This plan details the proposed high-level programme of work the NHSCFA will deliver during the final year of our three-year strategy. The Strategic Intelligence Assessment (SIA) details the key fraud threats and vulnerabilities, of which, priority areas will be reflected in our Control Strategy which we will address in 2025 to 2026. This integrated business plan captures the outcomes from our integrated planning cycle we use to inform our work to achieve the maximum impact over the life of our Business Plan and 2023 to 2026 Strategy.
Delivery of the plan is subject to changing priorities based on intelligence received, new and emerging threats, available funding and existing resources.
The challenge
| Fraud threats and vulnerabilities | value | Key |
|---|---|---|
| Procurement and commissioning | £388.3m | |
| Patient exemption | £240.2m | |
| Data manipulation | £165.1m | |
| Community pharmaceutical contractor | £130.2m | |
| GP contractor | £110.1m | |
| Optical contractor fraud | £94m | |
| Overseas visitors | £86.5m | |
| Dental contractor fraud | £58.6m | |
| NHS staff fraud | £31.9m | |
| Reciprocal healthcare | £400K |
- This figure is an estimate of the vulnerability to fraud, not the actual loss incurred by the health sector