Fraudulent access to secondary care

Fraud relating to inappropriate access to NHS secondary care by foreign nationals who avoid payment for services delivered.

Published: 13 September 2023


vulnerable from an expenditure of £2 billion

The term ‘fraudulent access to the NHS’ refers to 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.

The increase in financial vulnerability this reporting period can be attributed to an increase in the number of visitors to the UK. This is likely the result of easing in travel restrictions implemented during the COVID-19 pandemic, and which likely deterred many wishing to travel for NHS healthcare without charge.

It is highly likely that patients will return to or enter the UK, with the specific intent of accessing secondary care without charge, yet permanently reside abroad. By claiming to have returned to the UK on a settled basis, or failing to notify a GP of moving abroad, a visiting patient could access care without charge from the day of their arrival. There is also the possibility that revenue streams, such as online fundraising pages, could be created to pay for travel to the UK.

The high cost of healthcare in other countries and the cost-of-living crisis may encourage some to enter the UK with the specific intent of seeking NHS maternity care or fertility treatment without charge. For example, maternity care cannot be delayed for an advance payment as it is considered urgent and immediately necessary. It is therefore highly likely that some patients will enter the UK on a visitor visa and/or use a false address.

It is also highly likely that some patients will abuse the system by continuing to receive NHS repeat prescriptions whilst permanently residing abroad. Repeat prescriptions may be collected and sent abroad by associates.

Information reports received for fraudulent access

During this reporting period, the NHSCFA received a total of 299 reports compared to last year’s total of 314. Aside from 2020 – 2021, reporting is also at its lowest in the past five years and 40% lower than in 2018 – 2019. It is assessed this is due to the various COVID-19 travel restrictions in place over the previous couple of years of reporting. As such, there is a possibility that as travel resumes to pre-pandemic levels, there may be an increase in reporting.

The change in the number of fraud reports received in relation to fraudulent access from 2018 – 2019 to 2022 – 2023 is illustrated in the below chart:

Table showing the number of fraud reports received in relation to fraudulent access to secondary care from overseas-visitors from 2018 – 2019 to 2022 – 2023
2018 to 2019 2019 to 2020 2020 to 2021 2021 to 2022 2022 to 2023
2018 to 2019 498 2019 to 2020 446 2020 to 2021 290 2021 to 2022 314 2022 to 2023 299

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