The NHS Counter Fraud Authority (NHSCFA) are directed by the Secretary of State to prepare an annual “Strategic Intelligence Assessment (SIA) analysing fraud trends in the health service”. Our SIA provides an estimate of fraud losses and vulnerability across the NHS over the last year. It encompasses intelligence collated in 2022 – 2023 and financial vulnerability estimates based on activity and budget data from 2021 – 2022, giving us an understanding of potential threats and vulnerabilities whilst measuring potential losses to fraud in the NHS.
The SIA also gives an overview of the current and long-term issues affecting or likely to affect fraud. It should be used to draw inferences and make recommendations for prevention, intelligence, enforcement, and future fraud strategy.
This year we have seen another year of growth in estimated financial vulnerability to £1.264 billion, up £66 million from last year. There are several reasons for this:
- procurement and commissioning of services spend has increased, partly due to the impact of COVID-19 and through dental and optical treatment returning following the pandemic.
- optical contractor is likely to have risen because of businesses returning to normal following the pandemic.
- financial vulnerability within healthcare linked to travel, such as fraudulent access to the NHS, is estimated to have increased.
Although these are the primary reasons for the increase in financial vulnerability, there will be many more parts of the NHS that are being defrauded every day.
Despite this increase in financial vulnerability, the percentage of vulnerability against NHS expenditure continues to remain below 1% (this year at 0.8%) and is the second lowest percentage since the SIA was launched in 2017. I reflect on what £1.264 billion could deliver for the NHS. More doctors, nurses and ambulances could all be funded through this money, saving lives, and making a real difference to people’s health. We will never lose sight of this in our aim to find, detect and prevent fraud.
I believe it is a good thing to find fraud as it shows that we are doing something right. There is always going to be fraud and there isn’t one solution to it however, our SIA provides us with key areas we need to target as well as trends/patterns to help us identify fraud.
Putting together the SIA is a huge undertaking both internally at the NHSCFA and externally through our partners across the health system. Thank you to everyone who has contributed, and I hope you are able to make good use of the insight it offers.
Alex Rothwell
Chief Executive of the NHS Counter Fraud Authority
