Procurement and commissioning fraud relates to allegations of collusion, bribery and corruption within the pre-tender stages of the procurement and commissioning process. It also relates to false, intentionally inflated or duplicate invoices within the post tender stages.
Pharmaceutical contractor fraud relates to false claims for either the dispensing of items or for one of the enhanced services offered at the pharmacy.
Patient fraud relates to an individual who is not entitled to free NHS treatment, services or medication but who purports to be exempt from paying for the costs of prescription charges, dental treatment and optical services.
NHS staff fraud relates to a member of staff who fraudulently inflates or falsifies their income, expenses or working hours for financial gain.
Fraud in relation to national tariff and performance data manipulation relates to the intentional falsification of data and the Payment by Result (PbR) system.
General Practice fraud relates to the manipulation of income streams or activities that violate contractual terms perpetrated by either practitioners or staff members.
European Health Insurance Card fraud occurs when overseas visitors claim for treatments under EHIC when they are not entitled to do so.
Optical Contractor fraud occurs when optical contractors (opticians) submit fraudulent claims to the NHS for a range of services provided to patients.
Dental Contractor fraud occurs when dental contractors (dentist) submit fraudulent claims to the NHS for a range of services provided to patients.
Fraudulent access to NHS care relates to foreign nationals who obtain free healthcare to which they are not entitled.
NHS Pension fraud relates to an individual who has either falsified their circumstances or failed to notify of a significant change in their circumstances to the pension administration.
Fraud against NHS Resolution relates to fraudulent accidents/ insurance claims under the Liabilities to Third Parties Scheme (LTPS) or through clinical negligence.
NHS Student Bursary Scheme fraud relates to false applications or the use of false documents to support a bursary application, other NHS funded training or financial support stream.
We estimate that the NHS is vulnerable to £1.21 billion worth of fraud each year.
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