A Common Understanding 2012 - Working Together For Patients

Principles

Value for Patients

• All joint-working between the pharmaceutical industry and NHSScotland must be of measurable benefit to patients and be compatible with the principles of the NHSScotland Quality Strategy.
• All joint-working projects must promote and enhance equitable access to evidence-based health care.
• The costs and benefits of any joint-working agreement for patients, NHSScotland and the pharmaceutical industry must specifically address and assess the value for patients, the NHS and the pharmaceutical companies involved.

Business Standards and Transparency

• The joint-working agreement should not be seen as an endorsement or promotion of a specific company organisation, medicine or technology.
• The interests of individual patients must be protected, and joint-working should not undermine or conflict with the ethical requirements of any healthcare professional, including the duty of clinicians to provide the treatment considered to be clinically appropriate. Collaboration between NHSScotland and the pharmaceutical industry should not be represented as endorsement by NHSScotland of any specific medicine or technology.
• The pharmaceutical industry must comply with the relevant code of practice at all times. All NHSScotland staff/independent contractors must comply with NHS (and relevant professional bodies’) codes of conduct. NHSScotland and the pharmaceutical industry must work towards a common compliance framework to ensure that projects do not experience undue administrative delay.
• Under the Bribery Act 2010, any money, gift or consideration received by an employee in public service from a person or organisation holding or seeking to obtain a contract will be deemed by the courts to have been received corruptly unless the employee proves otherwise.
• Healthcare professionals should not achieve any personal financial benefit from joint-working.

Working with the industry

• There are genuine areas of common ground for industry and healthcare professionals, with shared aims and objectives. Pharmaceutical industry staff working in joint projects are stakeholders in health care. In working together, both sides can access a broader range of knowledge and expertise and ultimately ensure high quality patient care.
• Healthcare professionals have a shared responsibility to maintain high standards in any collaboration. Declare all relevant conflicts of interest and always be transparent about any involvement with industry and seek patients’ informed consent where appropriate. Industry will be required to collect and declare anonymised information about the total payment to healthcare professionals for certain services such as speaker fees and participation in advisory boards with the first annual declaration of payments to be made in 2013 for payments in 2012.
• Unacceptable practice in any aspect of joint-working should not be tolerated. Challenge any behaviours that seem inappropriate and report any suspected contraventions of the ABPI Code of Practice to the Prescription Medicines Code of Practice Authority (PMCPA).

Good Governance

• All joint-working should be underpinned from the outset by robust documentation. An early draft written agreement should lead to a final agreement that is acceptable to all parties and published on NHS Boards’ websites.
• There must be an agreed and obvious “exit strategy” from the outset to ensure that patient care is not compromised at any stage. Similarly, no recurring financial commitments should be placed upon NHSScotland without explicit prospective agreement.
• NHS Boards should establish monitoring arrangements to ensure accountability. An official register of interests should be established as part of the monitoring arrangements and all relevant individuals must subscribe to this. This register should be published on the websites of all the Boards involved.
• Care should be taken to ensure that NHS Boards do not enter into new joint-working arrangements that would conflict with Scottish Government policy and
  with recommendations issued by the Scottish Medicines Consortium or NHS Healthcare Improvement Scotland.
• Where the joint-working arrangement involves the pharmaceutical industry employing or seconding staff/independent contractors to provide services within NHSScotland, this must comply with Scottish Government policy on public sector healthcare provision and avoid any conflict of interest. An exit strategy and plans for future funding of the post and/or service must be agreed from the outset. NHSScotland staff must ensure that all undertakings are in keeping with the governance arrangements of their NHS Board.
• Clinical aspects of care, including the development of guidelines and protocols is the responsibility of the Health Board and, should always remain under
  local/national NHSScotland control.

Data, Patient Information and Intellectual Property

• There must be clarity from the outset of what data will be collected, and how it will be collected and evaluated to monitor the defined outcomes for the project.
• Reports, or information pertaining to joint-working must not be used or published, or be used for any commercial activity without the explicit permission of NHSScotland.
• Any patient identification should be removed from data, in line with the Data Protection Act to respect and preserve patient confidentiality and professional codes of conduct.
• Where a joint-working arrangement permitting access to patient-specific information is agreed then access to the data must be limited to use by registered healthcare professionals. The contract must draw attention to obligations of confidentiality, specify security standards to be applied, limit use of information to purposes specified in the contract and reinforce the fact that the contract will be terminated if these conditions are not met.
• Activities undertaken as part of joint-working should be covered by the public liability and professional indemnity arrangements of the NHS Board concerned. If necessary, advice should be sought to confirm this.
• The Scottish Health Informatics Programme Blueprint on Health Records Research in Scotland should be adhered to as best practice in handling patient information.
• Products originating from intellectual property within the NHS or affiliated bodies are covered by HDL(2004)09 A Framework and Guidance on the Management of Intellectual Property in NHSScotland, and NHS MEL (1998) 23 Policy Framework for the Management of Intellectual Property within the NHS.

Case Study 7: SPECIALIST REGISTRAR (SPR) TRAINING – Dr Hill; Scottish Respiratory Industry Group (SRIG); Scottish Thoracic Society; NHS Education for Scotland (NES)

“The ABPI Scottish Respiratory Industry Group’s support for Spr (specialist registrar) training is appreciated. Industry has a lot to offer trainees with strengths in areas which complement the core training provided.”

Dr Adam Hill, Consultant Respiratory Physician & Associate Post Graduate Dean South East Scotland, Royal Infirmary of Edinburgh

Case Study 8: CANCER SERVICE REDESIGN IN NHS GRAMPIAN – NOSCAN and Novartis Pharmaceuticals

“Industry support, in this case has enabled the development of innovative care within a local setting which fits a direction of travel of care consistent with patient needs.”

Peter Gent, Manager NOSCAN (North of Scotland Cancer Network)