Understand
- inform the NHS of fraud threats and risks
- support local fraud prevention activity
- engage new and existing partners
- share intelligence
- use data driven insight
Prevent
- develop the SIA and Enterprise level Fraud Risk Assessment (EFRA)
- embed and share good practice
- support counter fraud activity at a local level
- deterrence strategy
- counter fraud culture change
Respond
- collaborate to develop a Control Strategy
- lead on enforcement
- improve counter fraud skills
- develop an AI Strategy and deliver proactive fraud detection aligned to Response
- drive a robust counter fraud response
Assure
- Functional Standards compliance
- evidence impact
- drive improvements
- provide assurance and integrity
- fraud measurement
Further areas for delivery include:
- delivery of the health wide 2025 to 2026 financial target of £167.7m through a growth in fraud prevention, detection and enforcement activity
- transitioning and growing the learning and capabilities established through Project Athena into business as usual activity
- review and enhance the way intelligence is shared across the health sector to enable all parts of the NHS prevent, detect and recover financial loss to fraud
- improve the performance of the Local Counter Fraud Specialists (LCFS) through wider engagement, support and recording of information on systems
- engage at board level in health bodies to improve the response to fraud, supported by transparent fraud reporting via national data systems
- working with NHSE to engage new health stakeholders to get growth in and drive further counter fraud activity
- future proofing our organisation to be able to respond to new and emerging priorities from government, aligning the organisation’s work to support the health 10-year plan and governmental healthcare objectives
- further develop our fraud measurement methodologies to improve the evidence of impact