Annual reporting trends
Levels of fraud reporting received by the NHSCFA compared to previous periods.
Reporting has decreased by approximately 15% compared to last year (6,161 reports decreasing to 5,252) and largely the result of a significant reduction of 72% in COVID-19 related reporting (1,336 reports decreasing to 377). The pink sections of the bar chart display the additional reports classified as COVID-19 related during the collection period 2022 – 2023 compared with previous years.
The significant contributor to the decrease in COVID-19 related reporting is within procurement and commissioning of services fraud, which sees a decrease of 646, an 80% reduction from 2021 – 2022. This is attributed to a downturn in reporting of COVID-19 related scams such as telephone calls, texts, and emails to book vaccines, vaccine passports and obtain test kits.
It is assessed this decrease is attributable to urgent measures and funding streams reducing or withdrawn completely in the past year, and as such, less opportunity for fraud to be attempted. It is anticipated this downward trend in reporting will continue in the next collection period of 2023 – 2024.
Once COVID-19 related reporting is subtracted, the number of reports received by the NHSCFA is almost identical compared to the previous year (4,875 vs 4,825). However, these non-COVID reporting totals are still approximately 1,100 fewer per year than in each of the two years pre-pandemic (2018 – 2020). More broadly, non-COVID related reporting has decreased by 18% between 2018 – 2023 (5,943 reports in 2018 reducing to 4,875 in 2023). This is largely attributable to a 42% decrease in reporting of patient exemption fraud (1,486 reports in 2018 reducing to 866 in 2023).
The NHSCFA received 5,252 reports in 2022 – 2023, of which approximately 86% relate to these top four thematic areas.
NHS staff fraud reporting equates to 51% of all reporting received this collection period and a slight increase when compared with the previous year. Both figures are indicative of a return to pre-pandemic levels after a significant downturn in 2020 – 2021, with the increase attributed to greater oversight of activity following staff returning to workplaces and COVID-19 restrictions being removed. Aside from the anomaly 2020 – 2021, reporting has increased annually with a 12% increase between 2018 – 2023.
Patient exemption fraud reporting has reduced by 18% this period and is at its lowest over the past five years and approximately 40% lower than in 2018 – 2019 (1,486 reports vs 891). This could be explained by expansion of Real Time Exemption Checking (RTEC) and legacy impacts from the lockdown periods.
Reporting for procurement and commissioning of services fraud has almost halved in comparison to the previous period, due to reductions in COVID-19 related reports. Despite this, reporting is higher than all but one of the past five years and 88% higher than in 2018 – 2019 (652 reports vs 346).
Fraudulent access to secondary care from overseas visitors has seen a consistent decrease over the past five years and is now 40% lower than in 2018 – 2019 (498 reports vs 299). This is likely attributable to travel restrictions enforced during the pandemic.
It is assessed these trends are indicative of the transparency and visibility of suspicious activity within these areas and not necessarily the scale of possible fraudulent activity. The impact of NHSCFA prevention guidance and interventions should also be considered when analysing reporting trends.
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