The NHS Counter Fraud Authority (NHSCFA) is a health authority charged with identifying, investigating and preventing fraud and other economic crime within the NHS and the wider health group.
As a health authority focused entirely on counter fraud work, the NHSCFA is independent from other NHS bodies and directly accountable to the Department of Health and Social Care (DHSC).
Our vision is to lead and proactively support the NHS to understand, find, prevent and respond to fraud
Our purpose is to:
- Provide leadership and expertise in counter fraud as a valued NHS partner
- Collaborate nationally and locally with the NHS to understand fraud threats, vulnerabilities and enablers
- Deliver intelligence-led counter fraud services to find, respond to and prevent fraud
- Reduce the impact of fraud on the NHS
- Work with partners to deliver financial savings that can be reinvested in patient care
The NHSCFA's departmental sponsor is the Department of Health and Social Care Anti-Fraud Unit (DHSC AFU), which holds the NHSCFA board to account for the delivery of its strategy. Statutory Instrument 2017 No 958 sets out the establishment and constitution of the organisation. Schedule 2, parts 1 and 2, details the requirements for specific roles which make up our board. To find out more about the role of the NHSCFA board and its members please see the NHSCFA Board of Directors Section.
Our remit covers the NHS and the wider health group in England. In Wales we provide specialist counter fraud support functions to the Welsh Government under section 83 of the Government of Wales Act 2006. Please see the NHS Counter Fraud Service Wales page for more details.
The Evolution of the NHSCFA
We're all emerging from an incredibly testing time for the NHS. A global pandemic is, for the healthcare sector, at least the equivalent of a world war and the consequences will be felt by all NHS colleagues for some time as economies, worldwide, now pivot to cope with the economic and wellbeing toll.
Our CEO, Alex Rothwell, is currently embarking on a testing programme of stakeholder relationship-building sessions. This journey slide is one he’ll be sharing widely. At times like this, it’s worth taking a look back on the roots of the community in which we operate, for what is any organisation but a collection of people gathered together to serve a common purpose, in our case a community dedicated to protecting the NHS from the fraudulent abuse of public funds that should be directed to front line care?
Directorate of Counter Fraud Services (DCFS) created and assigned with overall responsibility for all the work to counter fraud and corruption undertaken in the NHS
Inclusion of the Counter Fraud Operational Service (CFOS) providing a regional investigative capacity
NHS Counter Fraud and Security Management Service (NHS CFSMS), set up as a special health authority an arm’s length body of the Department of Health, to protect the staff, assets and resources of the NHS in England and Wales
NHS CFSMS was amalgamated into the NHS Business Services Authority (BSA) to be part of a single special health authority
The CFSMS division of the NHSBSA is renamed NHS Protect with its counter fraud function aligned to the development and delivery of the DHSC anti-fraud strategy
NHS Protect achieves its first million pound recovery with Dentist Joyce Trail required to pay back £1.4million she had defrauded from the NHS
NHS Finance Manager Barry Cosson ordered to pay back £2.1 million defrauded from his NHS employer
Four NHS Clinical specialists ordered to pay back £520,000 they had conspired to defraud from the NHS
The NHS Counter Fraud Authority (NHSCFA) is created as a new special health authority charged with identifying, investigating and preventing fraud and other economic crime within the NHS and the wider health group (removing responsibility for the protection of staff in the NHS)
First NHSCFA strategy. Organisation establishes itself as a leader in counter fraud
£126m financial benefit achieved (2019-20)
The NHSCFA increased their profile with 'Fraud Squad NHS' BBC One TV documentary series
NHSCFA remit renewed by parliament for another three years
Current strategy target of £400m overall financial benefit
£54m achieved in 2020-21 (against target of £50m)
Evolution Programme starts
Stakeholder Engagement programme launched
Clue implemented across NHS
Appointment of new Chief Executive, Alex Rothwell
Ongoing evolution development of new NHSCFA strategy
Our timeline, albeit relatively brief, shows how we have evolved to face past challenges like recessions, austerity and hardship. It also reminds us that we need to keep looking forward, to keep adapting to remain future fit and it’s here where our strategy comes in.
The organisation is continuously evolving to keep fraud in check. Our current organisation structure is available to view in PDF format.
At no stage in this timeline were we ever alone. The NHSCFA is an enabling function, a facilitator and orchestrator of the local counter-fraud effort within the NHS Trusts. Our timeline is a reminder of the links in that chain and how important that golden thread of dedication and collaboration will be moving forward.
Hopefully, publishing this now will prompt those who explore our journey to consider the part they played in the past, play now and will play in the future as there will be rewarding and testing times ahead for us all.