The NHSCFA estimates that £189.1m of NHS funding is vulnerable to data manipulation fraud. Please see our latest strategic intelligence assessment for more details.
Data manipulation fraud includes falsifying data to meet targets, increase revenue or hiding undesirable outcomes, including within A&E. It encompasses the ‘2023 - 2025 NHS Payment Scheme’ (NHSPS) and the four different payment mechanisms it governs within secondary care.
For a full list of fraud types in this category, please check NHS systems in the fraud definitions.
To assist you on how to spot the signs of Data manipulation and how to put measures in place to stop this type of fraud, please see below.
Think Prevention
- Are diagnoses and procedures being recorded more than once, unnecessarily or is a more expensive diagnosis / treatment being used (up-coding)?
- Are patients being transferred to avoid extended waiting times? For example, in Accident & Emergency with the use of diagnostic holding centres or clinical decision units.
- Is there an intentional delay in discharging patients, including patients being deliberately kept in hospital / care for an extended period of time, or are records of patient stays being manipulated?
- Is a different date to the actual date of an appointment being input?
- Are lists for hospital facilities being closed when they are not filled and excluded from reporting?
Further information
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.