Strategic Intelligence Assessment

The NHSCFA conducts an annual strategic intelligence assessment to estimate fraud losses, identify possible threats, vulnerabilities, and facilitators, and evaluate the risk of fraud to the NHS. This assessment also evaluates the NHSCFA's ability to counter and reduce this risk.

Published: 25 September 2025

  • Image showing Alex Rothwell, Chief Executive Officer

    Foreword

    Alex Rothwell, Chief Executive Officer of the NHSCFA, introduces the 2025 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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    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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    Cyber-facilitated fraud

    Fraud which is facilitated by cyber breaches or attacks.

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    Procurement and commissioning of services fraud

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

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    Patient exemption

    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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    Data manipulation

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

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    Community pharmaceutical contractor

    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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    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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    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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    Fraudulent access to secondary care from overseas-visitors

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

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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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    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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