Information requested
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The total number of cases of fraud reported in primary care in the last 5 years.
- Please can you provide the data for approximately the last 3 years (1st Jan 2022-present date). This falls within the specified time and hopefully will limit the volume of data requested.
- The primary care service is: GENERAL PRACTICE
- For clarification of fraud: Any reported incidents reported in relation to any type of financial gain or loss through deception. Examples of this (and coding used) may include: false accounting, misrepresentation, theft, forgery, abuse of position, omission, money laundering
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A list of fraud cases reported in primary care in the last 5 years (amended to 3 years) where the allegation has been made against a practice manager
- Please provide all cases identified, irrespective of job title. This will provide us with the greatest opportunity identify all referred cases.
- Please provide the data for job title if logged, but we accept there may be missing data.
- N/A (duplicate request)
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A list of fraud cases reported in primary care in the last 5 years where the allegation has been made against a non-clinical partner or business manager.
- Please provide all cases identified, irrespective of job title. This will provide us with the greatest opportunity identify all referred cases.
- The lists of fraud cases reported in primary care in the last 5 years (using items 3 and 4 above), with details including the geographical location of the offence, the type of offence(s) and the monetary cost of each fraud case (GBP sterling).
- Please provide the data by ICB. Please provide all cases, even if the geographical area is missing.
- Please provide all data available for fraud identified, prevented and recovered. This will allow us to categorise the data accordingly. All types of cost is relevant.
- The total number of successful convictions by the NHS, GP practices or Crown Prosecution Service relating to any type of fraud in primary care in the last 5 years (amended to 3).
- Please provide all data on cases that were referred to the authority for which you have records. Thank you for clarifying that you do not hold data for CPS or private prosecutions.
NHSCFA response
- From 01/01/2022 to 30/06/2025 the NHSCFA received 714 allegations of GP fraud.
- From 01/01/2022 to 30/06/2025 the NHSCFA received 86 allegations of fraud where the allegation was against a Practice Manager.
To provide a list of fraud cases reported would require the disclosure of person identifiable information . Such disclosures are exempt under Section 40 (2) of the Freedom of Information Act. In addition, the categories recorded in the CLUE case management system and the methods used to record within the categories, means that it is difficult to capture the categories of data in the request. To do so will involve a search of both electronic and manual records to identify and verify the categories and titles of fraud which fit this description.
Therefore, I estimate that the cost of complying with your request would exceed the appropriate limit of £450. The appropriate limit has been specified in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 and for non-central Government departments it is set at £450. This represents the estimated cost of one person spending 18 hours in determining whether the Authority holds the information, and locating, retrieving and extracting the information. Under section 12 of the Freedom of Information Act the Authority is not obliged to comply with your request.
- N/A
- From 01/01/2022 to 30/06/2025 the NHSCFA received 27 allegations of fraud where the allegation was against a non-clinical partner or business manager.
To provide a list of fraud cases reported would require the disclosure of person identifiable information . Such disclosures are exempt under Section 40 (2) of the Freedom of Information Act. In addition, the categories recorded in the CLUE case management system and the methods used to record within the categories, means that it is difficult to capture the categories of data in the request. To do so will involve a search of both electronic and manual records to identify and verify the categories and titles of fraud which fit this description.
Therefore, I estimate that the cost of complying with your request would exceed the appropriate limit of £450. The appropriate limit has been specified in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 and for non-central Government departments it is set at £450. This represents the estimated cost of one person spending 18 hours in determining whether the Authority holds the information, and locating, retrieving and extracting the information. Under section 12 of the Freedom of Information Act the Authority is not obliged to comply with your request.
- Geographical Location: -
The list below shows the ICBs that the relevant GP Practices fall under for the 714 reports mentioned above. For reports in Wales the Local Health Board is given. Where a report was received before the change from CCG to ICB (01/07/2022) the relevant ICB is given.
- ANEURIN BEVAN UNIVERSITY LHB / 7A6 4
- BATH AND NORTH EAST SOMERSET, SWINDON AND WILTSHIRE ICB - 92G 1
- BEDFORDSHIRE, LUTON AND MILTON KEYNES ICB - M1J4Y 16
- BETSI CADWALADR UNIVERSITY LHB / 7A1 9
- BIRMINGHAM AND SOLIHULL ICB - 15E 30
- BLACK COUNTRY ICB - D2P2L 21
- BRISTOL, NORTH SOMERSET AND SOUTH GLOUCESTERSHIRE ICB - 15C 4
- BUCKINGHAMSHIRE, OXFORDSHIRE AND BERKSHIRE WEST ICB - 10Q 9
- CAMBRIDGESHIRE AND PETERBOROUGH ICB - 06H 4
- CARDIFF & VALE UNIVERSITY LHB / 7A4 4
- CHESHIRE AND MERSEYSIDE ICB - 01F 29
- CORNWALL AND THE ISLES OF SCILLY INTEGRATED CARE BOARD / QT6 1
- COVENTRY AND WARWICKSHIRE ICB - B2M3M 6
- CWM TAF MORGANNWG UNIVERSITY LOCAL HEALTH BOARD / 7A5 4
- DERBY AND DERBYSHIRE ICB - 15M 14
- DEVON ICB - 15N 7
- DORSET ICB - 11J 5
- FRIMLEY ICB - D4U1Y 11
- GLOUCESTERSHIRE ICB - 11M 9
- GREATER MANCHESTER ICB - 00T 27
- HAMPSHIRE AND ISLE OF WIGHT ICB - D9Y0V 14
- HEREFORDSHIRE AND WORCESTERSHIRE ICB - 18C 6
- HERTFORDSHIRE AND WEST ESSEX ICB - 06K 19
- HUMBER AND NORTH YORKSHIRE ICB - 02Y 9
- HYWEL DDA UNIVERSITY LHB / 7A2 10
- KENT AND MEDWAY ICB - 91Q 24
- LANCASHIRE AND SOUTH CUMBRIA ICB - 00Q 14
- LEICESTER, LEICESTERSHIRE AND RUTLAND ICB - 03W 8
- LINCOLNSHIRE ICB - 71E 6
- MID AND SOUTH ESSEX ICB - 06Q 11
- NHS BUSINESS SERVICES AUTHORITY / T1450 1
- NHS COUNTER FRAUD AUTHORITY / T1453 1
- NHS ENGLAND / X24 74
- NORFOLK AND WAVENEY ICB - 26A 7
- NORTH CENTRAL LONDON ICB - 93C 29
- NORTH EAST AND NORTH CUMBRIA ICB - 00L 24
- NORTH EAST LONDON ICB - A3A8R 36
- NORTH WEST LONDON ICB - W2U3Z 40
- NORTHAMPTONSHIRE ICB - 78H 9
- NOTTINGHAM AND NOTTINGHAMSHIRE ICB - 52R 12
- POWYS TEACHING LHB / 7A7 3
- SHROPSHIRE, TELFORD AND WREKIN ICB - M2L0M 2
- SOMERSET ICB - 11X 3
- SOUTH EAST LONDON ICB - 72Q 22
- SOUTH WEST LONDON ICB - 36L 17
- SOUTH YORKSHIRE ICB - 02P 12
- SOUTH, CENTRAL AND WEST COMMISSIONING SUPPORT UNIT / 0DF 1
- STAFFORDSHIRE AND STOKE-ON-TRENT ICB - 04Y 9
- SUFFOLK AND NORTH EAST ESSEX ICB - 06L 9
- SURREY HEARTLANDS ICB - 92A 16
- SUSSEX ICB - 70F 14
- SWANSEA BAY UNIVERSITY LOCAL HEALTH BOARD / 7A3 11
- UNKNOWN / UNK 9
- WEST YORKSHIRE ICB - 02T 17 714
Type of Offences
This information is not recorded in intelligence reports.
To provide a list of fraud cases reported including their geographical location and monetary cost would require the disclosure of person identifiable information. Such disclosures are exempt under Section 40 (2) of the Freedom of Information Act. In addition, the categories recorded in the CLUE case management system and the methods used to record within the categories, means that it is difficult to capture the categories of data in the request. To do so will involve a search of both electronic and manual records to identify and verify the categories and titles of fraud which fit this description.
Therefore, I estimate that the cost of complying with your request would exceed the appropriate limit of £450. The appropriate limit has been specified in The Freedom of Information and Data Protection (Appropriate Limit and Fees) Regulations 2004 and for non-central Government departments it is set at £450. This represents the estimated cost of one person spending 18 hours in determining whether the Authority holds the information, and locating, retrieving and extracting the information. Under section 12 of the Freedom of Information Act the Authority is not obliged to comply with your request.
- Of the allegations reported to the NHSCFA during the specified time period, two have resulted in criminal convictions. A further four have resulted in disciplinary sanctions.