NHS Counter Fraud Authority sets out fraud fighting plans for 2022-23

The NHSCFA’s 2022-23 Business Plan, published on Friday 18 March 2022, sets out exactly what the organisation intends to deliver in the third and final year of its 2020-2023 strategy.

The plan contains:

• Foreword by the new CEO, Alex Rothwell, and Message from the Chair, Tom Taylor
• Description of NHSCFA’s business model and integrated approach to delivery
• A brief overview of NHSCFA’s achievements over the last year
• Delivery plan detailing areas of focus and activity for 2022-23 under each strategic objective

In launching the plan, NHSCFA’s Director of Performance and Improvement Tricia Morrison said today:

“As the NHS and the country as a whole recover from the impact of the COVID-19 pandemic, the NHSCFA is unwavering in its commitment to fighting fraud against our health service. We can only do this effectively by working together with our colleagues in the wider counter fraud community, both in the NHS and across the public sector, and we couldn’t do any of this without our people. This is why a continuing and determined drive to improve engagement with our stakeholders, both external and internal, is such an important part of our business plan for 2022-23.”

The business plan explains how NHSCFA’s areas of focus for the next financial year are informed by intelligence from across the health sector set out in our Strategic Intelligence Assessment (SIA) and are also shaped by employee and external stakeholder perceptions of where the main problems lie. This enables us to focus on where we can have the greatest impact, working together with our colleagues across the wider counter fraud community.

Our four strategic objectives for 2020 to 2023 remain to:

• Lead and influence the NHS to find, prevent and reduce fraud, recovering losses and putting money back into patient care
• Work with partners to reduce fraud loss in the NHS
• Support and empower our people to be the best in their roles and feel valued
• Effectively use our resources, identify and pursue opportunities for growth and innovation and reduce our operating costs

In delivering these objectives, the NHSCFA intends to leverage new and existing stakeholder relationships to amplify its voice, impact and reach, maximising the use of agile and smarter working in doing so.

During the first two years of our strategy, our operations were inevitably impacted by the COVID-19 pandemic and we refocused our resources on supporting colleagues across the NHS during a time of unprecedented pressure. However, there were a number of significant achievements during this time, which are reflected in the plan: from the rollout of Clue, a new fraud case management system for the NHS, to the introduction of new NHS requirements aligned to the Counter Fraud Functional Standard, from a successful drive to build capability around fraud risk assessment to the successful criminal justice outcomes we have delivered, often working in partnership with our stakeholders.

During this time NHSCFA has also taken the opportunity to listen, re-measure, analyse and refocus every aspect of its operating model. This includes the systems that drive its performance, planning and measurement processes now under the stewardship of a revitalised Board, new CEO and dedicated performance director.

Our new CEO, Alex Rothwell, underscores the ongoing threat posed by health fraudsters: “While frontline NHS colleagues have been responding in a fabulous way to the pandemic, the criminals have not been dormant. Far from it.”

But the CEO feels well equipped for the battle that lies ahead: “We have the right mixture of combined skills to meet the challenge of the final year of this strategy period and are in the process of devising further, future-fit strategies to move us through and past the long tail of COVID-19. This plan gives everybody much needed confidence as we enter and navigate the volatile and unpredictable post-pandemic period.

“By setting out a clear delivery plan driven by our strategic intelligence assessment, targeting improved reporting of outcomes, continuing to improve stakeholder engagement and giving health bodies the information they need to focus on impact, the plan reflects our ambition to continually develop how we work with our partners in the wider counter fraud community – as it’s only by working together that we can make a difference in the fight against fraud.”

The Chair of NHSCFA’s Board, Tom Taylor adds:

“During the global pandemic, the value of our function as one of the protectors of the NHS finances came into stark relief. It has been and will continue to be a time of unparalleled challenge and constant uncertainty. To stay ahead of the criminals, organisations like ours must continuously listen, learn and adapt. We have found an excellent new CEO in Alex Rothwell to lead that endeavour.”

If you suspect that anyone is committing fraud or another economic crime against the NHS, tell NHSCFA about it – you can visit our main website to report online: www.cfa.nhs.uk or telephone our 24-hour reporting line 0800 028 40 60.

“NHS fraud. Spot it, report it, together we stop it”

For more information contact the NHSCFA press office on media@nhscfa.gov.uk.

Notes to Editors

1. The NHS Counter Fraud Authority is a Special Health Authority established under the NHS Act 2006 as amended. It is sponsored by the Department for Health and Social Care, accountable to the department’s Anti-Fraud Unit (AFU).
2. The NHSCFA assess that the NHS vulnerability to fraud, bribery and corruption leads to an estimated loss of £1.14 billion (2019-20).
3. When NHSCFA uses the term ‘fraud’, we refer to a range of economic crimes, such as fraud, bribery, corruption or any other illegal acts committed by an individual or group of individuals to obtain a financial or professional gain.
4. NHSCFA also supports the work of the NHS Counter Fraud Service (Wales).
5. NHSCFA works closely with NHS Local Counter Fraud Specialists across the NHS in England to ensure that healthcare crime is tackled, and a culture of fraud prevention and deterrence is in place.
6. NHSCFA works collaboratively with NHS Scotland Counter Fraud Services on fraud issues.
7. There are some 300 professionally trained and accredited Local Counter Fraud Specialists in place within health bodies across England and Wales.