General Practice (GP) contractors

Fraud relating to the manipulation of income streams or activities that violate contractual terms perpetrated by either GPs or practice staff.

The GP contractor area has not been subject to a loss measurement exercise this financial year and relies on historic loss measurement reporting and comparative analysis to dental and optical contractor fraud.

£93.8m

from an expenditure of £9.38 billion

Recent loss measurement exercises for dental and optical have identified overall vulnerability percentages of between 1% and 3.5%. 1% has been used to express the possible financial vulnerability.

Financial fraud vulnerability: £93.8 million.

It is assessed that this increase, compared to last years assessment, is likely a result of increased funding to General Practice contracts and as it is estimated that the fraud loss will increase in-line with increased funding.

Information reports received for General Practice (GP) contractors

Change in the number of fraud referrals (allegations) received in relation to General Practice (GP) contractors from 2016-17 to 2019-20.

13%

decrease in referrals for this theme compared to last year

2016-17 2017-18 2018-19 2019-20
100 122 190 165