The Public Interest Disclosure Act 1998 gives legal protection to employees against being dismissed or penalised by their employers as a result of disclosing information which is considered to be in the public interest. NHSCFA is a ‘prescribed person’ as defined under the Public Interest Disclosure (Prescribed Persons) Order 2014.
As such, individuals working outside the NHSCFA, but in the healthcare sector, may contact the NHSCFA if they have any concerns in relation to fraud, corruption or other unlawful activity in relation to the health service in England. Individuals can report to the NHSCFA in a variety of ways including using our online fraud and corruption reporting form and calling our Fraud and Corruption Reporting Line powered by Crimestoppers.
Since April 2017, all ‘Prescribed Persons’ are required to report in writing annually on workers (whistleblowing) disclosures they have received. The report must be published within six months of the end of the reporting period.
The report must contain, without including any information in the report that would identify a worker who has made a disclosure of information, or an employer or other person in respect of whom a disclosure of information has been made -
- The number of workers’ disclosures received during the reporting period that the relevant prescribed person reasonably believes are –
- Qualifying disclosures within the meaning of section 43B of the Employment Rights Act 1996; and
- Which fall within the matters in respect of which that person is so prescribed;
- The number of those disclosures in relation to which the relevant prescribed person decided during the reporting period to take further action;
- A summary of –
- The action that the relevant prescribed person has taken during the reporting period in respect of the workers’ disclosures; and
- How workers’ disclosures have impacted on the relevant prescribed person’s ability to perform its functions and meet its objectives during the reporting period;
- An explanation of the functions and objectives of the relevant prescribed person.
From 1 April 2022 to 31 March 2023, the NHSCFA received 272 reports where the source had stated they were making a disclosure under the Public Interest Disclosure Act 1998.
- 24 of these reports are open and so have not been actioned yet.
- 151 reports were closed with No Further Action and progressed no further.
Of the remaining 97 reports, 21 were tasked via CLUE to Local Counter Fraud Specialists and 76 reports were disseminated to another governing body, which also include disseminations to relevant LCFS’s for further lines of enquiry.
Of the 21 reports tasked directly via CLUE to a Local Counter Fraud Specialist, 16 have become cases on CLUE. Eight of these cases have been closed with no offences identified and eight cases remain open. Four reports have not yet been actioned by the LCFS.
Of the 24 reports that were open and waiting to be actioned as of 10th May 2023:
13 of these relate to GP frauds with 4 allegations which have been ongoing since October and November 2022 and 9 which have been received from March 2023 onwards, therefore are still going through processing within the Intelligence Unit. The other 11 reports relate to a mixture of taxonomy categories.
Of the 151 reports closed with No Further Action and progressed no further:
63 of these reports relate to patient issues with the majority concerning prescription frauds / altering of prescriptions. NHSCFA receive these in addition to the police and NHSE, therefore they are not pursued by NHSCFA.
61 reports relate to various other taxonomy categories where No Further Action was concluded, the reason for this is that the information in the report is either for Intelligence only purposes or that the Information is inadequate. Intelligence Only means that the report is kept on file but is unable to be progressed due to a lack of information available and Information Inadequate means there is not enough information to establish what offence may have been committed and it has not been possible to contact the source again.
A further 27 of these reports were categorised as No Fraud Against the NHS and therefore could not be actioned any further. No Fraud Established is used when there is no fraud to investigate, usually due to a misunderstanding by NHS staff or general public as to what constitutes a fraud or not.
The processing of such disclosures forms part of the NHSCFA’s “business as usual” activities and consequently the impact on the NHSCFA’s ability to perform its functions and meet its objectives during the reporting period was negligible.
Explanation of the functions and objectives of the relevant prescribed person
The NHSCFA is a Special Health Authority focused entirely on counter fraud work, independent from other NHS bodies and directly accountable to the Department of Health and Social Care (DHSC). Our mission is to lead the fight against fraud affecting the NHS and wider health service and protect vital resources intended for patient care.
The NHSCFA’s main objectives for 2020-2023 are to:
- Lead and influence the NHS to find, prevent and reduce fraud, recovering losses and putting money back into patient care
- Work with partners to reduce fraud loss in the NHS
- Support and empower our people to be the best in their roles and feel valued
- Effectively use our resources, identify and pursue opportunities for growth and innovation and reduce our operating costs