The Strategic Intelligence assessment (SIA) is produced to identify fraud threats and estimate the amount of NHS funding in England vulnerable to fraud, bribery and corruption annually on behalf of the Department of Health and Social Care (DHSC). This informs the NHSCFA and its stakeholders of the priorities for the year ahead by capturing established, emerging, and potential future threats.
The amount of NHS funding vulnerable to loss through fraud, bribery, and corruption in England is estimated to be £1.301bn, which is a decrease of around £45.06m when compared with the previous year. Additionally, this equates to 0.66% of the NHS budget for 2025 - 2026 of £198.095bnd , which is also a decrease when compared to the previous year despite an increase in the NHS budget. By comparison, between 3-10% of healthcare spending in the United States of America is estimated to be lost to fraud.
Between April 2025 and March 2026, the NHSCFA received 8,048 reports, an increase of almost 19% compared with the previous year. Of these, 7,645 related to the twelve thematic areas. Each report was analysed as part of the intelligence cycle to identify emerging and prevalent trends for decision making.
As an intelligence led organisation, the NHSCFA has continued to monitor and document the ongoing fraud threat facing the NHS in England since 2016 - 2017. Although the SIA has remained a reliable and consistent source for the fraud community to draw upon, the format in which it is brought to the reader has evolved.
Within the previous SIA, the NHSCFA explained the place of the assessment within the intelligence cycle and the use of the National Intelligence Model (NIM)e for strategic direction, laying the groundwork for what was to come during 2025 - 2026.
To complete this process, the SIA has been transformed for 2026, focusing instead on prioritising the impact on patient safety, and the potential financial consequences of emerging and prevalent trends. Recent prosecutions within the thematic areas are presented as case studies and are followed by a PESTLEf analysis and an assessment of reporting trends. The number of trends represented visually has been increased and a single horizon scanning section is included at the end of the assessment.
Furthermore, we remain responsible for estimating the amount of NHS funding vulnerable to fraud, bribery and corruption. We continue to strengthen these figures by collaborating with stakeholders, including DHSC, NHSBSA and our data science colleagues to harness the benefits of artificial intelligence (AI).
The SIA has, and will continue to, ensure a coordinated response to fraud, with the merger of NHS England and DHSC presenting an opportunity to raise the visibility of fraud, bribery and corruption at executive level.
- Total NHS revenue department expenditure limit (RDEL) as per financial directions
- The NIM is a process dependent on analysis and intelligence to allocate resourcing based on demand
- Political, Economic, Social, Technological, Legal, and Environmental. As well as looking at organisational and media factors.