NHS staff fraud encompasses staff manipulating income and hours, insider abuses, and false representation during application processes.
The increase in financial vulnerability during 2023 - 2024 can be attributed to increases in expenditure and recruitment of staff, coinciding with the NHS Long Term Plan to recruit more staff within the NHS.
£31.9m
vulnerable from an expenditure of £90.7 billion
Working elsewhere whilst on sickness leave is a known threat within the NHS. Intelligence suggests staff could be falsifying sickness to receive both sick pay and extended leave, with some alleged to be working for other employer(s) or their own private work or business during their sickness period. Multiemployment / dual employment is also likely, where staff work simultaneously at another NHS trust whilst on short / long term sickness absence.
It is also a possibility that inflation of income and hours, including claiming for hours, shifts, overtime and patient care services, which were not worked is occurring, as staff can manipulate their timesheets and e-rostering systems to inflate their income. NHS staff may also retrospectively electronically book bank shifts on the rostering system with the intent to fraudulently claim for payment having not worked.
It is likely some NHS staff are working elsewhere during contracted times. For example, staff are alleged to be working for another NHS Trust or employer suggesting dual or multi-employment and / or working privately during their substantive contracted post or hours. Additionally, intelligence suggests clinical staff are completing privately paid practices, services, and / or treatment of private patients during NHS contracted hours.
Falsification of English Language Test result certification has been identified as highly likely. Intelligence suggests applicants from overseas have submitted forged and falsely obtained International English Language Testing System (IELTS), Occupational English Tests (OET) and Computer Based Test (CBT) certificates during the recruitment process. Test certificates are also known as a ‘Test Results Form’ (TRF).
Information reports received for NHS staff fraud
The change in the number of fraud reports received in relation to NHS staff fraud from 2019 - 2020 to 2023 - 2024 is illustrated in the chart below:
| 2019 - 2020 | 2020 - 2021 | 2021 - 2022 | 2022 - 2023 | 2023 - 2024 |
|---|---|---|---|---|
| 2019 - 20202,351 | 2020 - 20211,828 | 2021 - 20222,375 | 2022 - 20232,539 | 2023 - 20242,963 |
Horizon scanning
Reforms have been introduced to restrict care workers from bringing dependents to the UK as part of the government’s plan to reduce legal migration. These changes do not affect those employed on a Health and Care Worker visa. However, overseas workers requiring a general Skilled Worker visa (such as data analysts, IT and finance professionals, etc) but sponsored by an NHS organisation would be subject to these changes.
Although there is a staffing gap in the NHS which could potentially widen, it has reduced recently, and this could continue with the publication of the NHS Long Term Workforce Plan. It sets out direction locally, regionally, and nationally to tackle NHS workforce challenges in England. The Plan includes a series of actions to ‘train, retain and reform’ the workforce, thus improving patient care and increasing staffing numbers through investing in training facilities. The increase in staffing across the NHS should lessen the number of shifts which require cover, ultimately reducing the threat posed by manipulation from bank staff and agency workers.