Year one reflections and opportunities

A look back on what the NHSCFA achieved over the past year.

In year one, we introduced our four new fraud-focused pillars and the two foundations of our Resources and our People. We have initiated a series of corporate, transformation and control strategy projects including a data analytics programme called Project Athena that meets our strategic objective of increasing our focus on data and data analytics. We also introduced a new operating model. As a result, we are able to move forward in our second year to meet our ambition of challenging and facilitating efficiencies and improvements in operational service delivery to create a sustainable future for the organisation.

NHSCFA Fraud Hub

Our stakeholder engagement is being driven by our evolved Fraud Hub and we continue to work to grow our key strategic partnerships and collaborations. The work of our colleagues across health bodies is a vital part of preventing fraud in the NHS; one they have executed with diligence and expertise.

As part of our new operating model, we successfully established the Fraud Hub as the primary focal point for our colleagues in health bodies to work with us to tackle fraud. The Fraud Hub acts as the main point of contact between the NHSCFA and the wider NHS counter fraud community, bringing together the national and local counter fraud response; a valuable partnership with our counter fraud community. This collective working approach strengthens information sharing, amplifies our collective message and achieves better results across all parts of the NHS to reduce and prevent fraud.

The Fraud Hub’s successes in the first year of the three-year strategy include a substantial increase in sanctions recorded by the counter fraud community and numerous engagement and information sharing programmes. To help build a culture of continuous improvement and knowledge sharing, new learning reports identify and share outcomes using investigations from real cases across the sector.

Partnership working and international learning

Our engagement continues to strengthen the NHSCFA’s position as the national body for tackling fraud, bribery and corruption in the NHS.

In 2023 to 2024, we continued to work with our Four Nations partners in England, Scotland, Wales and Northern Ireland; meeting in Belfast and Cardiff for the final summit for counter fraud professionals in which we agreed our strategic intentions and shared our knowledge, experience and methodology. We have also shared key elements of counter fraud including the use of pillars, our approaches to prevention, data analytics, intelligence, and investigative best practices across the sector. The NHSCFA has also been represented internationally and our partners in Europe and the United States of America are part of a commitment to learn and evolve our thinking, practice and approach to fraud.

The theme of engagement across the sector continued with an emphasis on procurement in the NHS, where we took forward new local proactive exercises. These aim to drive improvements in due diligence and contract management capability in the health sector in England, improve our intelligence and the sectors’ investigative response to procurement threats, and identify savings in fraud prevention across the sector.

Introducing our values and behaviours

We introduced our values and behaviours framework called ‘Leading, Influence and empowerment, Fairness and Expertise’ (LIFE), which underpins all our activity in the NHSCFA. It is led and championed by our Senior Management Team and embodies our principles and behaviour to which we aspire. Our People and Workforce Development Team has driven new behaviours in appraisals, coaching and leadership development programmes and policies.

Data and influence

Our emphasis on exploring novel insights from data continued internally and externally.

Internally, we introduced our Corporate Dashboard Suite; a central collection of organisational data which is presented on an accessible platform. This was the first step in an approach which focuses on how data leads to valuable information that will, in turn, improve performance monitoring. This will then provide better outcomes, more informed decision making, earlier sight of developing issues and identification of opportunities.

We have introduced and developed sector-specific dashboards with our stakeholders. These show relevant information for counter fraud professionals and distinct reporting for directors of finance in health bodies.

External reporting to our colleagues across the counter fraud community is also within a framework of support, performance and insight underpinned by the work enabled by the Fraud Hub.

Advanced data analytics (Project Athena)

With the introduction of the 2023 to 2026 Strategy, we highlighted the need to use data to tackle fraud at scale and share data and information with the sector in new ways.

The NHSCFA will lead the proactive approach to fraud identification by incorporating an aligned response, using pilot funding to use machine learning and analyse data to identify fraud. We will maintain our professional and ethical principles whilst using advanced analytical techniques and approaches to inform our response. Detecting patterns in data will capture intelligence and offer opportunities for fraud prevention and enforcement. Greater use of data will also identify system weaknesses and support organisational wide fraud-proofing through processes and policies.

Collaboration and partnerships

As an arms-length body we will continue to build strong partnerships at a strategic level to influence system-wide change. To support this work, we will continue to develop bilateral partnerships with key stakeholders and create working relationships with international partners to benchmark performance and capture best practice. We are continuing to build on the links we have developed as we move into our second year of the strategy.

We will continue to maximise the benefits of our membership of the Health Counter Fraud Board, which brings together all national partners who are responsible for counter fraud service delivery by identifying the priority areas for collaborative effort.

The Control Strategy and Strategic Tasking and Coordination Group (CSSTCG) is an opportunity for us to collaborate with key partners include the NHS Business Services Authority (NHSBSA), NHS England (NHSE), the Department of Health & Social Care (DHSC) and UK Health Service Agency (UKHSA) to deliver focused and coordinated counter fraud activity based on agreed priorities and clear action plans.

Intelligence and horizon scanning

In the past year, we have seen a significant interest in the discipline of fraud risk assessment and how that influences behaviour, appetite for fraud and corrective action to mitigate risk.

The more we know about fraud in the NHS, the more effective our response will be. Fraud risk, alongside our Strategic Intelligence Assessment (SIA), will inform our understanding to help formulate the right response to fraud and drive activity. With the introduction of horizon scanning in our strategic planning cycle earlier in the year, we continue to improve our strategic awareness of new and emerging areas that may present a threat. This is a process well founded and embedded within our robust integrated planning approach.

Responses to fraud

Whilst enforcement continues to be a significant tool and an important deterrent in countering fraud, we must remain alive to new and emerging ways of detecting fraud.

We will also explore appropriate, and timely, methods of dealing with fraud when it is found.

Targeted campaigns to influence behavioural change and encourage reporting will also continue to be a key driver and will be supported by a targeted fraud-focused communications strategy which supports our stakeholders. Lessons learnt from investigative activity will be identified quickly with best practices shared. More prevention and investigative activity will be driven through data insight which will allow for system weakness to be closed.

Our people and resources

As part of a strengthened approach to strategic workforce planning, our new operating model will help to shape 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.

As we continue developing and embedding our performance culture, we believe that effective performance monitoring leads to better outcomes and more informed decision making. Therefore, in year two, there will be an increased focus on performance and accountability with clear data available and visible to the organisation at all levels. A new transformation function will also ensure the organisation can respond to a rapidly changing landscape.

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