The NHSCFA estimates that the NHS is vulnerable to £65.9 million worth of Dental Contractor fraud each year.
Dental Contractor fraud occurs when dental contractors (dentist) submit fraudulent claims to the NHS for a range of services provided to patients: for example, by claiming for services not received by patients, splitting courses of treatment, claims for patients who do not exist or carrying out unnecessary treatments.
For a full list of fraud types in this category, please check Dentist or Dental Practice in the fraud definitions.
To assist you on how to spot the signs of dental contractor fraud and how to stop this type of fraud, please see below.
- Are you aware of dental contractors claiming a higher level of treatment than the patient received?
- Are you aware of claims being made to the NHS for a service that the patient has already paid for privately?
- Are you aware of claims marked as exempt where the patient paid for the treatment?
Case study 1
A dentist was sentenced to 12 months' imprisonment and suspended for 12 months for fraud against the NHS.
The dentist defrauded the NHS of at least £24,000 when she was the co-owner of a Dental practice, and where she practised as a dentist. An investigation uncovered that the dentist had submitted multiple false claims for payment deliberately inflating the Units of Dental Activity (UDAs) she had delivered to make more money from the NHS.
This involved claims to the NHS for what were single courses of treatment to maximise her income, submitting a separate claim for an examination and then additional claims for fillings, crowns or dentures. Investigators spotted notes on records which were reminders to enter false treatment dates on the related claim forms. The dentist also made bogus claims for work that was never done at all.
The dentist was ordered to pay back the entire amount before sentencing and voluntarily paid the NHS a further sum of over £10,000 to cover other erroneous claims made.
Case study 2
A Birmingham dentist was jailed for seven years in 2012 for stealing £1.4 million from the NHS. The dentist submitted over 7,000 false claims for payment to the NHS, for work she had not performed including for deceased patients and patients she had never met. Almost 75% of the payments made under her NHS contract were based on false claims. She was found guilty of conspiracy to defraud the NHS and later pleaded guilty to intending to pervert the course of justice.
How to report fraud
Report any suspicions of fraud or attempted fraud to the NHS Counter Fraud Authority online at https://cfa.nhs.uk/reportfraud 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.