Policies on doctors’ declaration of interests in medical organisations: a thematic analysis

Abstract

Objectives There has been growing concern about doctors’ conflicts of interests (COIs) but it is unclear what processes and tools exist to enable the consistent declaration and management of such interests. This study mapped existing policies across a variety of organisations and settings to better understand the degree of variation and identify opportunities for improvement. Design Thematic analysis. Setting and Participants We studied the COI policies of 31 UK and international organisations which set or influence professional standards or engage doctors in healthcare commissioning and provision settings. Main outcome measures: Organisational policy similarities and differences. Results Most policies (29/31) referred to the need for individuals to apply judgement when deciding whether an interest is a conflict, with just over half (18/31) advocating a low threshold. Policies differed on the perception of frequency of COI, the timings of declarations, the type of interests that needed to be declared, and how COI and policy breaches should be managed. Just 14/31 policies stated a duty to report concerns in relation to COI. Only 18/31 policies advised COI would be published, while three stated that any disclosures would remain confidential. Conclusions The analysis of organisational policies revealed wide variation in what interests should be declared, when and how. This variation suggests that the current system may not be adequate to maintain a high level of professional integrity in all settings and that there is a need for better standardisation that reduces the risk of errors while addressing the needs of doctors, organisations and the public.

Pharmaceutical industry payments to NHS trusts in England: A four-year analysis of the Disclosure UK database

“…The implementation of the current-sector wide COI guidance by individual trusts, and how it might have been affected by their institutional cultures and policies, has not been investigated in relation to institutional COIs. However, compliance with the guidelines in relation to publishing individual-level COI declarations has been described as poor [ 121 ] or not always consistent across the studied trusts [ 122 ]. In addition, gaps in the reporting of joint working projects with drug companies suggest that at least some trusts lack a complete picture of their financial ties with external organisations [ 38 ].…”

The value of supporting women’s rights

“…The influence of conflicts of interest on clinical decision making is well established but does require greater transparency and coping strategies. An analysis of 31 UK and international organisations reveals a “wide variation in what interests should be revealed, when and how.” 3 Careful study design is an important but unreliable way of eliminating bias in research. 4 The challenge in clinical practice and policy making is harder to find neat solutions for.…”