Information requested
I would like to know:
- In total, how many of the reports received by the NHSCFA from January 1st 2017 - June 30th 2019 were of fraud undertaken by community pharmacy contractors?
-
How many of the total number of the community
pharmacy contractor fraud reports received in January 1st
2017 - June 30th 2019 were due to:
- Inappropriate claims relating to dispensing and enhances services offered at the premises
- Inflation of fees, allowances and reimbursements claimed under the drug tariff
- Activities that contravene the terms of the contractual agreement
- other (please specify)
- The data underpinning NHSCFA’s decision to investigate community pharmacy contractor fraud as a priority
- The estimated cost to the NHS of community pharmacy contractor fraud in 2017-2019.
NHSCFA response
Reports received relating to Pharmaceutical Contractor Fraud from 1st January 2017 to 30th June 2019:
| Fraud and Corruption Reporting on Line | Reporting via Local Counter Fraud Specialists | ||
| Total Reports | 362 | 275 | 87 |
| Inappropriate Dispensing /Enhancing Services | 281 | 226 | 55 |
| Inflation of Fees | 27 | 9 | 18 |
| Contract | 31 | 23 | 8 |
| Market Abuse* | 9 | 4 | 5 |
| Other | 14 | 13 | 1 |
*The category of ‘Market Abuse’ refers to concerns about inappropriate behavior intended to artificially manipulate the market for gain.
In response to points 3 and 4, the information is accessible in the NHS Counter Fraud Authority Strategic Intelligence Assessments 2016-17 and 2017-18,
Strategic Intelligence Assessment 2016-17
Strategic Intelligence Assessment 2017-18
The findings for the period 2018-19 will be included in the next Strategic Intelligence Assessment. It is the intention of NHS Counter Fraud Authority to publish this assessment at a future date, therefore under Section 22 of the Freedom of Information Act 2000 this information is exempt from disclosure.