This year’s Business Plan aligns with the last year of our 2023 to 2026 Strategy. Our strategic pillars of Understand, Prevent, Respond and Assure have been fully embedded in our work for over two years and we are looking forward to completing the last year of our strategic cycle. During this time the counter-fraud profession has evolved rapidly and it will continue to do so. By way of example, artificial intelligence (AI) and technology advances are now embedded in many aspects of our lives and the counter-fraud community is having to actively consider these as both a threat and an opportunity. Another major change is of course the formation of a new government, which has meant we have new relationships to build. With health being one of the government’s core missions, including growth and efficiency, and a 10-year plan in development, this provides us with an opportunity to align our work to published objectives. Whilst tackling fraud is our main objective, we do so in order to contribute to better healthcare outcomes for UK citizens and that will be at the forefront of our mind when delivering this plan.
We have enjoyed strong support from our Sponsor Team at the Department of Health and Social Care (DHSC) and we look forward to working with the team whilst delivering this plan. We will also contribute to the wider Arm’s Length Body (ALB) network in health by sharing information, knowledge and expertise wherever possible.
Our work is also supported by the Public Sector Fraud Authority (PSFA) which has continued to grow capacity and capability across the entire government network. As a relatively mature fraud function in government, we are proud that in a recent PSFA audit we were rated good or above in all areas of the functional standard for fraud - the only organisation to have achieved this rating so far. Both the Treasury and PSFA have asked counter-fraud leads to be ambitious in developing our future plans and to focus on how we can deliver a return on investment (ROI). Generating ROI in areas like secondary care will feature heavily in the delivery of this plan as we utilise our network of specialist staff to seek financial value from both enforcement and local proactive activity. This will be carried out alongside our partner ALBs to target priority areas and make the greatest impact on fraud within the NHS.
Wider stakeholder engagement will also be a strong feature of this year’s plan.
We recognise that significant events such as those that led to the Post Office IT Horizon Inquiry will raise questions about enforcement activity in large organisations. I want the NHS Counter Fraud Authority (NHSCFA) to develop its status as a trusted partner to other healthcare organisations and continue to develop close ties with other counter fraud agencies, government bodies and private sector organisations, including those based internationally. I believe that close collaboration, openness and promoting a culture of integrity is essential in the fight against fraud. The positive opportunities to share experience, effective practice and data are too great to overlook.
On the subject of data, Project Athena is continuing to progress and our growing capability is now being deployed. We will detect patterns in data indicative of fraud on a large-scale using advanced data science techniques enabling us to respond to the threats that are observed. This will be achieved by maximising the impact of our technical counter fraud capabilities in data management, data science, data engineering and proactive counter fraud response combined. Project Athena will help set a new proactive detection and response to combatting fraud in the NHS.
Finally, I would like to recognise the work of our former Chair, Tom Taylor, who remained in his role throughout last year, culminating in six years of incredible service. His understanding of the CFA was critical to our success and our Interim Chair, Gaon Hart, will take the organisation forward until a permanent Chair is recruited into post later in the year.
Alex Rothwell