2022007

The total number of reports you have received of potential fraud undertaken by community pharmacy contractors between March 1, 2020 and February 11, 2022/the current date.
Of the reports received between March 1, 2020 and February 11, 2022/the current date, the number that have so far been converted into cases.
Of the reports converted into cases, the number of cases that currently remain open.
Please can you supply details of the incidents described in points 1 and 2, including:

From 01/03/2020 to 28/02/2022 NHS Counter Fraud Authority received 283 reports of potential fraud undertaken by community pharmacy contractors.
Of these 33 have been converted into cases (although there are only 32 cases, two reports have been converted into the same case).
Of these, 25 remain open.
Of the 283 reports received

140 relate to dispensing irregularities

25 relate to false claims for allowances and expenses

25 relate to false claims submitted for patient exemption

24 relate to false claims for patient services (e.g. MURs etc)

12 relate to dispensing reissued medication

11 relate to false claims for fees incurred for things like Specials, Out of Pocket Expenses etc

4 relate to ghost patients

3 relate to dispensing medication at one pharmacy but submitting the claim for payment at another pharmacy

2 relate to dispensing counterfeit medication

The remaining 37 reports don’t fall into any of these categories and are classed as “other”.

The outcome of closed cases is as follows:

2 cases - No Fraud Identified

2 cases - No outcome recorded

3 Cases - No fraud found or proven.

Freedom of Information request: 2022007