The NHSCFA estimates that the NHS is vulnerable to £9.5m worth of NHS Pensions each year. Please see our latest strategic intelligence assessment for more details
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. The NHS pension scheme is Europe’s largest pension scheme, paying pension payments, lump sum payments, widow and dependent payments, death gratuities, transfers out, and payments to other schemes and refunds.
The main fraud types in this category are:
- ‘Suppression of death’ fraud: which is when relatives intentionally fail to notify the NHS pension scheme that the pension recipient has died.
- Survivor pension fraud: where the recipient of the NHS pension deliberately fails to notify the NHS pension scheme of their remarriage or cohabitation with another person, which makes the continued payment of a pension no longer valid.
- Misrepresenting the state of health: where a pensioner lies about their state of health in order to obtain an NHS pension.
A Scheme member’s NHS pension benefits may be reduced to recover the loss to fraud associated with a criminal, negligent or fraudulent act or omission.
For a full list of fraud types in this category, please check NHS pensions in the fraud definitions.
To assist you on how to spot the signs of NHS pension fraud and how to stop this type of fraud, please see below.
Think prevention
- Have you informed NHS pensions of a change in circumstances that would affect your pension benefits?
- Are you in receipt of a pension payment you are not entitled to?
- Are you misrepresenting your circumstances to receive an NHS pension?
Further information
Case Study
An individual dishonestly continued to obtain their deceased mother’s NHS pension by deliberately failing to notify the NHS pension scheme of their mother’s death. The individual’s mother, who received an NHS pension as a ‘surviving partner’, died however the individual, who held a power of attorney, continued to receive payments.
The individual pleaded guilty to claiming almost £28,000 from their deceased mother’s NHS pension.
How to report fraud
Report any suspicions of fraud or attempted fraud to the NHS Counter Fraud Authority online at https://cfa.nhs.uk/report-fraud or through the NHS Fraud and Corruption Reporting Line 0800 028 4060 (powered by Crimestoppers). All reports are treated in confidence and you have the option to report anonymously. You can also report to your nominated Local Counter Fraud Specialist if you are an NHS employee or contractor.