NHS organisations are entering into working partnerships with drug companies, but they are not making the details, and even existence, of many of these deals available to the public, reveals an investigation by The BMJ conducted in collaboration with University of Bath’s academics.
These partnerships are used to support a variety of initiatives, including several projects to review the medication of people with ADHD, and more than 20 projects that focus on patients with age-related macular degeneration.
The BMJ, working with a team of university researchers including Dr Piotr Ozieranski (Department of Social & Policy Sciences) and Dr Britta K. Matthes (Department for Health), sent freedom of information requests to all 194 acute care NHS trusts in England to find out how many were involved in joint working arrangements in 2016 and 2017 and what joint working policies trusts had in place.
Joint working arrangement is the term used to refer to initiatives that involve shared investment by the NHS and drug companies. They are designed to bring benefits to patients, the NHS, and the companies.
Companies spent £3m in 2016 and £4.7m in 2017 on joint working arrangements, and under the NHS Long Term Plan, collaboration between health services and industry is set to treble over the next decade.
Yet the researchers found that a fifth of trusts would not release details of the deals, despite official guidance that joint working agreements must be conducted in an “open and transparent” manner.
Trusts are also expected to record and monitor all funding agreements related to the joint working projects, yet 13 (7%) said that they did not keep a central record of any such arrangements and so could not provide the information.
Even when trusts did provide details, the information they provided was often inaccurate or contradicted by other sources. Others claimed not to know about joint working arrangements at all.
Dr Piotr Ozieranski from the Department of Social & Policy Sciences explained: “Joint working is an increasingly important form of collaboration between the NHS and the pharmaceutical industry, and as such has received a considerable amount of policy backing. Given its prominent status, we were very surprised to find that many NHS trusts did not appear to understand the nature of joint working and, even if they did, there were serious shortcomings in how information about it was managed and made available to the public. We know very well that any collaborations involving the use of public resources should be entirely transparent and this should also be the case with joint working.”
Dr Britta K. Matthes from the Department for Health added: “We are currently working on a comprehensive piece of research which uses investigative research methods to examine the transparency of information on joint working arrangements in the NHS in England. Building on our findings, we offer suggestions on how to address the present challenges. We find it crucial to look ahead as we expect that joint working will gain more prominence in the next years.”
The industry says that joint working projects can accelerate the spread of new treatments for the benefit of patients. The BMJ found that many of the 93 projects running in 2016 and 2017 specifically referred to increasing the use of products marketed by the company funding the project.