The SIA is produced annually on behalf of the DHSC to identify fraud threats and the level of NHS funding exposed to the risk of loss from fraud. The National Intelligence Model and the Control Strategy (health partner priorities) are used to determine where counter fraud resources should be focused for the year ahead.
The SIA highlights both emerging and current fraud threats, presents the future fraud landscape through horizon scanning and captures reporting figures. Financial vulnerability estimates are calculated across ten thematic areas, alongside a further two strategic oversight areas. This analysis informs the NHSCFA and its stakeholders of priorities for the year ahead by capturing established, emerging and potential future threats. This approach has and will continue to support a coordinated response to fraud and protect funding intended for patient care.
The diagram below provides an overview of some of these thematic areas, with procurement and commissioning fraud remaining one of the areas of highest fraud risk vulnerability. Recognising the changing health landscape, counter fraud priorities today may differ from those of tomorrow as vulnerabilities emerge. This strategy is therefore subject to re-prioritisation should new threats emerge and require a realignment of effort and resources across the sector. Any such changes will be subject to appropriate governance and assurance processes.
The Health Group Enterprise Fraud Risk Assessment (EFRA) provides a high-level assessment of strategic priority areas exposed to the highest fraud risk. Each strategic assessment is underpinned by a thematic and full fraud risk assessment which provides further granular detail on specific funding streams. The EFRA and supporting fraud risk assessments are conducted in accordance with the Government Counter Fraud Profession standards and best practice guidance.
Currently, the approach to fraud risk management across the sector varies between NHS bodies, with each responsible for responding to fraud risks according to their local fraud risk appetite and tolerance levels. Whilst the decentralised approach provides agility, it also presents challenges in understanding and capturing the overall response to fraud. During this strategic cycle, further engagement and support will be provided with the long-term vision of developing and integrating a more consistent approach to fraud risk management.