Effective counter fraud activity depends on collaboration across the health system and beyond. There is a need to strengthen shared understanding of fraud risk and position fraud resilience, prevention and detection as a collective responsibility. This approach supports patient care, financial sustainability and system performance – a priority that becomes even more important as the NHS undergoes change. In 2026–27, our focus will be on strengthening strategic relationships, increasing the visibility of fraud risk and enabling a more consistent and coordinated approach to tackling fraud across national, regional and local partners.
To deliver this, we will:
- continue to investigate and respond to fraud, pursuing sanctions where fraud is evidenced
- align to the needs of the NHS, developing a strategic stakeholder map identifying those delivering core health priorities with the highest fraud risk vulnerability
- where identified in Year 1, engage with stakeholders leading high fraud risk/ high priority health initiatives to drive the use of counter fraud tools, frameworks and processes to develop fraud resilience and embed fraud prevention principles during system change
- work with DHSC, NHS England and the PSFA to develop clearer counter fraud governance, accountability pathways, performance management frameworks and assurance expectations aligned to GOVS013 counter fraud standards
- continue to strengthen professional capability through the ongoing development and delivery of counter fraud skills and standards across the health sector
- continue to deliver targeted counter fraud communications, sharing lessons learnt, post investigation insights, advice and engagement activities to stakeholder groups, improving awareness, reporting and strengthening counter fraud controls
- develop relationships with targeted efficiency/cost improvement, commissioning, transformation and finance teams to embed consideration of fraud risk, prevention and value for money during service review, redesign and investment decisions
- re-frame board-level and senior leadership discussions on counter fraud risk, performance and assurance
- work with a range of partners, including technology providers, academia and international counterparts, to share insight, learn from emerging practice and drive future counter fraud approaches for the health sector
- ensure the NHSCFA is represented at key national decision-making committees and forums
By March 2027, this work will have resulted in:
- structured stakeholder analysis and ongoing engagement of national and regional partners on high fraud risk priority initiatives, enabling more constructive engagement on fraud risk
- selected leaders at national, regional and local level having clearer visibility of counter fraud performance, risk and emerging vulnerabilities with participating local systems having an improved understanding and ownership of what good counter fraud governance and oversight looks like in practice
- transformation, policy, commissioning and service redesign teams having access to clear, consistent fraud prevention principles and guidance aligned to GOVS013 counter fraud standards with clearer routes for stakeholders to access help and advice
- continued work with DHSC, PSFA and wider stakeholders on the ongoing evolution of counter fraud approaches, standards and performance frameworks
- appropriate sanctions and financial returns realised from investigation activity
- evidence of strengthened professional capability, including uptake of development activity and improved clarity of expectations