Strategic Intelligence Assessment

The NHSCFA conducts an annual strategic intelligence assessment to establish fraud threats and the amount of NHS funding vulnerable to loss through fraud, bribery, and corruption in England on behalf of the Department of Health and Social Care (DHSC).

Published: 13 October 2026

  • Image showing Alex Rothwell, Chief Executive Officer

    Foreword

    Alex Rothwell, Chief Executive Officer of the NHSCFA, introduces the 2026 Strategic Intelligence Assessment.

  • Image showing an NHSCFA poster with the words stop fraud above a raised hand making a stop gesture

    Executive summary

    A brief overview of the NHS’s overall vulnerability to fraud, bribery and corruption.

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    Introduction

    Why the NHSCFA produces an annual strategic intelligence assessment, and how the content should be interpreted.

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    The NHSCFA’s Thematic Area definitions

    Definitions for each of the NHSCFA's 12 thematic areas.

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    How do we calculate fraud vulnerability

    Our approach to assessing how financially vulnerable the NHS is to fraud.

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    Reporting trends

    Levels of reporting received by the NHSCFA alleging fraud, bribery and corruption against the NHS in England compared to previous periods.

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    Failure to prevent fraud

    If large organisations, including some NHS organisations, profit from fraud, they can now be held to account following the introduction of the corporate criminal offence of ‘Failure to prevent fraud.

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    Intelligence sharing with domestic and international counterparts

    The NHSCFA uses intelligence and collaboration to protect the NHS in England from fraud.

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    Procurement and commissioning fraud

    Fraud relating to pre-tender activity, the commissioning process, post-tender activity and mandate fraud.

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    Patient exemption fraud

    Fraud within the main NHS services that require payment upfront in return for access. It also encompasses the onward sale or supply of prescribed medication.

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    Pharmaceutical contractor fraud

    Fraud relating to the falsification or exaggeration of services, as well as collusion.

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    General Practice (GP) contractor fraud

    Fraud relating to the manipulation of income streams or activities that violate contractual terms perpetrated by either GPs or practice staff.

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    Fraudulent access to NHS care from overseas-visitors

    When a patient falsely represents themself as entitled to NHS care without charge, fails to disclose they are chargeable, or when an NHS staff member abuses their position to facilitate fraudulent access.

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    Optical contractor fraud

    Fraud relating to submitting inappropriate claims to the NHS for optical treatments, services, or enhancements not delivered or clinically required.

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    Data manipulation fraud

    Fraud through falsifying data to meet targets, increase revenue or hide undesirable outcomes.

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    Dental contractor fraud

    Fraudulent claims submitted to the NHS by dentists and their staff members for a range of NHS services provided to patients.

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    NHS staff fraud

    Fraud relating to NHS staff who manipulate their income and hours, insider abuses, and false representation during application processes.

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    Reciprocal healthcare fraud

    Fraudulent use of European Health Insurance Cards (EHICs), Global Health Insurance Cards (GHICs), Provisional Replacement Certificates (PRCs) and various other reciprocal healthcare arrangements. Also, false representation during the application stage.

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    Horizon scanning

    Analysing the future landscape to identify fraud threats to the NHS.

  • Image showing two workers analysing reports at a desk.

    Previous strategic intelligence assessments

    Read the NHSCFA’s annual assessments of the NHS’s financial vulnerability to fraud from 2016-17 data onwards.

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