Following a review of our operating model in 2022-23, the NHSCFA has reshaped to support, enable, and maximise our counter fraud impact. By doing this work we have also created opportunities to implement some key services for the community and drive collaboration and partnership working that will also support efficiency.
NHSCFA Fraud Hub
The Fraud Hub will be a primary focal point for all health bodies to work in partnership with us to tackle fraud in the NHS. It will provide real-time support and access to our counter fraud expertise and guidance to raise the effectiveness of the overall counter fraud response of the local counter fraud community.
The Fraud Hub will provide a collaborative approach to both proactive and reactive counter fraud activity and will aim to deliver improved financial outcomes and sanctions, assist health bodies to take action to prevent losses to fraud, and enable the recovery of NHS funds taken through fraud.
Our relationship with stakeholders will be advisory, constructive, and supportive but challenging where necessary. The Fraud Hub will provide a quantifiable service. The impact and benefit of practical engagement will be measured as will the anticipated improvement in levels of performance by local health bodies in their functional standards returns and prevention, detection, and enforcement outcomes.
Collaboration and partnerships
Collaboration will be at the heart of our business. Fraud prevention can and should be included in strategic planning and the development of new process and policy. Using our status as an independent arm’s length body we intend to build strong partnerships at a strategic level to influence system-wide change. To support this work we will develop bilateral partnerships with key stakeholders and create working relationships with international partners to benchmark performance and capture best practice.
The Health Counter Fraud Board brings together all national partners responsible for counter fraud service delivery. We will maximize the benefit of our membership of this group through the identification of priority areas for collaborative effort. An example of how this will work in practice is the creation of a Strategic Tasking and Coordination Group to deliver focused counter fraud activity based on agreed priorities and clear action plans.
Intelligence and horizon scanning
The more we know about fraud in the NHS the more effective our response will be. An enterprise fraud risk assessment will inform our response and understanding and we will use our Strategic Intelligence Assessment (SIA) to drive activity. Systematic horizon scanning will improve our strategic awareness and when required we will respond quickly to emerging threats.
Data
We will innovate by exploring novel insight within data to generate intervention opportunities at a tactical level and to inform strategic change. This will include a range of advanced Data Science techniques, visualisation, and targeted data models. We will actively collaborate with partners in a wide range of analytical areas of counter fraud. We acknowledge that data, data expertise and tools are not only operational assets but key strategic drivers that will be used to tackle fraud in an ever-increasing digital world. Greater use of data will play a key role in our ability to identify system weaknesses and support organizational-wide fraud-proofing through process and policy.
Responses to fraud
Whilst enforcement will continue to be a significant tool and an important deterrent in countering fraud there will be an enhanced focus on prevention. A communications strategy will drive targeted campaigns to influence behavioral change and encourage reporting. Lessons learnt from investigative activity will be identified quickly with best practice shared and more investigative activity will be driven through data insight which will in turn lead to policy changes designed to reduce fraud.
Our people and resources
As part of a strengthened approach to strategic workforce planning our new operating model will enable the response to fraud under the four pillars of activity. Internalisation of our HR function will provide quicker recruitment and stronger support to the workforce, improving areas such as talent management and wellbeing.
There will be an increased focus on performance and accountability with clear data available and visible to the organisation with Executive level oversight and a new transformation function will ensure the organisation can respond to a rapidly changing landscape.