Prescribed person 2023-24

Introduction

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. The 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 -

1. the number of workers’ disclosures received during the reporting period that the relevant prescribed person reasonably believes are –
   1. qualifying disclosures within the meaning of section 43B of the Employment Rights Act 1996; and
   2. which fall within the matters in respect of which that person is so prescribed;
2. the number of those disclosures in relation to which the relevant prescribed person decided during the reporting period to take further action;
3. a summary of –
1. the action that the relevant prescribed person has taken during the reporting period in respect of the workers’ disclosures; and
2. how workers’ disclosures have impacted on the relevant prescribed person’s ability to perform its functions and meet its objectives during the reporting period;
4. an explanation of the functions and objectives of the relevant prescribed person.

From 1 April 2023 to 31 March 2024, the NHSCFA received a total of 346 reports, where the source had stated they were making a disclosure under the Public Interest Disclosure Act 1998, highlighting an increase of 27% when compared to the previous financial year recording 272. 

Of the 346 reports:

• 241 reports were disseminated to Local Counter Fraud Specialists (LCFSs) via CLUE for further lines of enquiry or progressed to an investigation.
• 105 reports were closed with No Further Action (NFA) and progressed no further.

Of the 241 reports disseminated out to a Local Counter Fraud Specialist:

• 52 progressed to an investigation
• 189 records were closed

Of the 52 reports disseminated which progressed to an investigation 20 of these investigations have been closed with no fraud identified, 40% were investigations classed as ‘Staff- Employees-Income/hours’. 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.

Four investigations have been closed with offences identified. Three of the investigations related to prescription fraud, such as changing the quantity of medication prescribed or impersonating an individual to obtain medication.

One investigation resulted in a dismissal as the individual resigned prior to a completion of the internal investigation.

Nine of the investigations have been closed.

One resulted in restorative justice relating to patient prescription fraud.

With 15 of the investigations remaining open with the majority relating to prescription fraud and theft of drugs for personal use.

Of the 105 reports closed with NFA and progressed no further:

• 48 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 are not pursued by NHSCFA.

• 26 reports related 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.

• 31 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 disclosure’s forms part of the NHSCFA’s “business as usual” activities, consequently impacting 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 2020-2025 are to:

1. Lead and influence the NHS to find, prevent and reduce fraud, recovering losses and putting money back into patient care
2. Work with partners to reduce fraud loss in the NHS
3. Support and empower our people to be the best in their roles and feel valued
4. Effectively use our resources, identify and pursue opportunities for growth and innovation and reduce our operating costs