Project Athena has proved that at scale data analytics can and has found patterns in data indicative of fraud, creating new opportunities to improve services, enhance efficiency and tackle fraud more effectively.
Our ambition is to ensure that modern technology implemented for and by the health sector is fraud resilient by design, safeguarding public investment and enabling smarter, safer care. Data-driven analytics will detect fraud when it occurs, identify and expose systemic vulnerabilities and provide a strong foundation for fraud prevention initiatives. By harnessing digitalisation, big data, advanced analytics and automation, we will not only disrupt fraud but also ensure NHS leaders adopt strengthened counter fraud controls.
We will achieve this by:
- tackling fraud through harnessing digitalisation, advanced data analytics, national and local data sets, and emerging technologies to support the health sector not only to prevent detect and respond to fraud, but to also identify potential efficiencies
- sourcing and using broader data sets, as healthcare provision changes and grows, to provide fraud vulnerability insight that helps health leaders identify emerging risks and strengthen controls, supporting proactive action and intervention
- shaping key health-wide technology developments to ensure fraud resilience is built into digital innovation right from the start
- conducting fraud loss measurement activity in agreed high-risk areas to strengthen understanding of scale, impact and return on investment
- adopting the use of artificial intelligence and automation to create pace and efficiencies across health-wide counter fraud activities
- using technology to improve efficiency, and the quality and timeliness of counter fraud products
Outcomes by 2029
This objective focuses on using data and technology to strengthen insights and intelligence on fraud risks, improve performance and efficiency and enable a modern counter fraud response.
We will ensure that:
- intelligence becomes a strategic asset to prevent, detect and respond to fraud and drives robust and informed decision-making
- national and local datasets, modern analytics platforms and automated intelligence functions underpin a system where fraud risks are predicted, detected and prevented to minimise loss to public funds
- counter fraud products such as intelligence assessments and dissemination are faster, more efficient and more productive, achieving better outcomes
- fraud-proofing technology innovation strengthens the NHS’s resilience against fraud
The result will be a more resilient, transparent, and financially sustainable NHS, where fewer opportunities for fraud exist and more resources are available for frontline patient care.