Pharmaceutical contractor fraud - Fraud relating to the falsification or exaggeration of services, as well as collusion.
Data manipulation fraud - Fraud through falsifying data to meet targets, increase revenue or hiding undesirable outcomes, including within A&E. It encompasses the ‘2023 - 2025 NHS Payment Scheme’ (NHSPSg ) and the four different payment mechanisms it governs within secondary care.
Dental contractor fraud - Fraudulent claims submitted to the NHS by dentists and their staff members for a range of NHS services provided to patients. NHS dental services in England are provided by dental practitioners under contract to deliver general care and treatment.
Fraudulent access to NHS care from overseas-visitors - 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 when an NHS staff member abuses their position to facilitate fraudulent access.
General Practice (GP) contractor fraud - Fraud relating to the manipulation of income streams or activities that violate contractual terms perpetrated by either GPs or practice staff.
Reciprocal healthcare fraud - Fraudulent use of European Health Insurance Cards (EHICs), Global Health Insurance Cards (GHICs), Provisional Replacement Certificates (PRCs) and various other reciprocal healthcare arrangements. It also includes false representation during the application stage which can enable the card / certificate holder to benefit from a reciprocal healthcare agreement.
NHS staff fraud - Fraud relating to NHS staff who manipulate their income and hours, insider abuses, and false representation during application processes.
NHS bursary fraud- Fraud relating to monthly payments including the basic award, childcare allowance and non-means-tested grant. As well as one-off payments including the hardship grant, tuition fees and travel and dual accommodation expenses.
NHS pension fraud- Fraud relating to an individual who has falsified their circumstances to access an NHS pension or failed to notify of a significant change in circumstances resulting in an overpayment.
Optical contractor fraud - Fraud relating to submitting inappropriate claims to the NHS for optical treatments, services, or enhancements not delivered or clinically required.
Procurement and commissioning fraud - Fraud relating to pre-tender activity, the commissioning process, post-tender activity and mandate fraud.
Patient exemption fraud - Fraud within the main NHS services that require payment upfront in return for access, including within prescriptions, dentistry and ophthalmology. It also encompasses the onward sale or supply of prescribed medication.
- Rules, prices and guidance for the payment of services from providers of NHS funded healthcare