Annual reporting trends
Levels of fraud reporting received by the NHSCFA compared to previous periods.
Reporting has increased by 19.77% compared with 2020 to 2021, it is therefore a realistic possibility that reporting has begun to recover to former levels. Reporting could stabilise as restrictions are withdrawn and the plan of living with COVID-19 continues.
Compared to 2020-21, the NHSCFA received an additional 942 reports. The pink sections of the bar chart display the additional reports which were COVID-19 related during the collection period.
From April 2021 to July 2021 and September 2021 to January 2022 reporting slowly increased. This correlates with the roll out of the COVID-19 vaccination programme, flu vaccination programme and later the COVID-19 booster programme. However, reporting in both fraud and COVID-19 related reports began to decline by January 2022 as 90% of the population had received their first COVID-19 vaccine and on the 27th of January all Plan B restrictions were lifted, followed by an end to travel restrictions and self-isolation requirements.
Reports regarding procurement and commissioning saw the largest increase in reporting. The increase of 88.47% can be partially attributed to the large amount of COVID-19 related scam telephone calls, texts and emails which were reported to the NHSCFA and categorised under third party usage in procurement and commissioning. It should be noted that the majority of the COVID-19 related scams were focussed on defrauding members of the public rather than the NHS directly. However, reporting relating specifically to mandate fraud also saw an increase.
Top four thematic areas by number of referrals received in 2021-22
In total 5,706 (373 reports relate to allegations not relating to fraud and were appropriately disseminated) reports were received, 85.1% of all reports relate to the top 4 thematic areas, with the remaining 14.9% relating to the other areas.
It is assessed that this is indicative of how transparent and visible suspicious activity is within the areas and not necessarily the scale of possible fraudulent activity.
NHS Staff fraud has experienced an increase in reporting when compared with the previous year. This reporting figure is close to the number of allegations received in 2018-2019 and potentially indicative of reporting returning to pre-pandemic levels. An increase in reporting could potentially be attributed to staff returning to workplaces and COVID-19 restrictions being removed, thus enabling greater oversight of activities.
Additionally, reporting on Procurement and Commissioning fraud has almost doubled in comparison to the previous period, a majority of which are linked to COVID-19. For example, the high number of COVID-19 related scam telephone calls, texts and emails reported which relate to vaccination passports. Patient Exemption fraud also saw a 7.14% increase in reporting this period, just over 11% of which are determined to be COVID-19 related.
However, fraudulent access to secondary care from overseas visitors has continually seen a year on year decrease from 2017-2018 to 2021-2022. From 2019-2020 this could potentially be connected to the travel restrictions enforced during the pandemic. The decrease also coincides with the introduction of the legal requirement for relevant bodes to recover funds in advance of providing treatment to a chargeable patient in 2017 (unless the care was urgent or immediately necessary).
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