Information requested

  1. In total, how many of the reports received by the NHSCFA from 1 July 2019 to 30 June 2021 were of fraud undertaken by community pharmacy contractors?
  2. How many of the total number of the community pharmacy contractor fraud reports received from 1 July 2019 to 30 June 2021 were due to:
    • Inappropriate claims relating to dispensing and enhanced services offered at the premises
    • Inappropriate claims relating to the pandemic delivery service
    • Inflation of fees, allowances and reimbursements claimed under the drug tariff
    • Activities that contravene the terms of the contractual agreement
    • Other (please specify)
  3. The data underpinning NHSCFA’s decision to investigate community pharmacy contractor fraud as a priority
  4. The estimated cost to the NHS of community pharmacy contractor fraud in from 1 July 2019 to 30 June 2021.

NHSCFA response

In total, how many of the reports received by the NHSCFA from 1 July 2019 to 30 June 2021 were of fraud undertaken by community pharmacy contractors?

309 reports were of fraud undertaken by community pharmacy contractors.

How many of the total number of the community pharmacy contractor fraud reports received from 1 July 2019 to 30 June 2021 were due to:

  • Inappropriate claims relating to dispensing and enhanced services offered at the premises

    • 256

  • Inappropriate claims relating to the pandemic delivery service

    • This figure is included within the above figure (256)

  • Inflation of fees, allowances and reimbursements claimed under the drug tariff

    • 11

  • Activities that contravene the terms of the contractual agreement

    25

  • Other (please specify)

    • 17 (no further information - not individually classified)

The data underpinning NHSCFA’s decision to investigate community pharmacy contractor fraud as a priority The NHS Counter Fraud Authority has not been in a position to specifically measure losses within the community pharmacy contractor thematic area and are relying on a baseline 1% loss to fraud as an estimate. This leaves a substantial gap in our strategic intelligence picture, meaning that it remains a priority.

The estimated cost to the NHS of community pharmacy contractor fraud in from 1 July 2019 to 30 June 2021. The total estimated losses to fraud can be found in the Strategic Intelligence Assessments which are published on our website:

Strategic Intelligence Assessment | NHS Counter Fraud Authority (cfa.nhs.uk)