Alex Rothwell outlines the organisation's priorities for the next three years in the fight against fraud, bribery, and corruption affecting the NHS.

I am proud to share the NHSCFA’s 2023-2026 Strategy. This document sets out our key priorities for the coming years and details how we are going to deliver them to reduce fraud affecting the NHS.

Healthcare expenditure in 2021 was estimated at £277bn, which was an increase in nominal terms of 7.4% on spending in 2020. The NHSCFA has assessed, that, in the context of a 2021 to 2022 NHS budget in England of almost £150.614bn , that the NHS is vulnerable to fraud, bribery and corruption to an estimated £1.198bn.

There are more than 1.2 million full-time equivalent staff working in the NHS across 219 trusts (including 10 ambulance trusts), as well as 42 regionally based Integrated Care Systems. The NHS also has a developing relationship with private sector health providers. It is a complex landscape to operate in and means that the development of a shared strategy and a shared understanding of risk is challenging – but that is why the NHSCFA exists. To protect the budget in such a complex and diverse organisation our task requires strong relationships in all areas of the business. In recognition of the collaborative effort required to deliver against our objectives we have therefore created a new vision:

“Working together to understand, find and prevent fraud, bribery and corruption in the NHS.”

At the heart of our strategy is a collaborative approach. There will be many opportunities in the next three years for the NHSCFA to influence the development of a stronger response to fraud and in creating this strategy we asked ourselves and our stakeholders where our focus should be. The result of this work is the creation of four key pillars of activity, supported by our people and our resources, which describe not only our current approach but what we believe we will need to achieve to drive vulnerability down and increase the amount of fraud we detect, prevent and recover. These pillars of activity will form the basis of everything we do.

Underpinning the strategy is a desire to maximise the use of data and data analytical techniques. In a highly digitised environment, I believe this is the key to unlocking more savings. We will pursue the opportunities that exist with vigour whilst respecting the inherent requirements of privacy and security.

For this strategy to be a success, we need to promote The International Public Sector Fraud Forum principles to combat fraud:

There is always going to be fraud - It is a fact that some individuals will look to make gains where there is opportunity, and organisations need robust processes in place to prevent, detect and respond to fraud and corruption.

Finding fraud is a good thing - If you do not find fraud you cannot fight it. This requires a change in perspective, so the identification of fraud is viewed as a positive and proactive achievement.

There is no one solution - Addressing fraud needs a holistic response incorporating detection, prevention, enforcement and redress, underpinned by a strong understanding of risk. It also requires cooperation between organisations under a spirit of collaboration.

Fraud and corruption are ever changing - Fraud, and counter fraud practices, evolve very quickly and organisations must be agile and change their approach to deal with these evolutions.

Prevention is the most effective way to address fraud and corruption - Preventing fraud through effective counter fraud practices reduces loss and reputational damage. It also requires less resources than an approach focused on detection and recovery.

This strategy is the start of a new phase of working for the NHSCFA.

It will develop and evolve during its lifetime, and it will ensure that every pound spent on the NHS is used for its intended purpose – patient care and protecting the nation’s health.

Alex Rothwell

Chief Executive of the NHS Counter Fraud Authority

Image of Alex Rothwell Chief Executive of the NHS Counter Fraud Authority

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