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Conflict of interest constraints could block integration, says NHSCC chief

Conflict of interest constraints could block integration, says NHSCC chief

Conflict of interest constraints for clinical commissioning groups are a potential barrier against a fully integrated healthcare system
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Conflict of interest constraints for clinical commissioning groups are a potential barrier against a fully integrated healthcare system, a health care leader has said.

Julie Wood, chief executive of NHS Clinical Commissioners, said using a “blunt instrument” to manage competing interests in clinical commissioning groups (CCGs), runs the risk of reducing clinician engagement.

She said: “A lot of people have interests that we really do want to get into the mix of the conversation.

“We just have to make sure that we don’t have a blunt instrument for how we manage those potential competing interests, which eliminates clinician engagement and involvement.”

Wood added that, by 2021, constraints on conflicts of interest in CCGs “might get worse before it gets better”.

Last week, NHS England released a consultation document on measures to tighten conflict of interest guidelines.

Drawn up by a Task and Finish Group chaired by Professor Sir Malcolm Grant, chair of NHS England, the consultation said conflicts of interest are “institutionalised” as the NHS increasingly depends on “partnership and collaboration”.

“Clinicians who deliver care are involved in making decisions about how it is organised,” Grant says in the consultation document.

He adds: “The central issue for us is therefore the proper management of potential conflicts of interest, to ensure that they do not crystallise into situations involving an actual conflict of interest with the risk that personal interests will prevail over the interests of the NHS.”

Speaking on a panel at the UK Health Show in London today on the future of commissioning, Wood stressed the importance of removing the divide between commissioner and provider to integrate care by 2021.

She said the key lies in “looking at who’s got the right levers to pull to actually make the difference and not think that it’s all the health service’s job or our responsibility to do so”.

Michael Bell, chairman of the Croyden Health Services NHS Trust, who was also on the panel, said the division between purchaser and provider “has had its day”.

As the only part of the country where both the CCG and trust are in financial special measures, Bell said: “We could spend the rest of the decade balancing the deficit between ourselves – or we could do something different.

“If we choose to do something different, the present structures are not fit for purpose.

“We need to find ways of sharing risk and benefit between the purchaser and the provider, if we go for transformation.”

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