MANAGING CONFLICTS OF INTEREST POLICY
DOCUMENT CONTROL
Tonia Michaelides, Chief
Operating Officer
Version
2.0
Integrated Governance Approved Version 2 – February 2015
Review
June 2016
Author
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Page
CONTENTS
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3
1. Introduction ……………………………………………………………………………………………………………
2. Definitions ………………………………………………………………………………………………………………
3. What are Conflicts of Interest? ………………………………………………………………………………..
4. General Safeguards ………………………………………………………………………………………………….
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5. Managing Conflicts of Interest ………………………………………………………………………………….
Register of Interests …………………………………………………………………………………………………
Declarations of Interests……………………………………………………………………………………………
Board Members ……………………………………………………………………………………………………….
General……………………………………………………………………………………………………………………..
6. Transparency in Procuring Services …………………………………………………………………………..
Where GPs are potential providers of CCG-commissioned services …………………………..
Contractors ………………………………………………………………………………………………………………
Designing service requirements ……………………………………………………………………………….
7. Preserving integrity of decision-making process when all or most GPs have an
Interest in a decision …………………………………………………………………………………………………
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8. Dispute Resolution …………………………………………………………………………………………………..
9. Code of Conduct ……………………………………………………………………………………………………….
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10. Transparency – Publication of Contracts ……………………………………………………………………
11. Role of Commissioning Support ………………………………………………………………………………..
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12. Linked Policies/Guidance ………………………………………………………………………………………….
Appendices:
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1– Declaration of Interests for Members of the CCG Board, Committee members, and
senior employees (Band 8A and above) template
19
2 – Declaration of Conflict of Interests for bidder`s/contractors template
21
3- Code of Contact Template
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1. NTRODUCTION
1. Introduction
The Health and Social Care Act sets out clear requirements for Clinical Commissioning Groups
(CCGs) to make effective arrangements for managing conflicts of interest or potential conflicts of
interest, to ensure they do not affect or appear to affect the integrity of the CCG’s decision
making processes. By identifying where and how conflicts arise and dealing with them
appropriately, CCG’s will be able to ensure proper governance, robust decision making and
appropriate decisions about the use of public money.
Managing potential conflicts of interest appropriately is needed to protect the integrity of the
NHS commissioning system and protect clinical commissioning groups and GP practices from
wrong-doing.
This policy is compliant with the updated national guidance provided from NHS England (NHSE) –
Managing conflicts of interests: Statutory Guidance for CCGs – published in December 2014
2. DEFINITIONS
Members of the Kingston Governing Body
CCG Employees
Member Practices
Member Representative
Practice
Register of Members
Register of Interests
Members appointed to the Governing Body in
accordance with the Constitution
Any member of staff who is directly employed by
the CCG or works closely with the CCG.
A Practice which has successfully completed the
application process for Membership of the CCG
and whose name is recorded in the Register of
Members in accordance with paragraph 3.4 of
this Constitution (and “Membership”) shall be
construed accordingly).
An individual nominated by Member to
represent that Member on the Members Forum
in accordance with paragraph 27 of this
Constitution.
An individual or organisation that is provider of
primary medical services pursuant to: a general
medical services contract; arrangements under
section 83(2) of the Act; or arrangements under
section 92 of the Act, for the provision of
primary medical services of a prescribed
description.
A written register as amended from time to time
of the names and addresses of the Members of
the CCG established and maintained in
accordance with the Constitution.
A written register as amended from time to time
of the interests of each member of the
Governing Body as described in the Constitution.
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3. WHAT ARE CONFLICTS OF INTEREST?
3.1 A conflict of interest occurs where an individual’s ability to exercise judgement or act in one
role is or could be impaired or otherwise influenced by his or her involvement in another role
or relationship. The individual does not need to exploit his or her position to obtain an actual
benefit, financial or otherwise. A potential for competing interests and/or a perception of
impaired judgement or undue influence can also be a conflict of interest.
3.2
“For the purposes of Regulation 6 [National Health Service (Procurement, Patient Choice
and Competition) (No.2) Regulations 20137], a conflict will arise where an individual’s
ability to exercise judgement or act in their role in the commissioning of services is impaired
or influenced by their interests in the provision of those services.”
Monitor - Substantive guidance on the Procurement, Patient Choice and Competition
Regulations (December 2013)
3.3 Conflicts can arise from:
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A direct financial interest – for example, where an individual may financially benefit
from the consequences of a commissioning decision (e.g. as a provider of services);
An indirect financial interest – for example, where an individual is a partner, member or
stakeholder in an organisation that will benefit financially from the consequences of a
commissioning decision;
A non-financial interest – for example, where an individual holds a non-remunerative or
not-for-profit interest in an organisation, that will benefit from the consequences of a
commissioning decision (e.g. where an individual is a trustee of a voluntary provider that
is bidding for a contract);
A non-financial personal benefit – where an individual may enjoy a qualitative benefit
from the consequence of a commissioning decision which cannot be given a monetary
value (e.g. a reconfiguration of hospital services that might result in the closure of a busy
clinic next door to an individual’s house);
Conflicts of loyalty (e.g. in respect of an organisation of which the individual is a member
or has an affiliation);
Personal or professional relationships with others, e.g. where the role or interest of a
family member, friend or acquaintance may influence an individual’s judgement or
actions, or could be perceived to do so.
3.3 For a GP or any other individual involved in commissioning, a conflict of interest may, therefore,
arise when their own judgement as an NHS commissioner could be, or be perceived to be,
influenced and impaired by their own concerns and obligations as a healthcare or related provider,
as a member of a particular peer, professional or special interest group, or as a friend or family
member.
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3.4 In determining what need to be declared, individuals should ask themselves the following
questions:
 Am I, or might I be, in a position where I or my family or associates could be perceived to
gain from the connection between my private interests and my employment with the CCG?
 Do I have access to information which could be perceived to influence purchasing decisions?
 Could my outside interest be perceived in any way detrimental to the CCG or to patients’
interest?
 Do I have any other reason to think I may be risking a conflict of interest?
3.5 If in doubt, the individual concerned should assume that a potential conflict of interest exists.
3.6 The Bribery Act 2010, which repealed existing Corruption legislation, introduced the offences of
offering and or receiving a bribe. It also places specific responsibility on organisations to have in
position sufficient and adequate procedures to prevent bribery and corruption taking place. Under
the Act, bribery is defined as “Inducement for an action which is illegal, unethical or a breach of
trust. Inducements can take form of gifts, loans, fees, rewards and other privileges”. No actual gain
or loss has to be made. Corruption is broadly defined as the offering or acceptance of inducements,
gifts, favours, payments or benefit-in-kind which many influence the improper action of any person.
Corruption does not always result in a loss. The corrupt person may not benefit directly from their
deeds; however, they may be unreasonably using their position to give some advantage to another.
To demonstrate that NHS Kingston CCG has sufficient and adequate procedures in place and to
demonstrate openness and transparency, all staff are required to comply with the Managing
Conflicts of Interest policy. Should employees wish to report any concerns or allegations, they should
contact their Local Counter Fraud Specialist.
4. GENERAL SAFEGUARDS
4.1 The general safeguards that will be needed to manage conflicts of interest will vary to some
extent, depending on at what stage in the commissioning cycle decisions are being made. The
following principles will need to be integral to the commissioning of all services, including
decisions on whether to continue to commission a service, such as by contract extension.
4.2 Conflicts of interest can be managed by:
 Doing business appropriately. If commissioners get their needs assessments, consultation
mechanisms, commissioning strategies and procurement procedures right from the outset,
then conflicts of interest become much easier to identify, avoid and/or manage, because the
rationale for all decision-making will be clear and transparent and should withstand scrutiny;
 Being proactive, not reactive. Commissioners should seek to identify and minimise the risk of
conflicts of interest at the earliest possible opportunity, for instance by:
o considering potential conflicts of interest when electing or selecting individuals to
join the governing body or other decision-making bodies;
o ensuring individuals receive proper induction and training so that they understand
their obligations to declare conflicts of interest.
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By establishing and maintaining registers of interests, and agree in advance how a range of
possible situations and scenarios will be handled, rather than waiting until they arise;
Assuming that individuals will seek to act ethically and professionally, but may not always
be sensitive to all conflicts of interest. Rules should assume people will volunteer
information about conflicts and, where necessary, exclude themselves from decision-making,
but there should also be prompts and checks to reinforce this;
Being balanced and proportionate. Rules should be clear and robust but not overly
prescriptive or restrictive. They should ensure that decision-making is transparent and fair,
but not constrain people by making it overly complex or cumbersome
Openness – ensuring early engagement with patients, the public and with the Health and
Wellbeing Board in relation to proposed commissioning plans;
Transparency – documenting clearly the approach that will be taken at every stage in the
commissioning cycle;
Responsiveness and best practice – ensuring that commissioning intentions are based on
local health needs and reflect evidence of best practice; securing ‘buy-in’ from patients and
clinicians to the clinical case for change;
Securing expert advice – ensuring that plans take into account advice from appropriate
health and social care professionals, and draw on commissioning support as required;
Engaging with providers – early engagement with both incumbent and potential new
providers over potential changes to the services commissioned for a local population;
Creating clear and transparent commissioning specification – that reflect the depth of
engagement and set out the basis on which any contact will be awarded;
Following proper procurement processes and legal arrangement, including even handed
approaches with providers;
Ensuring sound record keeping, including an up-to-date register of interests – applying best
practice in sound record keeping, making appropriate information available and accessible,
and maintaining a register of interest with a clear system for declaration of interests;
Dispute resolution – having systems for resolving disputes, clearly set out in advance.
4.3 In addition to the principles above, the following will also need to be considered:
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Planning which services or pathways need to be commissioned differently or decommissioned, e.g. engaging with a wide range of providers, securing independent
clinical advise and specifying services on the basis of best practice and outcomes;
Agreeing which services or pathways should be commissioned or de-commissioned, e.g.
identifying potential conflicts, designing the decision making processes to avoid such
conflicts and using contractual mechanisms to mitigate any residual risk; and
Monitoring the services commissioned, to ensure they are delivering to the agreed
specification, e.g. securing patient involvement and independent clinical advice in
monitoring the quality of the services commissioned.
4.4 These safeguards and principles will be particularly important in relation to the key
commissioning decision-making points leading up tom during and after the actual procurement
of services, and in deciding whether to go out to procurement.
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4.5 Particular considerations pertain to CCGs who hold responsibilities for delegated or joint
commissioning of primary care.
5. MANAGING CONFLICTS OF INTEREST
5.1 Kingston CCG has put in place arrangements, as outlined in this document, to manage conflicts
and potential conflicts of interest so that the decision will be taken, and seen to be taken,
without any influence by external or private interest.
5.2 The Lay Member of the Governing Body with responsibility for Governance, will be available to
provide advice to any individual who believes they have, or may have, a conflict of interest.
5.3 The Governing Body will take such steps as it deems, appropriate, and request information
from individuals it deems appropriate, to ensure that all conflicts of interest and potential
conflicts of interest are declared and published.
5.4 Register of Interests:
5.4.1
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Kingston CCG will maintain a Register of Interests for:
Members of the Kingston CCG Governing Body
CCG employees
Representatives of each member Practice through the Council of Members.
5.4.2
The Register of Governing Body Members will be updated on at least a Quarterly basis, to
be reviewed by the Governing Body twice per year. Members are required to notify any
changes during the year, The Register for the Council of Members and CCG employees
will be reviewed by the Audit Committee.
5.4.3
A copy of the Register for Governing Body will be available in the following ways:
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A summary of Governing Body Members’ interests will be available at meetings to be held in
public;
Upon application (either by post or email)
A copy of the Register will be published on the website (www.kingstonccg.nhs.uk)
5.5 Declarations of Interests:
5.5.1
Declarations of Interests will be made in the following ways:
 On appointment – When an appointment to the Governing Body is made, a formal
declaration of interests should be requested and recorded. The Chair or Chief Officer will
consider whether conflicts of interest should exclude individuals taking up appointment –
this will include an assessment of the materiality and extent of the interest. Any individual
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who has a material interest in an organisation, which provides or is likely to provide
substantial business to a CCG (either as a provider of healthcare, or commissioning
support services), should not be a member of the Governing Body.
 Quarterly – All interests will be confirmed on a Quarterly basis
 At meetings – All meeting Agendas will include a standing item at the beginning of the
meeting
 For Declaration of Interests pertaining to the items to be discussed. Even if an interest has
previously been declared in the Register of Interests, it should be declared in meetings
where matters relating to that interest are discussed. Declarations of interest will be
recorded in Minutes of the meetings.
 On changing role or responsibility – Where an individual changes role or responsibility within
the Governing Body or Membership of the CCG, any change to the individual’s interests
should be declared.
 On any change of circumstances – Wherever an individual’s circumstances change in a way
that affects the individual’s interests (e.g. where an individual takes on a new role outside
the CCG or sets up a new business or relationship), a further declaration should be made
to reflect the change in circumstances. This could involve a conflict of interest ceasing to
exist or a new one materialising.
5.5.2
Individuals will declare any interest that they have, in relation to a decision to be
made by Kingston CCG, in writing to the Governing Body, as soon as they become aware of it
and in any event not later than 28 days after becoming aware. (Appendix 1)
5.5.3
Where an individual is unable to provide a declaration in writing, for example, if a
conflict becomes apparent in the course of a meeting, they will make an oral declaration
before witnesses, and if appropriate, provide a written declaration as soon as possible
thereafter to the Governing Body.
5.5.4
Where an individual has an interest, or becomes aware of an interest that could lead
to a conflict of interest, that potential conflict is subject to the provisions of this policy and the
Constitution.
Whenever interests are declared, they should be reported to the Executive Business Lead,
(person designated with responsibility for the register of interests) who will then update the
register accordingly.
The CCG will set out a process to follow if an individual fails to comply with its policies on
managing conflicts of interest as set out in the constitution.
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5.6 Governing Body Members
5.6.1
Individual members of the Governing Body, its Committees and employees will
comply with the arrangements for managing conflicts or potential conflicts of interest as set
out in this policy
5.6.2 Any conflicts of interests pertaining to scheduled business should be declared orally
at the start of each meeting.
5.6.3 If a conflict, or potential conflict, of interests has been identified relating to the CCG
Chair, the Deputy Chair may require the CCG Chair to withdraw from the meeting or part of
it. Where there is no Deputy Chair the members of the Governing Body meeting will select
one.
5.6.4 Where a Governing Body member is aware of an interest which has not been
declared, either in the Register or orally, they will declare this at the start of the meeting.
The Governing Body will then determine how this should be managed and inform the
member of their decision. The member will comply with these arrangements, which must be
recorded in the minutes of the meeting. The interest must subsequently be reported to the
Business Manager for recording in the Register.
5.6.5 In making this decision, the Chair will consider whether the meeting is quorate, in
accordance with the Terms of Reference/Constitution. Where the meeting is not quorate,
owing to the absence of certain members, the discussion will be deferred until such time as
a quorum can be convened.
5.6.6 Where a quorum cannot be convened from the membership of the Governing Body,
owing to the arrangements for managing conflicts of interest or potential conflicts of
interests, the Chair may invite on a temporary basis one or more of the following to make up
the quorum so that the Kingston CCG can progress the item of business:
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5.6.7
A Member of Kingston CCG;
An individual appointed by a member to act on their behalf in the dealings between
themselves and the CCG;
A member of a relevant Health and Wellbeing Board;
A member of another CCG Governing Body
These arrangements must be recorded in the Minutes.
5.7 General:
The following process will be followed for all meetings where a conflict, or potential conflict is
identified:
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Where a conflict is declared in advance of a meeting, the Chair, or officer on his/her behalf,
will explain the arrangements for managing the conflict or potential conflict of interests to
the individual confirming at what point the individual should withdraw from specified
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activity, on a temporary or permanent basis. The individual will not be able to vote on the
issue under any circumstances.
In the event of a conflict of interest being declared during the course of a meeting, the Chair
of that meeting may require the individual to withdraw from the meeting or part of it. The
Chair’s decision will be final in the matter and the individual will comply with the
arrangements, which must be recorded in the Minutes of the meeting.
Where the Chair of a meeting has a personal interest in relation to the business of the
meeting, they must make a declaration and the Deputy Chair will act as Chair for the
relevant part of the meeting.
In any transaction undertaken in support of the Kingston CCG’s commissioning functions
(including conversations between two or more individuals, emails, correspondence and
other communications), individuals must ensure that, where they are aware of an interest,
they conform to the arrangements confirmed for the management of that interest.
6. PROCUREMENT OF SERVICES
6.1 The NHS Act, the Health and Social Care Act (“the HSCA”) and associated regulations set out
the statutory rules with which commissioners are required to comply when procuring and
contracting for the provision of clinical services. They need to be considered alongside the
Public Contract Regulations12 and, where appropriate, EU procurement rules. Monitor's
Substantive guidance on the Procurement, Patient Choice and Competition Regulations advises
that the requirements within these create a framework for decision making that will assist
commissioners to comply with a range of other relevant legislative requirements.
6.2 The Procurement, Patient Choice and Competition Regulations place requirements on
commissioners to ensure that they adhere to good practice in relation to procurement, do not
engage in anti-competitive behaviour that is against the interest of patients, and protect the
right of patients to make choices about their healthcare.
6.3 The regulations set out that commissioners must:
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manage conflicts and potential conflicts of interests when awarding a contract by prohibiting
the award of a contract where the integrity of the award has been, or appears to have
been, affected by a conflict; and
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keep appropriate records of how they have managed any conflicts in individual cases.
6.4 Monitor has a statutory duty under section 78 of the HSCA to produce guidance on compliance
with any requirements imposed by the regulations and how it intends to exercise the powers
conferred on it by these regulations. Monitor’s Substantive guidance on the Procurement,
Patient Choice and Competition Regulations is the relevant statutory guidance. NHS England
works closely with Monitor with regard to these matters and has engaged with Monitor in
developing this revised guidance.
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6.5 Kingston CCG recognises the importance in making decisions about the service it procures in a
way that does not call into question the motives behind the decision.
6.6 Kingston CCG will procure services in a manner that is open, transparent, non-discriminatory
and fair to all potential providers, ensuring that conflicts and potential conflicts of interests are
managed when awarding a contract by prohibiting the award of a contract where the integrity
of the award has been or appears to have been affected by a conflict, and
6.7 Kingston CCG will maintain a register of procurement decisions taken, including:
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the details of the decision; who was involved in making the decision (i.e. governing body or
committee members and others with decision-making responsibility); and
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a summary of any conflicts of interest in relation to the decision and how this was managed
by the CCG.
The register will be updated whenever a procurement decision is taken.
6.8 Potential conflicts of interests will vary to some degree depending on the way in which a
service is commissioned.
6.9 Competitive Tender – Where a CCG commissioning a service through competitive tender (i.e.
seeking to identify the best provider or set of providers for a service), a conflict could arise
where GP practise or other providers in which CCG members have an interest are amongst
those bidding.
6.10 Any Qualified Provider – Where a CCG wants patients to be able to choose from a range of
possible providers and is therefore commissioning a service through Any Qualified Provider, a
conflict could arise where one or more GP practices (or other providers in which CCG members
have an interest) are amongst the qualified providers from which patients can choose. In these
circumstances (and more generally) there are a number of options for demonstrating that GP
practices have fully informed choice at the point of referral and for auditing and publishing
referral patterns. These will build on well-established procedures for declaring interests when
GPs or other clinicians make a referral.
6.11 Commissioning service from GP practices on a single tender basis – Where a CCG is
commissioning a service from GP practices where there are no other capable providers and the
proposed service goes beyond the scope of the services provided by GP practices under their
GP contract (Appendix 3)).
6.12 The CCG will publish a Procurement Strategy approved by the Governing Body, which will
ensure that:
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The Business Case subcommittee on the relevant working groups engaged in the
development of the specifications to procure services;
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Service redesign, pilot projects and procurement processes are conducted in an open,
transparent, non-discriminatory and fair way.
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6.13 Kingston CCG receives commissioning support for the procurement process currently from
the South London Commissioning Support Unit. The Register of Interests must be referred to
as part for the procurement process.
Where GPs are potential providers of CCG-commissioned services:
6.14 It is essential that Kingston CCG should be able to commission a range of community based
services, including primary care services, to improve quality and outcomes for patients. Where
the provider for these services might be within general practice, the CCG will need to be able
to demonstrate that those services:
 Clearly meet local health needs and have been planned appropriately;
 Go beyond the scope of the GP contract; and
 The appropriate procurement approach is used.
“The Code of Conduct: Managing conflicts of interest where GP practices are potential
providers of CCG-commissioned services” (NHS Commissioning Board, July 2012) sets out
additional safeguards that CCGs are advised to use when commissioning services for which GPs
could be potential providers, The proposed additional safeguards are designed to:
 Maintain confidence and trust between patients and GPs;
 Enable CCGs and member practices to demonstrate that they are acting fairly and
transparently and that members of CCGs will always put their duty to patients before any
personal financial interest;
 Ensure that CCGs operate within the legal framework but are not bound to over-prescriptive
rules that risk stifling innovation or slowing down services they wish to commission to
improve quality and productivity; and
 Build on existing guidance, in particular the Procurement Guide for commissioners of NHSfunded services and Principles and Rules of Cooperation and Competition.
6.15 The template at Appendix 3 sets out the factors that the Governing Body will assure itself
upon when commissioning services from GP practices, including provider consortia or
organisations in which GPs have a financial interest. That may include scenarios in which one
or more of the CCG’s Members Practices are anticipated to bid, whether that is under
competitive tender, Any Qualified Provider procurement, or through single tender.
6.16 The CCG has set up a Delivery Group to provide oversight of CCG commissioning resources,
including the objective review of business cases, investment and efficiency proposals. The subcommittee has been formed to minimise the risk of conflicts of interest between the CCG as a
statutory NHS commissioning body and the commissioning of services from providers that
compromise the membership of the CCG.
6.17 Where decisions are being made on such matters either at the Board or Committees of the
CCG, GP practice members who have declared a specific interest in the matter, or all GP
practice members at the meeting will be excluded form relevant part of the meeting,
Alternatively, if deemed appropriate by the Chair of the meeting (or Vice Chair of the meeting
if the Chair of the meeting has declared an interest in the matter) they may join in the meeting
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discussions, but not take part in the decision making itself and would normally be asked to
leave the room until a decision has been made. In such circumstances the quorum
arrangements for the Governing Body or Committee will apply.
6.18 If the Governing Body or Committee considers it prudent in particular circumstance, to seek
additional scrutiny for assurance purposes on such a decision they may refer the matter to the
CCG’s Audit Committee for additional review of the proposal; this will take place prior to a final
decision on the matter by the CCG Governing Body or one of its committees as relevant.
Contractors
6.19 Anyone seeking information in relation to a procurement, or participating in a procurement,
or otherwise engaging with the CCG in relation to the potential provision of services or
facilities, will be required to make a declaration of interest (Appendix 2).
6.20 Anyone contracted to provide services or facilities directly to the CCG will be subject to the
same provisions of the Constitution in relation to managing conflicts of interests. This
requirement will be set out in the contract for their services.
Designing service requirements:
6.21 It is good practice to engage relevant providers, especially clinicians, in confirming the design
of service specification. Such engagement, done transparently and fairly, is entirely legal and
not contrary to competition law. However, conflicts of interest can occur if a commissioner
engages selectively with only certain providers in developing a service specification for a
contract for which they may later bid.
6.22 The CCG will seek, as far as possible, to involve stakeholders in the design of services and to
specify the outcomes to be delivered through a new service, rather than the way in which
these outcomes are to be achieved. As well as supporting innovation, this helps prevent bias
towards particular providers in the specification of services.
6.23 Engagement with potential providers when designing service specifications will follow the
main principles below:
 Use engagement to help shape the requirement but take care not to gear the requirement in
favour of any particular provider(s).
 Ensure at all stages that potential providers are aware of how the service will be
commissioned, e.g. through competitive procurement or through the ‘Any Qualified
Provider’ route.
 Work with participants on an equal basis, e.g. ensure openness of access to staff and
information.
 Be transparent about procedures.
 Maintain commercial confidentiality of information received from providers.
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Register of procurement decisions
Kingston CCGs will maintain a register of procurement decisions taken, including:
 the details of the decision;
 who was involved in making the decision (i.e. governing body or committee members and
others with decision-making responsibility); and
 a summary of any conflicts of interest in relation to the decision and how this was managed
by the CCG.
The register will be updated whenever a procurement decision is taken.
In the interests of transparency, the register of interests and the register of decisions will be publicly
available and easily accessible to patients and the public including by:
 ensuring that both registers are available in a prominent place on the CCG’s website; and
 making both registers available upon request for inspection at their headquarters.
The registers will form part of the CCG’s annual accounts and will thus be signed off by external
auditors
PRESERVING INTEGRITY OF DECISION-MAKING PROCESS WHEN ALL OR MOST GPS HAVE AN
INTEREST IN A DECISION
6.24 Where certain Members have a material interest, they should either be excluded from
relevant parts of meetings, or join in the discussion but not participate in the decision-making
itself (i.e. not have a vote).
6.25 In the majority of cases, where a limited number of GPs have an interest, exclusion of
relevant individuals from decision-making will be straightforward.
6.26 In other cases, where all GPs or other practice representative, with an interest in a decision
the CCG will:
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Refer the decision to the Governing Body and exclude all GPs or other practice
representatives, with an interest from the decision making process, so that the
decision is made only by the non-GP members of the Governing Body including the Lay
Members, Registered Nurse and Secondary Care Doctor;
Consider co-opting individuals from the Kingston Health and Wellbeing Board, or from
another CCG to review the proposal, to provide additional scrutiny;
Ensure that rules on being quorate at meetings enable decisions to be made; and
Plan ahead to ensure that meetings are quorate.
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6.27 Depending on the nature of the conflict, GPs or other representatives could be permitted to
join in the decision about the proposed decision, but should not take part in any vote on the
decision. This arrangement will be noted in the Minutes.
7. DISPUTE RESOLUTION
7.1 It is anticipated that disputes arising as a result of conflicts of interest will normally be resolved
informally, without recourse to a formal process. If, however, the dispute cannot be resolved
informally, the process by which any perceived breach would be handled is set out below. The
procedure is based on the principle that disputes should be resolved at the most local level
possible. If the dispute is not successfully resolved by the CCG, the complaint should then by
heard by NHS England.
Objectives:
7.2 The objectives of the procedures are as follows:
 To provide the CCG with an appropriate mechanism for dealing with disputes about conflict
of interests.
 To resolve disputes transparently, fairly and consistently.
 To assure bidders and service providers that the process is fair and transparent.
 To mitigate risks and protect the reputation of the CCG.
 To prevent, where possible, legal challenge/expensive referral processes.
7.3 When handling disputes the CCG will:






Commit to transparency.
Communicate the process and decision making criteria widely and in advance.
Engage all relevant stakeholders.
Publish findings within and across the CCG to enable consistency.
Be objective and base the analysis and the decision on objective information and
criteria.
Maintain an audit trail.
Procedure:
7.4 The Kingston CCG dispute resolution procedure in relation to conflicts of interests is made up
of the following stages:
Stage 1: Making the Complaint- Any complaint must be submitted to the Chair of the Kingston
CCG in writing. The complaint will be acknowledged within five working days;
Stage 2: Triage – Following receipt of the complaint, the Chair may contact the complainant to
request clarification or further information. If the complaint is not deemed by the Chair to
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warrant proceeding further, the complainant will be notified that the complaint will not
progress.
7.5 If the complaint should be fast tracked to another organisation for legal, governance or safety
reasons, the complainant will be informed of the course of action.
7.6 Where a complaint is in scope and not subject to fast tracking, it will proceed to the next stage.
In most cases, the triage process should be carried out within five working days.
Stage 3: Chair Review – Following triage, the Kingston CCG Chair will review the complaint to
determine whether a swift resolution can be achieved without the need to involve the
Governing Body. The Chair may call a meeting of the parties concerned to discuss the matter
informally and without prejudice. If the Chair is unavailable or if the complaint involves the
Chair, the Chief Officer will review the complaint and act in accordance with this procedure as
appropriate. The Lay Member for Governance will be made aware, and will make him/herself
available for advice.
Stage 4: The Governing Body – If the complaint cannot be resolved by the Chair, an appropriate
committee of the Governing Body, chaired by the Lay Member for Governance will then
formally review the complaint (with external advice as required) and may refer on to the Audit
Committee to advise on the appropriateness of the procedure followed.
Stage 5: The Decision – Following review of the complaint, the CCG will notify the complainant
of the decision, explaining the rational and, if necessary, any required course of action.
7.7 It is expected that the procedure as a whole should not take longer than three months.
Right of Appeal:
7.8 The CCG expects that most complaints will be successfully resolved. However, if the
complainant is unsatisfied by the results of this procedure, they can refer the complaint to the
NHS England process. Appeals to the NHS England must be made within three months of the
complainant being notified of the CCG’s decision.
8. CODE OF CONDUCT
8.1 All individuals, including Membership of the CCG, Governing Body, and staff, will at all times
comply with the Constitution, including the requirements set out in this policy for managing
conflicts of interest, and be aware of their responsibilities as outlined in that document.
8.2 They should act in good faith and in the interests of the Kingston CCG and Kingston patients
and should follow the Seven Principles of Public Life as set out by the Nolan Principles.
8.3 Individuals contracted to work on behalf of the Kingston CCG, or otherwise providing services
or facilities to the Kingston CCG, will be made aware of their obligation with regard to declaring
conflicts or potential conflicts of interest.
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9. TRANSPARENCY –
9.1 In the interests of transparency, the register of interests and the register of decisions will be
made publicly available and easily accessible to patients and the public including by:
9.2 ensuring that both registers are available in a prominent place on the Kingston CCG website;
and
9.3 making both registers available upon request for inspection at their headquarters.
9.4 sending paper or electronic copies of both registers available to members of the public on
request.
9.5 The registers will form part of the CCG’s annual accounts and will thus be signed off by external
auditors .
9.6 The CCG will publish details of all contracts, including the contract values, on the website as
soon as contracts are agreed. For services commissioned through AQP, the CCG will publish on
the website the type of services being commissioned and the agreed price for each service.
Where services are commissioned through an AQP approach, information on the providers
who qualify to provide the service will be made publicly available.
10. ROLE OF COMMISSIONING SUPPORT
10.1 The South London Commissioning Support Unit (CSU) will provide support to the CCG in
deciding the most appropriate procurement route, undertake procurements and manage
contracts in ways that manage conflicts of interest and preserve integrity of decision making.
The CCG will require assurance from the CSU that their business processes are robust to enable
the CCG to meeting its duties in relation to procurement.
10.2 To ensure the CCG is acting fairly and transparently, the CSU will prepare and present
information on bids, including an assessment of whether providers meet pre-qualifying criteria
and an assessment of which provider provides best value for money.
10.3 The CCG cannot lawfully sub-delegate commissioning decisions to an external provider of
commissioning support. Although the CSU will play a key role in helping to develop
specifications, preparing tender document, inviting expressions of interest and inviting
tenders, the CCG will:
 Sign off the specification and evaluation criteria;
 Sign off decisions on which providers to invite to tender; and
 Make final decisions on the selection of the provider.
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LINKED POLICIES/GUIDANCE

CCG Constitution (www.kingstonccg.nhs.uk)

Standards of Business Conduct for NHS Staff (HSG (93) 5):
(document is available on the Department of Health website:
http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/Healthserviceguideli
nes/DH 4017845)

Code of Conduct for NHS Managers
(document is available on the Department of Health website:
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuid
elines/Browseable/DH 4097226)

Commercial Sponsorship Ethical Standards for the NHS
(document is available on the Department of Health website:
http://www.dh.gov.uk/prodconsumdh/groups/dhdigitalassests/@dh/@en/documents/digit
alaseet/dh 4076078.pdf
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APPENDIX 1 – Declaration of Interest for Members of the CCG, Governing Body,
Council of Members and Employees of the CCG
NHS Kingston Clinical Commissioning Group
Member / employee/ governing body member / committee or sub-committee
member (including committees and sub-committees of the governing body)
[delete as appropriate] declaration form: financial and other interests
This form is required to be completed in accordance with the CCG’s Constitution and section
14O of The National Health Service Act 2006, the NHS (Procurement, Patient Choice and
Competition) regulations 2013 and the Substantive guidance on the Procurement, Patient Choice
and Competition Regulations
Interests that must be declared include:
a) Roles and responsibilities held within member practices;
b) Directorships, including non-executive directorships, held in private companies or
PLCs;
c) Ownership or part-ownership of private companies, businesses or consultancies
likely or possibly seeking to do business with the CCG;
d) Material shareholdings of companies in the field of health and social care;
e) Positions of authority in an organisation (e.g. charity or voluntary organisation) in the
field of health and social care;
f) Any connection with a voluntary or other organisation contracting for NHS services;
g) Research/funding grants that may be received by the individual or any organisation
they have an interest or role in;
h) Any other role or relationship which the public could perceive would impair or
otherwise influence the individual’s judgement or actions in their role with the CCG.
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Guidance Notes:

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
Within 28 days of a relevant event, members and senior staff (Band 8A and above)
need to register their financial and other interests.
The signed hard copy of the completed form should be sent to the Executive
Business Lead [email protected]
Any changes to interests declared must also be registered within 28 days of the
relevant event by completing and submitting a new declaration form.
A summary of the registers will be published on the CCG’s website and in the Annual
Report.
Anyone required to complete this declaration form must provide sufficient detail of
each interest so that a member of the public would be able to understand clearly
and the circumstances in which a conflict of interest with the business or running of
the CCG might arise.
If in doubt as to whether a conflict of interest could arise, a declaration of the
interest should be made.
DECLARATION OF INTERESTS
Name:
Position with the CCG:
Type of Interest
Personal interest/family
member/ other acquaintance?
Details
a. Roles and Responsibilities held
within member practices
b. Directorships, including nonexecutive directorships, held in
private companies or PLCs
c. Ownerships or part – ownership of
private companies, businesses or
consultancies likely or possibly
seeking to do business with the CCG
or NHS England
d. Shareholdings (more than 5%) of
companies in the field of health and
social care
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e. Positions of authority in an
organisation (e.g. charity or
voluntary organisation) in the field
of health and social care
f. Any connection with a voluntary or
other organisation contracting for
NHS services
g. Research funding/ grants that may
be received by the individual or any
organisation they have an interest or
role in.
h Any other role or relationship
which the public could perceive
would impair or otherwise influence
the individual’s judgement or actions
in their role within the CCG
i. No Interests to declare
To the best of my knowledge and belief, the above information is complete and correct. I undertake
to update as necessary the information provided and to review the accuracy of the information
provided regularly and no longer than Quarterly. I give my consent for the information to be used for
the purposes described in the CCG Constitution and published accordingly
Signed: ……………………………………………………………………….
Date:……………………………………………………………………………
Please forward a signed copy of the Declaration of Interests form to the Business Executive Lead at
[email protected] no later than 30th April 2014.
Thank you
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APPENDIX 2 – Declaration of Conflict of interests for bidders / contractors template
NHS [geographical reference] Clinical Commissioning Group
Bidders/potential contractors/service providers declaration form: financial and
other interests
This form is required to be completed in accordance with the CCG’s Constitution, and s140 of
the NHS Act 2006 (as amended by the Health and Social Care Act 2012) and the NHS
(Procurement, Patient Choice and Competition) (No2) Regulations 2013 and related guidance
Notes:

All potential bidders/contractors/service providers, including sun-contractors, members of a
consortium, advisers or other associated parties (Relevant Organisation) are required to identify
any potential conflicts of interest that could arise if the Relevant Organisation were to take part
in any procurement process and/or provide services under, or otherwise enter into any contract
with, Kingston CCG or with NHS England in circumstances where the CCG is jointly
commissioning the service with, or acting under a delegation from, NHS England
If any assistance is required in order to complete this form, then the Relevant Organisation
should contact the CCG senior manager leading the procurement. The completed form should
be sent to the Executive Business Lead [email protected]

Any changes to interests declared either during the procurement process or during the term of
any contract subsequently entered into by the Relevant Organisation and the CCG must notified
to the CCG by completing a new declaration form and submitting it to [specify].

Relevant organisations completing this declaration form must provide sufficient detail of each
interest so that a member of the public would be able to understand clearly the sort of financial
or other interest the person concerned has and the circumstances in which a conflict of interest
with the business or running of Kingston CCG or NHS England (including the award of a contract)
might arise.

If in doubt as to whether a conflict of interests could arise, a declaration of the interests should
be made.
Interests that must be declared (whether such interests are those of the Relevant Person themselves
or of a family member, close friend or other acquaintance of the Relevant Person), include the
following:

The Relevant Organisation or any person employed or engaged by or otherwise connected with
a Relevant Organisation (Relevant Person) has provided or is providing services or other work for
Kingston CCG or NHS England;;
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
A Relevant Organisation or Relevant Person is providing services or other work for any other
potential bidder in respect of this project or procurement process;

The Relevant Organisation or any Relevant Person has any other connection with Kingston CCG
or NHS England; whether personal or professional, which the public could perceive may impair
or otherwise influence the CCG’s or any of its members’ or employees’ judgements, decisions, or
actions.
Declarations:
Name of Relevant Organisation:
Interests
Type of Interest
Details
Provision of services or other work for Kingston
CCG
Provision of services or other work for any other
potential bidder in respect of this project or
procurement process
Any other connection with Kingston CCG, or NHS
England whether personal or professional, which
the public could perceive may impair or
otherwise influence the CCG’s or any of its
members’ or employees’ judgements, decisions,
or actions.
Name of Relevant Person
Interests
Type of Interest
[complete for all Relevant Persons]
Details
Personal interest or that of a
family member, close friend or
other acquaintance?
Provision of services or other work for
Kingston CCG
Provision of services or other work for
any other potential bidder in respect of
this project or procurement process
Any other connection with Kingston
CCG, whether personal or professional,
which the public could perceive may
impair or otherwise influence the
CCG’s or any of its members’ or
employees’ judgements, decisions, or
actions.
To the best of my knowledge and belief, the above information is complete and correct. I undertake
to update as necessary the information.
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Signed: ……………………………………………………………….
On behalf of: ……………………………………………………………….
Date: ……………………………………………………………….
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APPENDIX 3 – Procurement template
To be used when commissioning services from GP practices, including provider consortia, or
organisations in which GPs have a financial interest.
Service:
Question
Questions for all three procurement routes
How does the proposal deliver good or improved
outcomes and value for money – what are the
estimated costs and the estimated benefits?
How does it reflect Kingston CCG’s proposed
commissioning priorities? How does it comply
with the CCG’s commissioning obligations?
How have you involved the public in the decision
to commission this service?
What range of health professional have been
involved in designing the proposed service?
What range of potential providers have been
involved in considering the proposals?
How have you involved the Kingston Health and
Wellbeing Board? How does the proposal
support the priorities in the relevant Joint Health
and Wellbeing Strategy (or strategies)?
What are the proposal’s for monitoring the
quality of the service?
What systems will there be to monitor and
publish data on referral patterns?
Have all conflicts and potential conflicts of
interests been appropriately declared and
entered in registers which are publicly available?
Have you recorded how you have managed any
conflict or potential conflict?
Why have you chosen this procurement route?
What additional external involvement will there
be in scrutinising the proposed decisions?
How will Kingston CCG make its final
commissioning decision in ways that preserve
the integrity of the decision-making proces and
award of any contract?s?
Comment/Evidence
Additional question when qualifying a provider on a list or framework or pre selection for tender
(including but not limited to any qualified provider) or direct award (for services where national
tariffs do not apply)
How have you determined a fair price for the
service?
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Additional question when qualifying a provider on a list or framework or pre selection for tender
(including but not limited to any qualified provider) (where GP practices are likely to be qualified
providers)
How will you ensure that patients are aware of
the full range of qualified providers from whom
they can choose?
Additional question for proposed direct awards toGP providers
What steps have been taken to demonstrate
that the services to which the contract relates
are capable of being provided by only one
provider?
In what ways does the proposed service go
above and beyond what GP practices should be
expected to provide under the GP contract?
What assurances will there be that a GP practice
is providing high-quality services under the GP
contract before it has the opportunity to provide
any new services?
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