Article Text
PDF
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’.
- conflict of interest
- gifts and hospitality
- freedom of information act (foia)
- pharmaceutical industry
- nhs trusts
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Footnotes
Contributors All authors contributed to and approved the final manuscript. BG and HRF conceived the associated website resource which was built by Seb Bacon. BG supervised the project. BG and HRF are guarantors.
Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare the following: JM reports grants from Oak Foundation, NordForsk, ESRC and Netherlands Organisation for Scientific Research, and grants and other from Scottish Institute for Policing Research. JM has received a very small additional income (under £150 in total) for writing about problems around evidence and policy. These are all outside the submitted work. 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. BG has also received funding from the Wellcome Trust, the NHS National Institute for Health Research, the Health Foundation, and the World Health Organisation; he also receives personal income from speaking and writing for lay audiences on the misuse of science. ND is employed on BG’s grant from LJAF. HRF has received research funding from the Wellcome Trust, Green Templeton College, Guarantors of Brain and Oxford University Clinical Academic Graduate School. DEC has received research funding from the Jean Shanks Foundation and the Wellcome Trust. He has received software development funding from the Open Society Foundations, Jisc and the Public Library of Science (PLOS). He has received travel funding from PLOS and the Scholarly Publishing and Academic Resources Coalition.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement All underlying data and analysis is shared alongside this manuscript on FigShare.