According to our latest estimate, the NHS is vulnerable to £1.264 billion worth of fraud each year.
As an intelligence-led organisation, the NHSCFA will use information from a wide range of sources to build a better understanding of the fraud risks faced by the NHS and develop creative, innovative and proportionate solutions to tackle fraud.
Our strategy 2023-2026
You can find more details about our approach to tackling NHS fraud and other economic crime in our Strategy 2023-2026 and Business Plan for 2023-26.
Strategic fraud-focused pillars
To achieve our vision, we have identified four fraud-focused pillars which will translate into delivery:
- we will understand how fraud, bribery and corruption affects the NHS
- we will ensure the NHS is equipped to take proactive action to prevent future losses from occurring
- we are equipped to respond to fraud
- we can confidently assure our key partners, stakeholders and the public that the overall response to fraud across the NHS is robust
At the heart of our approach is an ambition to ensure we are supporting our people to deliver counter fraud activity in the NHS using our resources whilst striving to identify and pursue opportunities for growth and innovation.
Our Strategic Pillars are aligned to the four objectives set out in the DHSC Counter Fraud Strategy 2023-26 which centres around minimising loss by demonstrating continuous improvement in preventing, detecting and recovery in the following key areas:
- proactivity and prevention
- utilising digital and data analytics
- collaboration and coordination
- response and enforcement
The NHSCFA is a centre of excellence employing specialists in intelligence, fraud prevention, computer forensics, fraud investigation, financial investigation, data analysis and communications. We provide a range of specialised services to tackle NHS fraud.
As an intelligence-led organisation, we use a wide range of information to build a more accurate picture of the fraud risks facing the NHS, to inform preventative action and to support investigations.
We investigate the most serious, complex and high-profile cases of fraud, and work closely with the police and the Crown Prosecution Service to bring offenders to justice. Our specialist financial investigators have powers to recover NHS money lost to fraud, and we have a digital forensic computing team who collect and analyse digital evidence.
We develop a range of targeted fraud prevention solutions to address identified fraud risks. This may include reviewing and redesigning whole systems or developing tailored guidance or other solutions.
The Fraud Hub has been developed to act as the focal point of contact between the NHSCFA and the counter fraud community across the NHS. Its purpose is to support and enable health bodies to tackle fraud in the most effective way.
People, workforce and development
Our people are the NHSCFA's most important asset. We are committed to developing a skilled workforce, in line with the government's counter fraud professional standards. We will develop our workforce through a range of initiatives including: a new Talent Management and Succession Planning approach to align our skills with organisational needs.
By raising awareness of fraud against the NHS and publicising the work of the NHSCFA, we encourage NHS staff, other stakeholders and the public to join the fight against NHS fraud.
Digitalisation and technology
We strive to be a digital by default organisation, using technology to make our work quicker, smarter and more data-driven.
We use complex algorithms and data mining tools as a means to identify both normal behaviour and outliers in NHS data, within which fraudulent behaviour can be found. The resulting analyses are used to support ongoing investigations as well as inform the intelligence picture and guide fraud prevention steps.