As the health system modernises under the 10-Year Health Plan, we have a clear opportunity to ensure our counter fraud capability and capacity evolves in step with wider system reform.
This Business Plan for 2026-27 sets out the Year 1 priorities for delivering the 2026-29 Health Service Counter Fraud Strategy, building on the foundations established through the last strategy, delivering a modern counter fraud approach to match the health sector’s ambitions.
Fraud is not a peripheral issue. It directly affects frontline patient care, financial sustainability and undermines public trust. Evidence shows that fraud prevention is most effective when embedded into system design from the outset, rather than applied retrospectively. During 2026–27, working closely with national programmes, policy leads, commissioners and Integrated Care Boards (ICBs), we will embed counter fraud by design principles into major reforms, new services and critical programmes of change. Through early engagement, targeted advice and counter fraud health checks, our goal is to strengthen the system to identify and address fraud risk before losses occur.
Intelligence, data and technology will be central to our approach, expanding our access to and use of national and local datasets we will move from reactive identification to proactive, risk-based intelligence, targeting the highest fraud risk vulnerabilities and maximising return on investment across the system. We will continue to drive appropriate enforcement actions where fraud is detected, driving deterrence messages across the sector.
Collaboration underpins delivery of this plan. Tackling fraud cannot be achieved in isolation and success depends on shared ownership across the health system. In Year 1 we will strengthen partnerships at national, regional and local levels, broaden engagement with system leaders, service designers, technology partners and academia, increase the visibility of fraud risk and embed fraud prevention as a collective responsibility within strategic commissioning and assurance discussions.
To support this shift we will strengthen counter fraud governance, reporting and oversight. By developing clearer expectations, piloting improved performance metrics and promoting more consistent assurance we will develop leaders to gain better insights and earlier visibility of emerging vulnerabilities, empowering them to intervene and take appropriate action. These improvements will also underpin the delivery and validation of agreed Year 1 counter fraud savings.
In parallel, working with the Department of Health and Social Care (DHSC), we will design a new operating model to ensure that counter fraud capability remains sustainable and aligned to the future NHS landscape. This includes clarifying roles, responsibilities and accountabilities; strengthening professional capability; developing digital, workforce and financial enablers and exploring future delivery and funding options. By the end of 2026–27, we will have a clear blueprint for how counter fraud activity should operate across the system to meet the challenges ahead.
The priorities set out in this Business Plan are ambitious but essential. The 2026-27 business plan builds on the work of previous years and embarks on new areas of activity. By strengthening prevention, intelligence, governance and collaboration we will reduce fraud losses and protect public funds. In doing so, we will support sound financial stewardship, uphold public trust and help ensure that NHS resources are used for their intended purpose - delivering safe, effective and sustainable care.
Alex Rothwell
Chief Executive Officer
NHS Counter Fraud Authority