Conflicts of Interest and the Integrated Care Board
As an Integrated Care Board (ICB) responsible for delivering health and care services for the people of Norfolk and Waveney, NHS Norfolk and Waveney ICB is committed to managing any actual or potential conflicts of interest that arise in the course of its business in a manner that demonstrates the highest degree of transparency, probity, and accountability.
The ICB sees the effective management of conflicts of interest as being essential to maintaining public trust and confidence in the commissioning system and assuring the public that the ICB decisions are robust, fair, and provide value for money. Furthermore, good management acts as key to safeguard to the reputations of the health and social care professionals who provide invaluable direction and leadership throughout the ICB’s commissioning work.
What are Conflicts of Interest?
A conflict of interest is described as ‘a set of circumstances by which a reasonable person would consider that an individual’s ability to apply judgement or act, in the context of delivering, commissioning or assuring taxpayer-funded health and care services is or could be, impaired or influenced by another interest they hold’.
A conflict can be ‘actual’, i.e. there is a current material conflict concerning the matter at hand. They can also be ‘potential’, i.e. there is the possibility of a material conflict between one or more interests at a point in the future. As such, individuals can have interests without immediately recognising that a potential conflict exists. In such circumstances, the ICB always advises caution and that the interest be declared where there is otherwise a risk of accusations of improper conduct.
Conflicts of interests fall into four main categories:
- Financial interests: Where an individual may receive direct financial benefit or detriment from the consequences of a commissioning decision.
- Non-financial professional interests: Where an individual may obtain a non-financial professional benefit or detriment from the consequences of a commissioning decision, such as increasing their professional reputation or status or promoting their professional career.
- Non-financial personal interests: Where an individual may benefit or suffer a detriment personally in ways which are not directly linked to their professional career and do not give rise to a direct financial benefit or detriment.
- Indirect Interests: Where an individual has a close association with an individual who has a financial interest, non-financial professional interest or a non-financial personal interest in a commissioning decision.
Offers of gifts, hospitality and/or commercial sponsorship can also give rise to real or perceived conflicts of interest or undue influence. Consequently, those involved in the work of the ICB are also required to declare any offers of gifts, hospitality and/or commercial sponsorship that fall within the thresholds set out in the ICB’s Conflicts of Interest Policy.
The ICB arrangements for managing Conflicts of Interest
The ICB Constitution and Conflicts of Interest Policy set out our arrangements for managing conflicts of interest. They also set out the expectations that apply to its Board Members, staff, ICB Members, and others involved in the work of the ICB. The arrangements described in the policy are in-line with relevant legislation and statutory guidance concerning the management of conflicts of interest.
What happens when a declaration is made?
In addition to being required to make declarations during the ICB appointment processes and on appointment to the ICB, it is the responsibility of individuals to notify the ICB of any potential conflicts of interest or offers of gifts, hospitality of commercial sponsorships that arise during the course of their undertaking ICB business. The ICB Conflicts of Interest Policy requires them to notify the ICB as soon as they become aware of the potential conflict and/or receive an offer. At a maximum, they are asked to do this within 28 days.
Once a conflict of interest is declared, it is recorded on the appropriate register of interest (see more information under the appropriate heading). Any offer of gifts, hospitality or commercial sponsorship that is declared is also recorded on the appropriate register.
Declarations are also invited prior to each relevant meeting of the ICB and thereafter managed in line with the ICB’s Conflicts of Interest Policy on a case-by-case basis. Any declarations that are made are recorded in the meeting minutes accompanied by the actions taken to manage the declaration in the meeting.
Registers of Interests and Gifts, Hospitality and Sponsorship
The ICB is required to publish registers of interest relating to Board Members and other decision making staff – notably our Joint Senior Leadership team. When a declaration is made, the relevant register is updated as well as being reviewed at set intervals on an annual basis.
The current registers can be found here:
The ICB full Staff Register of Interest can be viewed at one of the ICB offices by appointment – contact nwicb.contactus@nhs.net.
Conflicts of Interest Guardian
David Holt, Chair of the ICB Audit & Risk Committee has a lead role as the Conflicts of Interest Guardian. His role involves ensuring that the Board and the wider ICB behaves with the utmost probity at all times.
Supported by the ICB Corporate Affairs Manager and Governance Team they act as a confidential point of contact for anyone who has concerns about conflicts of interest at the ICB, supports the rigorous application of conflicts of interest principles and policies and provides advice and judgement concerning conflicts of interest and their management.
The ICB Register of Procurement Decisions
Any actual or potential conflicts of interest are managed throughout the ICB commissioning cycle with potential conflicts being identified at the outset and revisited throughout. Details of the ICB arrangements for the management of conflicts of interest during commissioning exercises are set out in the Conflicts of Interest Policy.
The ICB maintains a register of procurement decisions and contracts awarded, which also includes a record of any related conflicts of interest as appropriate. You can view the 2024/25 Register of Procurement Decisions and Conflicts of Interest here.
Breaches of the ICB Management of Conflicts of Interest
Anonymised details of any breaches of the Conflicts of Interest Policy can be found here.