Financial Issues & Gifts Flashcards
What are the principles surrounding financial and commercial arrangements?
You must be honest and open in any financial arrangements with patients
If you charge fees you must tell patients about your fees, if possible before seeking their consent to treatment and tell patients if any part of the fee goes to another healthcare professional.
You must not exploit patients’ vulnerability or lack of medical knowledge when charging fees for treatments and services.
What must you do if a patient offers you a gift?
You must not encourage patients to give, lend, or bequeath money or gifts that will directly or indirectly benefit you.
You may accept unsolicited gifts from patients and their relatives provided this does not affect or appear to affect the way you prescribe for, advise, treat, refer, or commission services for patients and you have not used your influence to pressurise patients or their relatives to offer you gifts.
However, if you receive a gift or bequest from a patient or their relative, you should consider the potential damage this could cause to your patients trust in you and the public’s trust in the profession. You should refuse gifts or bequests where they could be perceived as an abuse of trust.
You must not put pressure on patients or their families to make donations to other people or organisations.
What are the principles surrounding conflicts of interest?
Trust in the doctor-patient relationship may be damaged if your interests affect your professional judgement. Conflicts of interest may arise in a range of situations and are not confined to financial interests and may also include other personal interests.
Conflicts of interest are not always avoidable, and whether a particular conflict creates a serious concern will depend on the circumstances and what steps have been taken to mitigate risks, e.g. by following established procedures for declaring and managing a conflict.
You should:
- Use professional judgement to identify when conflicts of interest arise
- Avoid conflicts of interest wherever possible
- Declare any conflict to anyone affected, formally and as early as possible, in line with the policies of your employer or the organisation contracting your services.
- Get advice about the implications of any potential conflict of interest
- Make sure that the conflict does not affect your decisions about patient care
- If you are in doubt about whether there is a conflict of interest, act as though there is.
How should you remain impartial in decisions about patient care?
If you, or someone close to you, has a financial or commercial interest in an organisation providing healthcare (e.g. a pharmaceutical company, a nursing/carehome, a pharmacy), you must not allow that interest to affect the way you prescribe for, advise, treat, refer or commission services for patients. You must be open and honest with your patients about any such interests that could be seen to affect the way you prescribe for, advise, treat, refer, or commission services for them.
You must not try to influence patients’ choice of healthcare services to benefit you, someone close to you, or your employer. If your organisation dispenses medicines, you must not allow your financial interests to affect the way you prescribe.
You must not ask for or accept any inducement/gift/hospitality that may affect or be seen to affect the way you prescribe for, advise, treat, refer, or commission services for patients. You must not offer such inducements to colleagues.
If you plan to refer a patient for investigation, treatment or care at an organisation in which you have a financial interest, you must tell the patient about that interest and make a note of this in the patient’s medical record.
Where there is an unavoidable conflict of interest about the care of a particular patient, you should record this in the patient’s medical record.
What are the principles surrounding the commissioning of services?
This can lead to conflicts of interest for the individual Doctor involved. If you have responsibility for commissioning services, you must: satisfy yourself that all decisions made are fair, transparent and comply with the law, keep up to date with and follow guidance that governs commissioning of services where you work, formally declare any financial interest that you or someone close to you in accordance with the governance arrangements, take steps to manage any conflict between your duties as a doctor and your commissioning responsibilities, e.g. by excluding yourself from the decision making process and any subsequent monitoring arrangements.
What are the principles around recommending services outside of healthcare?
Some organisations providing services outside healthcare (such as insurance companies or solicitors) run schemes where payment is offered according to the number of customers referred.
Generally, doctors will not have the professional expertise to make recommendations or refer to
a particular organisation; their chief interest in such schemes is financial. You should not accept fees for referring patients to, or recommending the services of, particular organisations or individuals.
