NHS staff fraud

Falsified qualifications, references, experience and impersonation of medical professionals in the NHS is almost certain. This behaviour poses a direct threat to patient safety by enabling potentially unqualified individuals to enter roles.

An emerging threat in staff fraud is undeclared conflicts of interest. It is likely that staff are manipulating procurement processes, directing contracts to favoured companies or personal associates, bypassing tendering requirements, and shaping specifications to limit fair competition. This behaviour can also include improper pay decisions, unjustified pay‑band increases, and the recruitment of associates without transparency. These actions could compromise service quality, potentially impacting on patient safety.

Another emerging threat with potential implications for patient safety involves suspicious spam calls to patients. It is a realistic possibility that callers will impersonate NHS clinical professionals and ask for personal health information. These calls could undermine patient trust and create opportunities for identity fraud, including exploitation of an NHS patient record.

Areas where staff application fraud is reported to occur

A further emerging issue concerns nepotism within recruitment, it is highly likely that staff are recruiting associates into NHS roles without proper due diligence, relevant qualifications, or transparent processes, including inappropriate pay band uplifts. This can lead to unqualified individuals entering clinical or operational roles, potentially impacting on patient safety.

A persistent and highly likely threat involves the theft, misuse, and unethical prescribing of controlled drugs by NHS clinical staff. Staff are potentially misappropriating controlled medication for onward sale, which raises some safety concerns. Including with the sale of weight loss prescriptions such as Mounjaro. There is also the likelihood of clinical staff prescribing controlled drugs to friends, family, or colleagues.

It is almost certain that NHS staff are working while on sickness leave, including dual or multi-employment during periods of paid absence. This behaviour represents a noteworthy potential financial loss through fraudulent sickness pay claims and double earnings. It also creates operational strain and potential patient safety concerns when staffing levels are misrepresented.

Another almost certain threat involves working elsewhere during NHS contracted hours. Staff are potentially undertaking private work or for their own business, working for/at another NHS organisation or department, freelancing, treating private patients, or participating in Waiting List Initiatives during their NHS hours, with some failing to declare secondary employment. This behaviour results in direct financial loss through payment for hours not worked and creates patient safety concerns due to staff absence from duties.

Reporting trends around staff working elsewhere during NHS contracted hours

Inflation of income and hours, including false claims for shifts, overtime, and enhanced rates, as well as manipulation of e-rostering systems is almost certain and can carry a financial loss. Staff fraud can impact on honest staff who must cover shifts for colleagues committing timesheet fraud.

PESTLE analysis

Political: Change will be driven by the government's 10 Year Health Plan and a new 10 Year Workforce Plan. The government also aims to eliminate agency staffing by 2029.

Economic: From April 2026, all staff employed under Agenda for Change (AfC) terms will receive a 3.3% pay uplift to support recruitment and long-term workforce sustainability.

Social: NHS care is shifting toward community-based delivery through Neighbourhood Health Centres. Frontline staff will see the introduction of mandatory wellbeing standards and AI tools.

Technological: The government's 10 Year Health Plan and a new 10 Year Workforce Plan strategy shifts focus from increasing pure headcount to achieving a more productive, community-based, and digital-first workforce, with clinicians expected to use AI tools to reduce administrative workload.

Environmental: The workforce strategy moves toward a domestic-first pipeline, doubling medical school places and significantly expanding clinical apprenticeships to reduce reliance on international recruitment.

Legal: The government has confirmed the closure of the Care Worker Visa route as part of the May 2025 immigration white paper. The reforms also introduce new restrictions on skilled worker eligibility and access to work visas.

Organisational: The merger of NHSE and DHSC, as well as the merger and boundary changes for some Integrated Care Boards represents significant change for the NHS. From mid-March 2026 those who have opted for voluntary redundancy will begin leaving their roles.

Media Factors: Media coverage of fraud and false qualification cases involving healthcare workers may influence public opinion of NHS staff.

Reporting

During this reporting period, the NHSCFA received 3,753 reports compared to last year’s total of 3,391, potentially as a result of the increase in staff employed by the NHS since March 2025.