2024003

Request regarding Dental contractor fraud and methods used

Published: 28 January 2023

Information requested

‘Under the freedom of information act please may you provide me with the following information: In relation to dental contractor fraud, please list the different methods that are used to perform said fraud (eg claiming for treatments on ghost patients, or double claims for treatments performed as private treatments etc).

Next, for each of these methods, please state the amount of money that the NHSCFA believes the NHS is at risk of losing from each of these methods individually. It can be stated as a monetary figure, or as a percentage of the £57million that the CFA believes is at risk of being lost to dental contractor fraud each year.

Please give this information for each year, starting from 2018, up to 2024 if possible.

Please state if the NHSCFA has not calculated the numbers for each individual known method of performing the fraud, and has only calculated the total of £57 million for dental contractor fraud as a whole.’

NHSCFA response

In response to your request, the methods used for dental contractor fraud are contained within the strategic intelligence assessment and can be found detailed in the current and most previous SIAs (which date back to 2018) on the NHS Counter Fraud Authority’s website:

https://cfa.nhs.uk/about-nhscfa/corporate-publications/SIA-23/SIA-2023-dental-contractor-fraud - 2023

https://cfa.nhs.uk/about-nhscfa/corporate-publications/SIA-23/previous-SIA-reports 2018 to 2022.

The NHS Counter Fraud Authority no longer calculate the financial vulnerability based on a methodology broken down by methods of performing the fraud.

The final year the financial vulnerability was based on a methodology broken down by modus operandi was for the 2019 SIA which covered the period for 2017 to 2018 and is available at

https://cfa.nhs.uk/about-nhscfa/corporate-publications/SIA-23/previous-SIA-reports

The Strategic Intelligence Assessment for 2024 is awaiting finalization.

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