The NHSCFA completes its yearly strategic intelligence assessment in order to provide an estimate of fraud losses, to identify potential threats, vulnerabilities and enablers and measure the risk of fraud to the NHS alongside the NHSCFA’s ability as an organisation to mitigate this risk.
By identifying possible fraud, the NHSCFA, alongside stakeholders and other organisations, hopes to proactively reduce and stop public funds landing in the hands of criminals.
It is important to note that when discussing threat groups such as patients or NHS staff, the NHSCFA are only talking about the small minority that are exploiting vulnerabilities and enablers for their own personal gain. The NHSCFA feels it is important to bring these to the forefront as the small minority of individuals are causing public distrust and damaging the reputation of an otherwise exemplary workforce.
Whilst the budget for the NHS in England continues to rise to meet demands and pressures, the vulnerability to fraud has continued to reduce year on year.
Throughout this document assessments and judgements are presented based on the foundation of intelligence. It is important to note that intelligence is not fact or evidence, but hypothesis and inferences drawn from the best available information at the time of writing.
It is the responsibility of every member of the public and NHS employees to remain vigilant; reporting any suspicions to the Local Counter Fraud Specialist or direct to the NHSCFA. By reporting suspicions we can all assist in ensuring the NHS remains one of the top health services in the world.
What are the types of NHS fraud?
There are many types of NHS fraud and you can find definitions in the NHS fraud reference guide.
Watch the video below for an example of NHS fraud, involving a procurement fraud committed by an NHS manager and two of her organisation's external contractors.