Article Text

Original research
How are declarations of interest working? A cross-sectional study in declarations of interest in healthcare practice in Scotland and England in 2020/2021
  1. Margaret McCartney1,
  2. Raphaella Bergeron Hartman1,
  3. Harriet Feldman2,
  4. Ronald MacDonald1,3,
  5. Frank Sullivan1,
  6. C Heneghan2,
  7. Calum McCutcheon4
  1. 1University of St Andrews, University of St Andrews Bute Medical School, St Andrews, Fife, UK
  2. 2University of Oxford, Oxford, UK
  3. 3University of Dundee School of Medicine, Dundee, UK
  4. 4Medical School, University of Glasgow, Glasgow, UK
  1. Correspondence to Dr Margaret McCartney; mm494{at}


Objective To understand arrangements for healthcare organisations’ declarations of staff interest in Scotland and England in the context of current recommendations.

Design Cross-sectional study of a random selection of National Health Service (NHS) hospital registers of interest by two independent observers in England, all NHS Boards in Scotland and a random selection of Clinical Commissioning Groups (CCGs) in England.

Setting NHS Trusts in England (NHSE), NHS Boards in Scotland, CCGs in England, and private healthcare organisations.

Participants Registers of declarations of interest published in a random sample of 67 of 217 NHS Trusts, a random sample of 15 CCGs of in England, registers held by all 14 NHS Scotland Boards and a purposeful selection of private hospitals/clinics in the UK.

Main outcome measures Adherence to NHSE guidelines on declarations of interests, and comparison in Scotland.

Results 76% of registers published by Trusts did not routinely include all declaration of interest categories recommended by NHS England. In NHS Scotland only 14% of Boards published staff registers of interest. Of these employee registers (most obtained under Freedom of Information), 27% contained substantial retractions. In England, 96% of CCGs published a Gifts and Hospitality register, with 67% of CCG staff declaration templates and 53% of governor registers containing full standard NHS England declaration categories. Single organisations often held multiple registers lacking enough information to interpret them. Only 35% of NHS Trust registers were organised to enable searching. None of the private sector organisations studied published a comparable declarations of interest register.

Conclusion Despite efforts, the current system of declarations frequently lacks ability to meaningfully obtain complete healthcare professionals’ declaration of interests.

  • health policy
  • medical ethics
  • quality in health care

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • Contributors The study was conceived by MM in partnership with the lay group, methodology organised by MM, HF, FS and CH. Data collection and assessment were done by CM, RBH, MM and RM. Organisational elements were provided by CM, MM and RM. Data analysis was done by MM, CM, RM, FS and CH. Drafting and editing by MM, FS and CH. Revisions after peer review were done by MM and FS. MM is acting as guarantor.

  • Funding MM is funded by the Chief Scientist Office Scotland, RBH and RMcD had summer medical studentships from the University of St Andrews. No specific funding for this project was otherwise received. Grant award number: N/A

  • Competing interests MM and CH have written, broadcast and campaigned around issues pertaining to conflicts of interest which has included paid work.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.