Managing conflicts of interest in the NHS
We are living through a golden age of drug discovery. Newspaper front pages tell us weekly of the scientific breakthroughs being made in cancer, cardiovascular disease and HIV. The pharmaceutical industry is incredibly proud of our role in pushing forward these advances to benefit the lives of patients across the UK.
The story of discovering and developing a new drug from bench to bedside is an extraordinary one. On average, it takes over 12 years and costs over £1 billion to develop a new medicine. And crucial to this process is the role of doctors, nurses and other NHS professionals – working with industry – to deliver these breakthroughs.
That’s why I’m proud of these relationships and why I feel passionately that they are critical to the success of the medical innovations of the future. But for these relationships to thrive, transparency about them is crucial.
The Association of the British Pharmaceutical Industry (ABPI) has done much to increase the transparency about the relationships between healthcare professionals and pharmaceutical companies. The ABPI Code of Practice sets the standard, clearly setting out what pharmaceutical companies can and cannot do when engaging with doctors, nurses and other health care professionals. Importantly, the Code makes it absolutely clear that joint working between pharmaceutical companies and NHS employees ‘must always benefit patients’. It covers everything from prohibiting companies from giving doctors note pads and pens, to ruling that only economy flights can be taken to overseas conferences.
This year the ABPI took transparency further by establishing ‘Disclosure UK’. For the first time, details of payments or benefits in kind made to health professionals and healthcare organisations in the UK were made available on a publicly accessible database. It outlines payments for services including speaking at and chairing meetings and training services. But the vast majority of payments relate to research and development activity – predominantly clinical trials. When Disclosure UK launched on 30 June, £229m of the £340m of payments disclosed were for research activities. I thank the majority of healthcare professionals and organisations who have disclosed their data. This helps to tell the story of the NHS being at the forefront of developing and launching new medicines.
It is because of this commitment to transparency that I was pleased to accept the invitation from Sir Malcolm Grant to sit on the ‘Task and Finish’ Group to look at conflicts of interest in the NHS.
The Group was set up to look at how to establish a common approach to managing any perceived conflicts of interest across the NHS. Of course, this is a much wider question than just the relationship the NHS has with the pharmaceutical industry. But I was pleased to be able to give a perspective from the industry and share what we have learnt about how to manage any conflicts of interest arising.
For the ABPI, it is absolutely critical that pharmaceutical companies can continue to work with doctors, nurses and other NHS staff to develop and deliver new medicines. Without the insights from those on the frontline of patient care, we lack the feedback on how medicines are working in practice.
And these relationships are critical for the NHS too. Indeed, under the NHS England Mandate, the NHS has an objective to support research, innovation and growth to ‘harness research and innovation to enable cost effective, affordable, transformative new treatments to reach patients more quickly’. The pharmaceutical industry can be at the heart of delivering this alongside the NHS. The recent announcement that the NHS has appointed its hundredth clinical entrepreneur as part of a programme supported by a range of pharmaceutical companies is proof that this is already happening.
The Task and Finish Group enabled some good discussion about how this collaboration can be fostered, whilst giving the public confidence in the nature of these relationships. The consultation response seeks to strike that important balance.
Getting this balance right will be crucial in allowing our golden age of drug discovery to continue.