Information requested
Please provide information on the handling of fraud referrals within the NHS foundation trust relating to concerns about member of staff off sick from NHS but working in private practice hair transplant clinic . Specifically, I request:
1. Confirmation of whether such fraud referrals are initially received and assessed by the employing NHS Trust (via Local Counter Fraud Specialists or equivalent) or by NHS England.
2. Under what circumstances, if any, such referrals are passed directly to NHS England rather than being handled by the employing NHS Trust.
3. Under what circumstances such referrals are escalated to the NHS Counter Fraud Authority.
4. A description of the standard process flow for handling these types of fraud concerns, from receipt to closure or escalation.
NHSCFA response
1. eferrals are made either directly to the LCFS at the relevant Trust or to NHS Counter Fraud Authority (who would then disseminate to the relevant Trust).
2. A referral would only be passed to NHS England if the subject of the allegation was employed by NHS England.
3. Such referrals would not be escalated to the NHS Counter Fraud Authority unless they were cross border, involved bribery or was a complex and high value case, which for this type of allegation is highly unlikely.
4. The standard process flow for dealing with such allegations (if reported to the NHSCFA) is as follows: -
The allegation is processed in NHSCFA database. This involves giving the report a priority, checking if the subject has been reported before and establishing the relevant NHS body that is the victim of the fraud. It is then reviewed and further action decided upon. For an allegation of this nature if all the relevant information has been provided that would almost certainly mean dissemination to the relevant NHS Trust. An intelligence report is sent to the LCFS at the Trust.
We are unable to provide details of subsequent processes LCFSs take. This information would be provided by the responsible Trust.