Delivery plan 2025 to 2026

Within this plan, we propose to deliver £167.7m as part of the three-year strategy target of £500m. This will be a combination of initiatives and activities resulting from fraud prevention, fraud detection and fraud recovered. This target is health group wide, which includes fraud impact delivered by the DHSC, locally within health organisations and by Arms-Length Bodies (ALBs).

Our ambition is to

• with the support of our partners across the NHS, deliver a responsive SIA and EFRA to ensure the NHS is fully informed of the threat and effect of fraud against NHS funds, together with an identification of opportunities to respond to them from intelligence
• develop and enhance the way we evaluate and share strategic intelligence across the NHS landscape to ensure the NHS is able to take timely and appropriate action against fraud
• support health bodies to undertake local organisational level fraud risk assessments, to enable them to provide a localised response to the dynamic fraud risk landscape
• engage new and existing partners and stakeholders to broaden reach, strengthen insight and intelligence and set ambitious joint objectives to tackle fraud
• deliver a comprehensive intelligence gathering and dissemination function to support all parts of the NHS to evaluate, initiate and deliver an appropriate and effective operational response to fraud and prevent funds from being lost to fraud
• share fraud risk intelligence across the NHS to drive a more effective counter fraud response across health organisations to prevent fraud
• enhance our advanced data analytics and data science capability to assess threats, generate insight and detect patterns in data indicative of fraud. Driving tangible actions to prevent and deter fraud from occurring. This activity will include the measurement of fraud based on priorities derived from the Control Strategy
• continue to work with partners to access data for counter fraud purposes, providing the expertise in fraud detection, using data at the core and responding to new and emerging threats proactively
• maintain strong relationships with our international network to understand global health care fraud risks and share counter fraud insights

Our ambition is to

• lead the development of a health wide fraud prevention strategy, informed by data and deliver a prevention programme to reduce fraud losses across the NHS
• embed and share good prevention practice to reduce the occurrence and threat of fraud through
  • identifying emerging risks and threats
  • sharing guidance, good practice and lessons learnt
  • horizon scanning and identifying system weaknesses
  • supporting the adoption of new policy and legislation
  • influence fraud risk assessments for new policy/programme development
• support local area-based partnerships to detect, prevent and respond to fraud through the provision of guidance, data modelling and supporting them to use appropriate tools to respond to fraud where found
• develop a deterrence strategy and programme for the NHS to proactively promote a counter fraud culture that develops fraud awareness and understanding across all areas of spend. An effective culture is fostered through a cycle of education, measurement, monitoring and improvement. This will be achieved through:
  • engagement with a cross-section of stakeholders, including Directors of Finance and Audit Committee Chairs
  • implementation of management reporting through national NHS reporting systems, the digital information service designed to help NHS providers improve their productivity and efficiency
  • ongoing promotion and use of the Corporate Dashboard Suite
  • development of a NHSCFA Engagement Strategy and approach to drive key fraud prevention messages and behaviour change across the sector
  • drive the uptake of initial fraud impact and risk assessments
  • support organisations to drive counter fraud training and ownership at front line and operational roles
  • support the increased identification and reporting of fraud
  • drive the LCFS community to be part of the counter fraud profession

Our ambition is to

• use our understanding of fraud to develop a NHS wide Control Strategy to agree and coordinate counter fraud priorities, develop action plans, manage the strategic and tactical allocation of resources and close intelligence gaps
• with the support of our partners across the NHS, lead the development and management of an enforcement strategy for the sector
• improve capacity, capability and drive the professionalisation of the Counter Fraud community through the provision of support, advice and guidance to deliver robust enforcement outcomes via the NHSCFA Fraud Hub
• draw learning from our investigations and response activity to improve practice
• work in partnership with the PSFA to build capability and develop a culture of counter fraud to influence, measure, improve and maintain professional and operational standards, fostered through a cycle of education, measurement, monitoring and improvement
• develop an AI Strategy to support the counter fraud response and where appropriate improve our own drive for efficiency. We will use our advanced data science capability to detect fraud at scale in areas of strategic and operational interest underpinned by expertise and the highest ethical practices in data science
• provide an effective national counter fraud enforcement response to serious fraud, bribery and corruption affecting NHS expenditure through:
  • the NHSCFA National Investigation Service delivering a national enforcement function
  • the NHSCFA Digital Forensic Unit proving a responsive and accredited expert digital forensic capability to support criminal investigations in England, Wales and Scotland
  • review and update processes in relation to disclosure and digital forensics
  • deploying accredited financial investigators and financial intelligence officers to support the progress of criminal investigations and utilise powers under the Proceeds of Crime Act and wider civil powers to recover NHS funds

Our ambition is to

• measure, assure and report health bodies’ compliance with the Government Counter Fraud Functional Standard and the NHS’s Counter Fraud Requirements
• provide a robust evidence base, demonstrating the positive impact of the NHS counter fraud response and championing the work undertaken in the NHS counter fraud community
• lead the NHS counter fraud community to drive measurable improvements in the counter fraud response through collaborative partnerships and providing appropriate support and reporting
• work with and provide assurance to the DHSC and the PSFA through:
  • the development of the new 2026 to 2029 NHSCFA Strategy focussing on:
    • strengthening fraud prevention
    • making fraud personal
    • driving AI and big data
    • stronger focus on financial value
    • developing a continuous improvement mindset through testing, evaluation and learning
    • alignment to the 10-year plan including embedding counter fraud activity in NHS digital transformation
    • strengthening/improving our ability to influence key stakeholders.
    • improving our approach to developing and sharing strategic intelligence across the health sector and using it to drive action against agreed priorities
  • compliance with performance reporting requirements to the DHSC and PSFA
  • drive performance based reporting at an organisational level
  • share information relating to fraud affecting the NHS (threat levels, response activity and measurable outcomes) with the highest level of validation and statistical integrity
  • continue the ongoing development and validation of fraud measurement methodologies

Our ambition is to

• develop a sustainable approach to workforce and succession planning aligned to our People and Workforce Development Strategy
• develop visible, positive, confident and enthusiastic leaders who exemplify our LIFE values and ensure optimum employee experience for all our staff
• invest in and manage talent within the organisation
• build pipelines for:
  • a flexible and agile workforce
  • sourcing new and emerging expertise where required
  • pursue options that will promote the NHSCFA as an employer that attracts and retains talent
  • creating a truly inclusive environment appropriate for a modern workplace
• build on a strong, safe, legal and best practice foundation to enable us to deliver a comprehensive, diverse and inclusive portfolio of people and workforce services
• be a flexible and collaborative ‘One Team’ of professionals who are driven by our vision, purpose and values and behaviours in order to deliver
• understand and adopt, where appropriate, the use of technology and automation across the NHSCFA
• develop further insight and utilisation of our workforce data to inform evidence based people and workforce activity

Our ambition is to

• review the Government Functional Standards and implement these in a proportionate manner where relevant
• enable and support good commissioning practice through the review of the target operating model for the provision of commissioning and procurement support
• deliver the NHSCFA integrated business planning process
• review our priorities to support our planning and strategic delivery
• develop the new 2026 to 2029 NHSCFA Business Strategy
• enhance our ROI in partnership with the DHSC
• develop our Digital Strategy and continue to review our current and future technology requirements in line with business needs
• review and strengthen our governance and financial management processes
• deliver a robust performance, programme and project management offer across the NHSCFA and strengthen benefits management and delivery
• facilitate the continued transformation of the NHSCFA through the development of the NHSCFA 10-year transformation plan, in line with the 10-year health plan
• deliver strategic and operational corporate communications
• develop the organisation’s future estates strategy for the NHSCFA and optimise the physical and virtual environment where our people work