Results: 185 Trusts (78{\%}) provided a register. 71 Trusts did not respond within the 28 day time limit required by the FoIA. Most COI registers were incomplete by design, and did not contain the information necessary to assess conflicts of interest. 126/185 (68{\%}) did not record the names of recipients. 47/185 (25{\%}) did not record the cash value of the gift or hospitality. Only 31/185 registers (16{\%}) contained the names of recipients, the names of donors, and the cash amounts received. 18/185 (10{\%}) contained none of: recipient name, donor name, and cash amount. Only 15 Trusts had their disclosure register publicly available online (6{\%}). We generated a transparency index assessing whether each Trust met the following criteria: responded on time; provided a register; had a register with fields identifying donor, recipient, and cash amount; provided a register in a format that allowed further analysis; and had their register publicly available online. Mean attainment was 1.9/5; no NHS trust met all five criteria.Conclusion: Overall, recording of employees’ conflicts of interest by NHS trusts is poor. None of the NHS Trusts in England met all transparency criteria. 19 did not respond to our FoIA requests, 51 did not provide a Gifts and Hospitality Register and only 31 of the registers provided contained enough information to assess employees’ conflicts of interest. Despite obligations on healthcare professionals to disclose conflicts of interest, and on organisations to record these, the current system for logging and tracking such disclosures is not functioning adequately. We propose a simple national template for reporting conflicts of interest, modelled on the US “Sunshine Act”.",
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note = "BG is funded by the Laura and John Arnold Foundation to conduct work on research integrity, but not specifically this project. No funder had any involvement in the study design or the decision to submit.",
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A Cross-Sectional Study of All Clinicians’ Conflict of Interest Disclosures to NHS Hospital Employers in England 2015-2016. / Feldman, Harriet Ruth; DeVito, Nicholas J.; Mendel, Jonathan; Carroll, David E.; Goldacre, Ben (Lead / Corresponding author).

In: BMJ Open, Vol. 8, No. 3, e019952, 05.03.2018, p. 1-7.

Research output: Contribution to journalArticle

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T1 - A Cross-Sectional Study of All Clinicians’ Conflict of Interest Disclosures to NHS Hospital Employers in England 2015-2016

AU - Feldman, Harriet Ruth

AU - DeVito, Nicholas J.

AU - Mendel, Jonathan

AU - Carroll, David E.

AU - Goldacre, Ben

N1 - BG is funded by the Laura and John Arnold Foundation to conduct work on research integrity, but not specifically this project. No funder had any involvement in the study design or the decision to submit.

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N2 - Objective: We set out to document how NHS trusts in the UK record and share disclosures of conflict of interest by their employees.Design: Cross-sectional study of responses to a Freedom of Information Act request for Gifts and Hospitality Registers.Setting: NHS Trusts (secondary/tertiary care organisations) in England.Participants: 236 Trusts were contacted, of which 217 responded.Main Outcome Measures: We assessed all disclosures for completeness and openness, scoring them for achieving each of five measures of transparency.Results: 185 Trusts (78%) provided a register. 71 Trusts did not respond within the 28 day time limit required by the FoIA. Most COI registers were incomplete by design, and did not contain the information necessary to assess conflicts of interest. 126/185 (68%) did not record the names of recipients. 47/185 (25%) did not record the cash value of the gift or hospitality. Only 31/185 registers (16%) contained the names of recipients, the names of donors, and the cash amounts received. 18/185 (10%) contained none of: recipient name, donor name, and cash amount. Only 15 Trusts had their disclosure register publicly available online (6%). We generated a transparency index assessing whether each Trust met the following criteria: responded on time; provided a register; had a register with fields identifying donor, recipient, and cash amount; provided a register in a format that allowed further analysis; and had their register publicly available online. Mean attainment was 1.9/5; no NHS trust met all five criteria.Conclusion: Overall, recording of employees’ conflicts of interest by NHS trusts is poor. None of the NHS Trusts in England met all transparency criteria. 19 did not respond to our FoIA requests, 51 did not provide a Gifts and Hospitality Register and only 31 of the registers provided contained enough information to assess employees’ conflicts of interest. Despite obligations on healthcare professionals to disclose conflicts of interest, and on organisations to record these, the current system for logging and tracking such disclosures is not functioning adequately. We propose a simple national template for reporting conflicts of interest, modelled on the US “Sunshine Act”.

AB - Objective: We set out to document how NHS trusts in the UK record and share disclosures of conflict of interest by their employees.Design: Cross-sectional study of responses to a Freedom of Information Act request for Gifts and Hospitality Registers.Setting: NHS Trusts (secondary/tertiary care organisations) in England.Participants: 236 Trusts were contacted, of which 217 responded.Main Outcome Measures: We assessed all disclosures for completeness and openness, scoring them for achieving each of five measures of transparency.Results: 185 Trusts (78%) provided a register. 71 Trusts did not respond within the 28 day time limit required by the FoIA. Most COI registers were incomplete by design, and did not contain the information necessary to assess conflicts of interest. 126/185 (68%) did not record the names of recipients. 47/185 (25%) did not record the cash value of the gift or hospitality. Only 31/185 registers (16%) contained the names of recipients, the names of donors, and the cash amounts received. 18/185 (10%) contained none of: recipient name, donor name, and cash amount. Only 15 Trusts had their disclosure register publicly available online (6%). We generated a transparency index assessing whether each Trust met the following criteria: responded on time; provided a register; had a register with fields identifying donor, recipient, and cash amount; provided a register in a format that allowed further analysis; and had their register publicly available online. Mean attainment was 1.9/5; no NHS trust met all five criteria.Conclusion: Overall, recording of employees’ conflicts of interest by NHS trusts is poor. None of the NHS Trusts in England met all transparency criteria. 19 did not respond to our FoIA requests, 51 did not provide a Gifts and Hospitality Register and only 31 of the registers provided contained enough information to assess employees’ conflicts of interest. Despite obligations on healthcare professionals to disclose conflicts of interest, and on organisations to record these, the current system for logging and tracking such disclosures is not functioning adequately. We propose a simple national template for reporting conflicts of interest, modelled on the US “Sunshine Act”.

KW - conflict of interest

KW - freedom of information act (foia)

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KW - nhs trusts

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