NHSCFA CEO Alex Rothwell talks about the motivation behind the 2024 to 2025 Business Plan.

image of Alex Rothwell Chief Executive of the NHS Counter Fraud Authority

The Business Plan for 2024 to 2025 runs in parallel to the second year of our 2023 to 2026 Strategy. Following delivery of our first-year business plan, the strategic pillars of Understand, Prevent, Respond and Assure are now embedded in our working processes and operational methodology. Fraud, bribery and corruption continue to divert funds from NHS finances and therefore our purpose to protect the NHS in England remains as relevant as ever.

Countering fraud, bribery and corruption threats is a complex business and requires our people to have a wide range of skills. Our counter fraud specialists and supporting functions operate in an environment which constantly evolves, often with conflicting priorities and significant uncertainty. They must operate with precision in their area of expertise but also in a way that complements co-existing disciplines, for example, our criminal investigators play a significant role in developing prevention advice. This is why we have adopted an integrated approach to business planning. This year, development will continue by being more proactive and stepping up our use of technology. A strong human resources function will enable us to value our people and support our ambitions in this area.

To support our technology ambitions, the plan describes how we will make a significant investment in data analytical capability. Through the development of learning models focused on known areas of risk, we believe there is a substantial opportunity to improve the identification of fraud, error and abuse. This insight will enable controls to be strengthened, influence policy change, and improve operational outcomes. As machine learning and artificial intelligence develop in society and in government, this pilot programme will stand us in good stead to maximise the benefits of technology and people skills in this field. The programme will be known as Project Athena.

We will also continue to develop our relationships with stakeholders and value the support that Local Counter Fraud Specialists (LCFSs) provide to the health sector. The Fraud Hub has demonstrably improved our interaction with health bodies, LCFSs and the organisations that employ them. We will now seek to use our new operating model and the data we possess to drive improvements in performance and meet assurance standards. Our communications specialists will support this work and promote our activity.

Over the past year, we have successfully prosecuted people for criminal offences and secured substantial sentences. To enhance learning from investigations, we have produced learning reports which are shared with key stakeholders. This approach will continue and grow during the lifetime of this plan and forms part of our wider approach to prevention. Designing effective fraud prevention strategies and measuring their success takes time. This will need to be balanced against the need to maintain capacity to respond to emerging threats which have unknown fraud prevention values when first identified.

The past year has also provided an opportunity to connect and benchmark our work with overseas jurisdictions and we continue to share our collective expertise with the devolved nations. This approach will continue and is of particular importance in understanding technology-use cases.

I look forward to working with our colleagues, stakeholders and partners during the lifetime of this plan. However, I would like to recognise the work of our outgoing Chair Tom Taylor, who has been with us for six years, and Non-Executive Directors Martin Spencer and Jayne Scott, who left at the end of 2023. Their expertise, knowledge and leadership enabled us to deliver genuine change and meaningful impact.

Alex Rothwell

Chief Executive

NHS Counter Fraud Authority

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