A clinician wishes to include a new drug, manufactured by a company with which he has links eg. company shares, research grant, in the trust formulary.
Trust committee (eg drug and therapeutics committee) should require declarations of interest from clinicians submitting proposals for new products to be added to formularies and ensure the decision is based on clinical and cost effectiveness information.
A pharmaceutical industry representative wishes to present the case for a new product being included on a trust formulary.
The trust should establish and adopt a reasonable policy on approaches from industry representatives. Industry representatives should be required to sign up to compliance with such a policy before being given access to any meetings.
An offer from a company to provide for training of staff.
Employers should be careful to ensure that staff are not pressurised by sponsors of training to alter their own activity to accord with sponsors' wishes, where these are not backed up by appropriate evidence. Training provided by industry may be above board if it is unbiased, has mutual benefit for both the NHS and the sponsoring company, is evidence based and the hospitality is appropriate. However, participants should assess whether they may be influenced unduly and also bear in mind what benefits the company might derive (eg exposure to NHS, professional contacts, potential allies to use later, names of who to influence) often without the participants realising.
A manufacturer of ostomy equipment offers to sponsor a stoma nurse post in an NHS trust.
The trust should not accept the sponsorship if it would require the stoma nurse to recommend the sponsor's (products) in preference to other clinically appropriate appliances, nor if it requires the trust to recommend patients to use a particular dispensing service or withhold information about other products. Existing contracts containing any such provisions should, where possible, be urgently renegotiated.
A manufacturer of a particular type of nicotine replacement therapy offers to provide their product at a reduced rate to a health action zone or a health authority.
This arrangement is acceptable provided that there is a clear clinical view that these products are appropriate to particular patients and there is no obligation to also prescribe these products to other patients for whom an alternative product would be at least as beneficial.
A pharmaceutical company offers to provide starter packs at a discounted price.
This type of sponsorship is acceptable, but should always be declared in order to avoid any suspicion that subsequent prescribing might be inappropriate and linked to the provision of starter packs.
A catering company offers to provide discounted products to an NHS trust.
This agreement is acceptable, but should be routinely declared to the health authority.
A high tech home health care provider offers to supply equipment at reduced rate in return for business linked to a specific product.
Health authority contract negotiators should advise the company that any contract will not prejudice the provision of the most appropriate service to patients, and will not bear any relation to other contracts.
A manufacturer offers to pay the travelling costs or accommodation costs for clinicians invited to a conference to view medical products.
Only clinicians with a specific interest in the products should attend and the travel costs incurred should be paid for by the trust, unless the chief executive/director of finance gives approval for the potential supplier to take responsibility for the costs. Such decisions should be taken at least at director of finance level.
