NHS Scotland: Standards of Business Conduct

5. Annex A: Summary of Professional Regulatory Requirements

All the statutory regulators of health and care professionals have ethical standards which professionals are expected to observe, and have separately published the ethical requirements for their professionals, for example:

• Good medical practice – ethical guidance – GMC (gmc-uk.org)
• The Nursing and Midwifery Council (nmc.org.uk)
• Standards of conduct, performance, and ethics | (hcpc-uk.org)
• Standards for pharmacy professionals | General Pharmaceutical Council (pharmacyregulation.org)

On 8 August 2017 the chief executives of the regulators issued a joint statement as follows:

5.1 Conflict of Interests

This joint statement on ‘conflicts of interest’ sets out our expectations of health and care professionals in relation to avoiding, declaring, and managing conflicts of interest across all healthcare settings. It is intended to support the standards or code for each profession and any additional guidance they may have. These professional standards, codes and additional guidance should be the over-riding consideration for professionals. We believe that given the increasing move towards multi-disciplinary teams, there is great value in working together for a consistent approach. We will promote this joint statement to our registrants, students, and to the public, to ensure they all know what we expect.

We will support this with case studies to illustrate the principles of the statement and show how these issues might arise in different settings. We will encourage all registrants to reflect on their own learning and continuing professional development needs regarding conflicts of interest.

Handling 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. We expect health and social care professionals to:

• Put the interests of people in their care before their own interests, or those of any colleague, business, organisation, close family member or friend.
• Maintain appropriate personal and professional boundaries with the people they provide care to and with others.
• Consider carefully where conflicts of interest may arise – or be perceived to arise – and seek advice if they are unsure how to handle this.
• Be open about any conflict of interest they face, declaring it formally when appropriate and as early as possible, in line with the policies of their employer or the organisation contracting their services.
• Ensure their professional judgement is not compromised by personal, financial, or commercial interests, incentives, targets, or similar measures.
• Refuse all but the most trivial gifts, favours or hospitality if accepting them could be interpreted as an attempt to gain preferential treatment or would contravene your professional code of practice.
• Where appropriate, ensure that patients have access to visible and easy-to-understand information on any fees and charging policies for which you are responsible

On 19 March 2018, the Scottish Government’s chief professionals issued a Dear Colleague letter. The letter sharing the above statement, to remind colleagues of their professional responsibilities and previous guidance, A Common Understanding 2012, and to provide details of conflicts of interest to their employing health board.

This is underpinned by the system of medical appraisal in Scotland, which requires doctors to confirm the following statement within their appraisal: ‘I confirm that I have complied with the conflict of interests mechanisms of the Boards within which I work.’