Information requested
Under the Freedom of Information Act 2000, I would like to request the following information relating to Personal Health Budgets (PHBs) issued or managed by the North Central London ICB.
Please provide this information broken down by individual financial year(e.g. 2020/21, 2021/22, 2022/23, 2023/24, 2024/25 to date), for each of the past five financial years or as many as you have data for:
- The number of fraud concerns or cases involving Personal Health Budgets that were:
- Alleged or reported
- Under investigation
- Proven or substantiated
- Unfounded or dismissed
- The financial value (£) associated with:
- Proven or substantiated fraud cases
- Any financial recoveries made by the ICB as a result
- Where held, please indicate whether each case involved:
- Direct payments to individuals
- Third-party managed budgets
- Notional budgets
- If available, please include brief anonymised summaries of the types of fraud involved (e.g. falsified receipts, ineligible spending), while ensuring no personal or identifying information is disclosed.
- The above is to be summed for both adults and children.
NHSCFA response
In response to your request, NHS Counter Fraud Authority has records of three allegations reported. These refer to closed reports/investigations:
2021/2022 – 1. This did not progress to an investigation. This related to a direct payment to an individual.
2023/2024 – 2. Both investigations closed as No Fraud Identified. Both related to direct payments to individuals.
I am unable to provide a summary of the details of the report / investigations. To provide information may identify the persons linked with the investigations. Sections 40 (2) and 40 (3A) & 40 (4) of the Act are therefore engaged. The full wording of this Section of the Act can be found in Appendix A.