Significant progress has been made on the delivery of our Strategy and the 2024 to 2025 Business Plan, with most areas now delivered. Much of this will be detailed in our Annual Report and Accounts due later in 2025. However, some examples of the achievements for the 2024 to 2025 period are presented below.
The NHSCFA has supported the NHS and wider health group to deliver over £332m of fraud prevented, detected and recovered over the last two years, working collaboratively towards the realisation of the three-year strategic target of £500m. The NHSCFA has reported the delivery of £184.6m against the target of £138.3m in the first year of the NHSCFA strategic cycle and in year two is expecting to report the delivery of £147.7m against a target of £126m. This represents an early delivery of, and overachievement of, anticipated a profiled savings by 26% against the original objective. The NHSCFA is confident that the £167.7m will be delivered in 2025 to 2026, the final year of the current strategic cycle, meaning that the coordinated counter fraud response across the NHS and wider health group will realise in full the £500m of financial benefit to NHS funds. The NHSCFA will continue to maintain performance of and continue to significantly exceed the 3:1 ROI stretch target set by the PSFA.
Our Fraud Hub won a Tackling Economic Crime Award (TECA) for Outstanding Public Sector/Law Enforcement initiative. The award was a recognition of the exceptional impact of the Hub’s work on the counter fraud response on a local level and the growth in and its recorded outcomes.
Our LIFE values, standing for Leading, Influence and Empowerment, Fairness and Expertise, are being led and championed across the organisation by the Senior Management Team, via communications and drop-in sessions available to all NHSCFA staff. We benefit greatly from our engaged workforce. They are aligned to and driven by our purpose, in our latest staff survey 95% responded favourably to the question “I am motivated by our purpose, to protect the NHS from fraud, bribery and corruption.”
The Evolution Programme led a review of opportunities to improve outcomes from the local counter fraud response, strategic and operational stakeholder engagement, and a requirement to adopt a more target driven culture. There was also a need to review financial stability and internal resilience. Tranche one of the Evolution Programme led to a number of functional reviews across the organisation which identified improvement needs. The fundamental aim of these changes was to improve use of resources within NHSCFA, deliver qualitive outcomes and financial returns to combat fraud in the NHS.
The Procurement Local Proactive Exercise (LPE) was established to drive improvements in the due diligence and contract management capability and reduce procurement fraud vulnerability within the NHS. To date the total number of organisations participating in the LPE is 321 (as per the Counter Fraud Functional Standards Return (CFFSR) in 2023 to 2024), with a total of 546 quality improvement recommendations made. Project Athena was successfully established with the onboarding of staff and new technology, using advanced data analytics to detect patterns in data indicative of fraud. The project continues to collaborate with partners in the NHS England (NHSE) to counter fraud in secondary care, with positive results which will be declared post publication of this business plan.
The implementation of Real-Time Exemption Checking (RTEC) is a mechanism that allows a pharmacy to check in real time whether a patient must pay for prescribed medicines. The NHSCFA completed an extensive fraud measurement exercise during the year to determine the financial impact of the programme on preventing prescription fraud within the NHS in England. Working with our partners, NHS England and the NHS Business Services Authority, the exercise has demonstrated that fraudulent claims to prescription exemption has decreased by circa £58m as a result of its implementation of RTEC. There will be significant longer term counter fraud benefits of the RTEC system.
The NHSCFA plays a significant role in the coordination and delivery of health wide fraud targets. During 2023 to 2024 the overall health wide saving achieved was £184.6m, with the NHSCFA budget at £18.9m. The NHSCFA has been commended for and continues to significantly overachieve the PSFA’s ROI stretch target of 3:1.