This Strategic Intelligence Assessment (SIA) estimates the amount of NHS funding vulnerable to fraud, bribery, and corruption. It also provides intelligence around current and longer-term threats, recommendations for prevention and enforcement activity.
Between 2023 - 2024 the estimated financial vulnerability increased by £50.6 million, giving an overall total of £1.316 billion. However, as a percentage of the overall budget there has been a decrease in fraud vulnerability when compared with the NHS budget for 2022 - 2023. We believe this is partly due to increased and improved counter fraud activity, including the continued roll out of Real Time Exemption Checking (RTEC) and greater collaboration with and between stakeholders.
Despite this success, £1.316 billion could deliver so much for the NHS – doctors, nurses, ambulances, equipment – helping save lives and making a difference to people’s health. We can reasonably expect fraud to increase in future reporting periods due to predicted increases in NHS expenditure, increased digitalisation, and propensity for fraud.
It is difficult for the fraud ‘voice’ to be heard – especially alongside the operational and financial challenges that the NHS faces. However, such predicted increases in fraud are not irreversible. We believe that by using this assessment, which is unique to us, we can ensure that all stakeholders are appropriately informed and equipped to act.
One of the actions undertaken in the past year was to target procurement and commissioning fraud, which we estimate to have the highest amount of fraud vulnerability out of the thematic areas described in the report. We set up a dedicated working group and created a toolkit as part of a Local Proactive Exercise (LPE) for our stakeholders to conduct. It is anticipated that, following completion in late 2024, we will be able to analyse the results, act and subsequently evidence substantial improvements in the understanding and prevention of procurement fraud. This will be achieved by working directly with NHS organisations across the country and responding to the data provided.
We also launched Project Athena at the beginning of 2024, which will give us the tools to tackle the threats highlighted in this SIA. Project Athena will use advanced data analytics, combined with the practical expertise and knowledge of the NHSCFA and partners to reduce potential fraud losses to the NHS.
It has also been recognised that a co-ordinated national approach to fraud risk management is needed and this will align with the SIA to provide a more comprehensive understanding of the risks faced from fraud. The NHSCFA has led on the development and successful delivery of a health group wide Enterprise Fraud Risk Assessment (EFRA) which identifies key risk areas and, in collaboration with the SIA, can drive forward risk control and fraud prevention activity. The risks identified in the EFRA, and action taken as a result, will be reflected in future versions of the SIA and will give greater visibility of risk and efforts to mitigate them.
The SIA requires a huge amount of collaboration, analysis, and effort to complete, both from our partners across the health system as well as colleagues across the NHSCFA. I’d like to thank you all for your efforts and I look forward to using this document to counter fraud together over the coming year.
Alex Rothwell
Chief Executive Officer