East London NHS hospitals failing to record and share conflicts of interest

Researchers warn secrecy surrounding conflicts of interest risks undermining trust in healthcare pro

Researchers warn secrecy surrounding conflicts of interest risks undermining trust in healthcare professions. Picture: Barts Health NHS Trust - Credit: Barts NHS Health Trust

Hospitals across east London are failing to report conflicts of interest of doctors and medical staff, new research reveals.

The four main NHS trusts operating in Barking and Dagenham, Newham and Tower Hamlets will not say which companies paid what to their employees, nor publish these records online.

Nationally, 16 per cent of trusts log this information, the study published in journal BMJ Open found.

The researchers, led by bestselling science writer Ben Goldacre, call on a US-style public register of payments to tackle the issue.

They warn the “ongoing absence of transparency” surrounding conflicts of interest “may undermine public trust in the healthcare professions”.

Research shared with this newspaper shows NHS hospitals run by Barts Health; Barking, Havering and Redbridge University Hospitals (BHR Hospitals); East London Foundation and North East London Foundation Trusts leave out doctors’ names when declaring handouts.

Staff at Barts Health, the UK’s largest NHS trust, pocketed £41,558 in freebies including meals, travel and hotel fees between 2015 and 2016, according to registers of gifts and hospitality obtained through freedom of information requests.

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Recipients’ job titles were redacted on nearly half (46 per cent) of listings and most donors’ given vague names such as “Pharmaceutical company” and “Spinal implant provider”.

While direct gifts are banned by the pharma trade body, the Association of British Pharmaceutical Industry (ABPI), companies can still pay clinicians for lectures, sponsor their attendance at conferences and events, and provide training.

In 2015, the pharma industry reported this spend as £115 million.

Doctors and other healthcare professions are required to declare financial conflicts of interest so that their appropriateness, and possible impact on their job, can be assessed.

The register for BHR Hospitals, which omits details on those offered gifts, included flights to Amsterdam – “to evaluate a new food initiative” by French firm Sodexo – and dinner at Mansion House (speaker: Mark Carney). Both were accepted.

North East London Foundation Trust, or NELFT, meanwhile, mostly recorded gifts grateful patients had left doctors. They include: wine, coasters and six pairs of striped socks.

East London Foundation Trust (ELFT) told researchers a register was not needed as their policies “prohibits the acceptance of payments from pharmaceutical companies to members of staff”.

However, the ABPI database lists payments totalling £2,889.47 to five people registered at the trust from 2015-16.

“The undeclared sums were investigated and relate to training events, catering or where we’ve had paid speakers or similar costs,” said a spokeswoman for ELFT.

“A register of gifts and hospitality is publically available at request.”

Similar searches returned payments worth £715,388.19 at Barts Health, £145,708.16 at BHR Hospitals and one payment of £437.80 to an individual registered at NELFT. Not a penny was reported on the trusts’ respective disclosure logs.

“Thanks for drawing this to our attention,” said a NELFT spokesman.

The trust, he added, “is looking into the discrepancy”, though this “may take a while” as some staff have left.

A spokesman for BHR Hospitals said ABPI records relate “to funding for work carried out by our consultants, and sponsorship for events”, and so were not included.

Policies around conflicts of interest were reviewed regularly, he added.

Of the four trusts, only Barts Health addressed questions on whether declarations would be available online.

“We refreshed our policy on this issue at the end of 2017 to take into account new national guidance, meaning we will be publishing declarations regularly,” a spokesman said.