New counter fraud requirements for NHS-funded services

The requirements will enable NHS organisations to meet Government Functional Standard GovS 013: Counter fraud

Published: 3 February 2021

Image of multiple devies all showing the new online standards service.

On 29 January 2021, the NHSCFA rolled out new counter fraud requirements for NHS-funded services in relation to the Government Functional Standard GovS 013: Counter Fraud. The NHSCFA worked closely with a wide range of stakeholders to ensure that the NHS Counter Fraud Requirements had greater consistency and remained for purpose for organisations, including providers and commissioners. The standards apply to all NHS funded services (those receiving partial or full NHS funding), currently including NHS Trusts, Foundation Trusts, Ambulance Trusts, Special Health Authorities, Clinical Commissioning Groups, certain Independent Healthcare Providers, Health Boards and NHS England & Improvement. These requirements also apply, subject to qualifying criteria, to any subsidiary company of an NHS Foundation Trust/ Trust.

The purpose of the Government Functional Standard is to set expectations for the management of fraud, bribery and corruption risk across government and wider public services, and to reinforce the government’s commitment to fighting fraud against the public sector.

The NHSCFA is responsible for leading and influencing the improvement of counter fraud standards across the NHS and will be responsible for ensuring the effective implementation of the NHS Counter Fraud Requirements. The requirements have superseded our own fraud, bribery and corruption standards for providers, commissioners and NHS bodies in England and Wales.

Using the new counter fraud requirements set out on our website, the NHSCFA will support organisations through regular benchmarking, compliance testing, evaluation of effectiveness and value for money indicators. The NHSCFA is required to provide assurance to the Cabinet Office of NHS compliance with the Functional Standard. This will be accomplished by the receipt and validation by the NHSCFA of the Counter Fraud Functional Standard Return submitted by organisations providing any NHS funded services. The Quality Assurance Programme will enable the analysis of trends and patterns in performance in relation to each requirement. As part of this process, the NHSCFA will be engaging with the NHS to review compliance later in the year.

The requirements and further information on the standard can be found on the new dedicated Government Functional Standard area on our website.

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