As the health system evolves, there is a need to develop and embed a shared understanding of fraud risk and to position fraud prevention and response as a collective responsibility that supports patient care, delivery of efficiencies, financial sustainability and system performance.
Strategic collaboration is essential to delivering this strategy. Success will depend on meaningful partner engagement and on stakeholders recognising counter fraud activity as a key business enabler that supports the delivery of health objectives.
We will achieve this by:
- reflecting the needs of the health sector’s ambitions and driving leaders to embed and adopt fraud resilience and response principles across the NHS
- driving understanding of fraud in healthcare and the impact this has on frontline patient care to strengthen counter fraud response
- working with the DHSC, PSFA, professional bodies, the wider ALB health group and health regulators to shape and strengthen the GOVS013 standards, promote adoption of counter fraud knowledge, skills and behaviours and to drive fraud resilience, improved governance and alignment with NHS principles and values8
- investigating reports of fraud and pursuing appropriate enforcement action where fraud is found
- engaging non-fraud professionals to shape thinking, influence behaviour and guide the national conversation on fraud prevention and resilience
- using lessons learned from counter fraud activity to press leaders to adopt robust counter fraud controls
- strengthening counter fraud governance and oversight through support to boards
- engaging specialist expertise to strengthen counter fraud intelligence, insights and drive tangible actions
- collaborating with the four-nations and international health-systems to share best practice and strengthen both our own and global counter fraud capability
Outcomes by 2029
Our ambition is to grow strategic relationships that match the scale and complexity of the NHS’s ambitions. By fostering collaboration, strategic alignment, and a deliberate shift in narrative, we will position fraud prevention and resilience as an enabler of the 10-Year Health Plan.
We will ensure that:
- there is demonstrable progress in counter fraud leadership and governance, embedded within the cultural and strategic thinking of the NHS
- counter fraud practice and expertise promotes a cultural shift, where the health sector proactively understands and responds to fraud risks
- the health sector is more resilient and recognises fraud prevention as integral to patient safety, operational excellence and the protection of public resources
- decisive and appropriate action is taken where fraud is detected
- learning from stakeholders is shared and strengthens counter fraud practice