1. Introduction
1.1 This document provides information and guidance on the NHS Counter Fraud Authority’s (NHSCFA) nomination process for local counter fraud specialists (LCFSs) and Local Counter Fraud Technicians (LCFTs). It is primarily for NHS and non-NHS healthcare organisations and for employers providing contracted counter fraud services to them. This document also provides guidance on the relevant legal and data handling requirements in relation to staff engaged as LCFSs and LCFTs working in and for healthcare organisations. Those undertaking these roles are expected to meet the required standards of propriety and probity. The guidance aims to help with ensuring that this is the case.
1.2 Historically, NHS bodies were required to put in place arrangements to counter fraud under Secretary of State Directions. Provisions introduced under the Health and Social Care Act 2012 mean that such arrangements are now set out in the NHS Standard Contract rather than in Secretary of State Directions. The commissioning contract and its clauses apply to all providers. Service Condition 24.2 requires those providers which are licensed by Monitor, and NHS Trusts, to take the necessary action to meet the standards set by the NHSCFA. The NHSCFA also issues counter fraud standards in conjunction with NHS England for commissioners. More information on these requirements, and on the standards developed by the NHSCFA, can be found at Introduction and overview of the new Government Functional Standard 013 for counter fraud.
1.3 The NHS Standard Contract is published by NHS England. The current version is available at https://www.england.nhs.uk/nhs-standard-contract/ Section 24 of Service Conditions contains information on counter fraud arrangements. The contract should be used by Integrated Care Boards (ICBs) and NHS England when commissioning NHS funded services.
2. Overview of the nomination process
Employer identifies a potential recruit for the post of LCFS. Pre-employment checks are undertaken by the employer in accordance with NHS Employers’ Employment Check Standards, including Disclosure and Barring Service (DBS) checks.
https://www.nhsemployers.org/your-workforce/recruit/employment-checks
The individual holds the Accredited Counter Fraud Specialist (for LCFS) or Accredited Counter Fraud Technician (for LCFT) qualification.
The individual holds the, ACFS qualification, following training delivered by another supplier, e.g. DWP.
It is also recommended to access the anti-crime standards for Providers and Commissioners,available on the NHS Counter Fraud Authority website
If the individual does not hold the ACFS qualification, full training is required irrespective of other qualifications held or experience.
Details of training providers for the ACFS course can be found at northumbria.ac.uk
Once the training is successfully completed, individuals as designated in this guidance must submit a nomination form together with a copy of their official course certificate.
The nomination form is available on the NHS Counter Fraud Authority website
On receipt of the completed nomination form, the NHS Counter Fraud Authority assesses the information provided and considers the nomination.
The nomination form is available on the NHS Counter Fraud Authority website
On acceptance of the nomination, the NHS Counter Fraud Authority provides the nominated LCFS or LCFT with the necessary IT system access.
3. Initial appointment
3.1 The responsibility for undertaking the required pre-employment checks before individuals are nominated to the LCFS or LCFT role rests with the employing organisation. Checks should be carried out in accordance with NHS Employers’ Employment Check Standards guidance (http://www.nhsemployers.org/your-workforce/recruit/employment-checks/nhs-employment-check-standards). This will include Disclosure and Barring Service (DBS) checks; further information on DBS checking is available in Appendix A.
3.2 The nomination process cannot be started until potential nominees have successfully completed all pre-employment checks (including relevant DBS checks) and accredited training.
4. Training overview
4.1 A potential nominee must complete training to obtain the Accredited Counter Fraud Specialist qualification before being nominated for the role. Once the training is successfully completed, individuals as designated in this guidance must submit a nomination form – see section 5.
4.2 Details of training providers can be found on the Counter Fraud Professional Accreditation Board (CFPAB) website at https://www.northumbria.ac.uk/business-services/cfpab. Please note that the NHSCFA does not offer this training at this time.
5. Nominations for Local Counter Fraud Specialists
5.1 The responsibility for nominating an LCFS falls to an accountable board member. This is usually the Director of Finance (Chief Finance Officer in some organisations) from the nominating provider/commissioning organisation. This includes nominations for a support LCFS for the organisation. ‘Lead’ LCFSs will not be able to independently nominate a support LCFS.
5.2 The nomination form is available on the NHS Counter Fraud Authority website.
5.3 The nomination form must be completed and signed by the nominee’s employer and an accountable board member (usually the Director of Finance/ Chief Finance Officer) of the nominating provider/commissioner) for the organisation being nominated to. Any failure to disclose the information required or return the nomination form in full will prevent an individual being approved as an LCFS. Please note that the accredited training certificate will also be required as proof of accredited status.
5.4 The nomination form consists of a declaration from the employer, the nominee and the nominating provider/commissioner and confirms that the employer has undertaken a full NHS Employment Check Standard recruitment process, including DBS checks, and that details of any irregularities have been provided.
5.5 If any discrepancy is identified during the employment check, it must be disclosed on the nomination form. The nominating NHS organisation will be required to provide an explanation.
5.6 The nomination form will be reviewed by the NHSCFA and a decision will be made as to whether the nomination will be accepted.
5.7 The final decision for accepting a nomination for the position of LCFS or LCFT sits with the NHSCFA and is subject to the employer undertaking all appropriate pre- employment checks. Decisions on the outcome of a nomination request will be communicated to the NHS organisation making the nomination. If a nominee wants to re-apply they can do so, provided they have addressed, if appropriate, the reason for their nomination failing originally.
5.8 Any changes to the nominee’s employer or NHS organisation, must be communicated to the NHSCFA using the nomination form. In all instances the employer and NHS organisation must complete a current LCFS nomination form.
5.9 Access to NHSCFA IT systems will not be granted until the nomination process has been completed in full and approved by the NHSCFA.
5.10 Access and use of NHSCFA IT systems is a requirement under NHSCFA policy and NHS counter fraud standards.
5.11 Not all individuals are suited to perform these specialist roles. It is for the nominating organisation and LCFS/LCFT employer to assure themselves that the nominee is a suitable candidate and has the appropriate background. Further information is provided in Annex B to assist this process. The nominating organisation can also contact the NHSCFA for further guidance if unsure as to the suitability of a potential nominee. Information on appropriate standards of conduct can be found at Annex C.
6. Nominations for Local Counter Fraud Technicians
6.1 The process for nominating a Local Counter Fraud Technician (LCFT) is the same as that used for the Local Counter Fraud Specialist (LCFS) but the range of tasks that the LCFT is able to do is reduced because of the limitations of their training.
6.2 To nominate an LCFT, use the standard nomination form which is available on the NHS Counter Fraud Authority website. The nomination form must be completed and signed by the nominee’s employer and an accountable board member (usually the Director of Finance/ Chief Finance Officer) for the health body that the nominee is being nominated to. See Section 5 for more details about the nomination process.
6.3 The nomination form is available on the NHS Counter Fraud Authority website.
6.4 The completed and signed nomination form must be sent to NHSCFA Nominations (the email address is on the nomination form) along with a copy of the LCFT nominee's accredited training certificate.
6.5 Once the nomination has been accepted by the NHSCFA, the LCFT will be granted access to NHSCFA IT systems. Use of these systems is a requirement under NHSCFA policy and NHS counter fraud standards.
6.6 While the LCFS undertakes the most important and complex of counter fraud activities, the LCFT can play an important support role while also building on their own counter fraud experience. This table shows the tasks that the LCFT will perform in comparison to the LCFS when working on criminal investigations.
| Criminal Investigation Tasks | LCFT | LCFS |
|---|---|---|
| Inputting information onto Fraud Case Management System | ||
| Planning and Conducting Interviews Under Caution* | ||
| Note taking | ||
| Planning and conducting a PACE search | ||
| Obtaining and Providing Witness Statements*♦ | ||
| Evidence gathering | ||
| Handling and recording evidence | ||
| Reporting Findings | ||
| Disclosure | ||
| Developing a counter fraud strategy | ||
| Developing an anti-fraud culture | ||
| Deterrence and prevention work | ||
| Recording Local Proactive Exercises (LPEs) | ||
| Recording System Weakness Reports (SWRs) |
* Unless for the purpose of training and development, and under the close supervision of a qualified investigator; or observing only.
♦ Unless for the purpose of demonstrating continuity of evidence within an MG11 statement.
6.7 A clear distinction has been made between the LCFT role and that of the LCFS so that LCFTs and their managers have a clear understanding of the limits of the role. Because of the limited scope of LCFT training in comparison with the LCFS, the LCFTs would not be suitable to carry out some of the tasks undertaken by LCFSs such as investigative work. The separation of roles must be adhered to so that the primacy of the LCFS in counter fraud operations is maintained.
7. Ongoing monitoring and information accuracy
7.1 The NHSCFA will carry out checks each quarter to ensure that the information and records it holds on LCFS and LCFT nominations are up to date and accurate.
8. Summary
8.1 The procedures outlined above are intended to ensure that the integrity of those employed to create and maintain a counter fraud culture throughout the NHS is beyond reproach. This is part of the NHSCFA’s overall approach to the deterrence and prevention of crime.