A GP group in Croydon paid more than half a million pounds to a healthcare company of which half a dozen of its board members and senior clinicians are shareholders.
The payments were listed in the first annual accounts of Croydon Clinical Commissioning Group (CCG), which said it abides by "rigorous" rules to avoid any conflict of interests.
The accounts for 2013/14– published at a board meeting earlier this month - showed payments totalling £661,000 were made to a company called Communitas, set up by GP practices in Croydon.
Croydon CCG board members are shareholders of the company, formerly known as Croydon Practice Based Commissioning (PBC), including chairman Dr Tony Brzezicki.
The other shareholders are medical director Dr John Chan, governing body member Dr John Linney, and clinical leaders Dr Bobby Abbott, Dr Kamran Khan and Dr Farnham Sami.
The fact that the six doctors are shareholders of Communitas is pointed out in the accounts.
The company was formed in days of practice based commissioning, before CCGs, when practices grouped together to set up organisations to deliver services in their areas. The Croydon group is made up of nearly 40 GP practices in the borough and many GPs are shareholders.
Communitas was originally formed under the primary care trust (replaced by the CCG under health reforms in April, 2013) which, in 2011, awarded the company a contract to deliver ear, nose, throat and dermatology services in the community.
The deal was renewed by the CCG last year. A separate bid by Croydon Health Services, which runs Croydon University Hospital, was also succesfful.
Both are 'payment by results' contracts, so the organisations get paid based on the number of patients they see.
CHS provides the services in clinics within the hospital, while Communitas is based within the community.
The CCG said the bids followed national guidelines, were considered by an external panel, and did not involve the shareholding doctors.
The final decision as to whether to approve each bid was made by the CGG's governing body, but members connected to Communitas absented themselves from that process.
Paula Swann, chief officer of Croydon CCG, said: "Clinical Commissioning Groups must always adhere to rigorous ruels to ensure we avoid any conflict of interests.
"Procurements are run by independent panels, we publish a full register of interests and our clinical leadership are not allowed to take part in any discussions or vote where there is a potential conflict."
The accounts also showed significant differences in how much money board members' GP surgeries received for completing 'locally enhanced services'- extra treatments and services GPs are asked to take on. It is up to individual surgeries to decide whether to do the work.
The CCG said GPs on the governing body are not involved in discussions about the services.
The papers showed that the CCG posted a £18.2 million deficit – against a target of £19.9 million - in 2013/14.
Earlier this year GPs published a report predicting it will take until at least 2017 to balance the books, by which time the CCG will have accumulated a £42 million deficit, which it admits it has no prospect of paying back.Payments for locally enhanced services by board member and practice:
Dr Tony Brzezicki – Queenhill Medical Practice - £48,000
Dr Rajeev Sagar – Woodside Group Practice - £28,000
Dr Agnelo Fernandes – Parchmore Practice - £21,000
Dr Atif Hassan – Keston House & Purley Medical Practice - £18,000
Dr Kamran Khan – Stovell House Surgery - £14,000
Dr Agnelo Fernandes – Haling Park Medical Practice - £9,000
Dr Farham Sami – The Moorings Practice - £9,000
Dr John Chan - £8,000
Dr Bobby Abbott - £4,000
