According to our latest estimate, the NHS is vulnerable to £1.21 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.
Leading the fight against NHS fraud: our strategy 2017-2020
You can find more details about our approach to tackling NHS fraud and other economic crime in our 2017-2020 strategy document 'Leading the fight against NHS fraud'.
The NHSCFA's five main objectives for 2017-2020 are to:
- Deliver the Department of Health and Social Care strategy, vision and strategic plan and lead counter fraud activity in the NHS in England
- Be the single expert intelligence led organisation providing a centralised investigation capacity for complex economic crime matters in the NHS
- Lead and influence the improvement of standards in counter fraud work across the NHS
- Take the lead in and encourage fraud reporting across the NHS and wider health group
- Continue to develop the expertise of staff working for the NHSCFA.
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 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.
We set standards for counter fraud work across the NHS. We assess commissioners and providers of NHS services for compliance with the standards through our quality assurance programme.
Staff and organisational development
Our staff 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 carry out internal quality assurance, ensuring continued compliance with legislation and professional standards.
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.