The challenge

The importance of protecting the NHS from fraudulent activity.

Fraud, bribery and corruption are estimated to have cost the UK economy up to £81 billion in 2023-243 based on the Public Sector Fraud Authority’s (PSFA) methodology. Within health, the NHSCFA Strategic Intelligence Assessment (SIA) estimates that system-wide fraud risk and vulnerability stood at £1.346 billion in 2024-25, the equivalent to the annual running cost of one large Foundation Trust hospital4.

Losses at this scale can mean there are fewer staff such as doctors, nurses, healthcare assistants, porters and discharge staff working in our hospitals. It can also mean older equipment, fewer outpatient appointments and fewer operations as every pound lost to fraudsters is a pound lost from frontline patient care5. Fraud, bribery and corruption can also mean unsafe care for patients.

The health sector will deliver significant change and improvement which will also create new opportunities to tackle fraud more effectively. However, the process of change can mean that health budgets are more vulnerable to fraud risks as models of healthcare are developed.

Whole system change is needed to ensure that NHS resources are not lost to fraud, bribery, corruption and error. Many opportunities exist to strengthen the health sector’s response to the risk of fraud, including:

NHSCFA’s response to strengthen the risk of fraud Circular infographic illustrating NHSCFA’s strategic response to strengthening the risk of fraud, including counter‑fraud culture, governance, data sharing, fraud‑proofed systems, priority risk targeting, awareness raising, and enforcement. NHSCFA’s response to strengthen the risk of fraud Strengthening counter fraud culture, accountability and governance Strengthening roles and responsibilities for health-wide counter fraud roles Joining data sets to identify potential fraud Raising the profile of fraud and the impact of fraud on frontline services Ensuring new processes and systems are adequately fraud-proofed from inception Targeting counter fraud resources at the highest priority fraud risk areas
NHSCFA’s response to strengthen the risk of fraud Circular infographic illustrating NHSCFA’s strategic response to strengthening the risk of fraud, including counter‑fraud culture, governance, data sharing, fraud‑proofed systems, priority risk targeting, awareness raising, and enforcement. Strengthening counter fraud culture, accountability and governance Strengthening roles and responsibilities for health-wide counter fraud roles Raising the profile of fraud and the impact of fraud on frontline services Joining data sets to identify potential fraud Targeting counter fraud resources at the hightest priority fraud risk areas Ensuring new processess and systems are adequately fraud-proofed from inception NHSCFA’s response to strengthen the risk of fraud

The health sector has an estimated £35 million6 in resources to combat fraud, corruption, and bribery, just 2.6% of the £1.346 billion sector-wide fraud risk vulnerability. This strategy therefore focuses on areas where collective resources can make the greatest impact in reducing fraud vulnerability, using an evidenced-based approach to drive counter fraud priorities and ensure strong counter fraud capability across the sector.

  1. The impact of fraud and error on public funds 2023-24 - NAO overview
  2. Finance and accounts - University Hospital Southampton
  3. DHSC counter-fraud strategy: 2023 to 2026 - GOV.UK
  4. An Internal DHSC and NHSCFA study estimates these figures

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