Safeguarding our National Health Service's financial resources is of critical importance. This year's Strategic Intelligence Assessment reveals that while £1.346 billion of NHS funding remains vulnerable to fraud, bribery, and corruption, this represents a smaller percentage of our overall budget compared to previous years – a testament to our strengthening counter fraud approach across the health sector. However, £1.346 billion could supply the NHS with so much – including doctors, nurses, ambulances and, equipment to enable the NHS to move from analogue to digital, hospital to community and sickness to prevention – helping save lives and making a difference to people’s health.
The healthcare landscape continues to evolve rapidly. There will be structural changes as NHS England (NHSE) is merged with the Department of Health and Social Care (DHSC), the 10 Year Health Plan is introduced and Integrated Care Systems consolidate. Against this backdrop of transformation, our mission to protect NHS resources is vital. This assessment, which is unique to us, ensures that stakeholders are appropriately informed and equipped to act to find and prevent fraud in an increasingly complex environment.
In addition to providing an estimate on the amount of the NHS funding vulnerable to fraud, bribery and corruption. The SIA also provides an assessment of threats, vulnerabilities and enablers for prevention and enforcement activity. The intelligence gathered in this assessment will drive our strategic and tactical response in the coming year, informing targeted interventions and collaborative efforts across the system. Our intelligence-led approach, guided by the National Intelligence Model, ensures we remain agile in addressing both current and emerging threats.
I am particularly encouraged by the continued success of Real-Time Exemption Checking (RTEC). These technological solutions, alongside enhanced reporting mechanisms and cross-sector collaboration, demonstrate our commitment to innovation in counter fraud.
Over the last year we, in partnership with our stakeholders, targeted procurement and commissioning fraud, which we estimate to have the highest amount of fraud vulnerability of the thematic areas described in the report. This work is complete with over 390 Local Proactive Exercises (LPEs) undertaken in England and has resulted in a significant number of changes in NHS policy and processes to close system weaknesses. Over the next year we will focus on staff fraud and have established a working group to develop our response.
Project Athena, which was launched at the beginning of 2024, is now embedded. We have established a team of data scientists, analysts and engineers to deploy artificial intelligence and machine learning, enabling us to analyse large amounts of data to detect fraudulent activity. We have also gained access to several key data sources, such as Companies House information and Civil Registrations of Death, which provide insights that support efficient and effective investigations. We will continue to build on this progress over the coming year, which will in turn inform our SIA, ensure a strong counter fraud response and support delivery of the 10 Year Health Plan to create an NHS fit for the future.
The SIA requires extensive collaboration, analysis, and effort from partners across the health system and colleagues within the NHSCFA. I extend my sincere thanks to everyone involved in its production, and I look forward to using this document as we work together to counter fraud over the coming year.
Alex Rothwell
Chief Executive Officer