Optical contractor fraud

Optical contractor fraud occurs when optical contractors (opticians) submit fraudulent claims to the NHS for a range of services provided to patients.

The NHSCFA estimates that the NHS is vulnerable to £84.9m worth of Optical each year. Please see our latest strategic intelligence assessment for more details

Optical Contractor fraud occurs when optical contractors (opticians) submit fraudulent claims to the NHS for a range of services provided to patients; for example, by claiming for services which have already been paid for by the patient, by claiming for services not received by patients, carrying out re-tests for patients earlier than clinically recommended, requesting patients to have new glasses when they do not need new glasses.

For a full list of fraud types in this category, please check Optical practitioner or practice in the fraud definitions.

To assist you on how to spot the signs of optical contractor fraud and how to stop this type of fraud, please see below.

Think Prevention

  • Are you aware of optical contractors calling for unjustified early sight test recalls?
  • Are you aware of any claims being submitted for patients who did not receive claimed-for-services?
  • Are you aware of any claims being made to the NHS for a service that the patient has already paid for privately?

Further information

Case Study

The owner of two optical practices was jailed for 27 months having pleaded guilty to 6 offences of fraud by false representation. This involved defrauding the NHS of over £23,000 by charging for services they did not provide. Fraudulent claims for payment were submitted to the NHS on behalf of hundreds of patients whose signatures were falsified on the claim forms. The owner also failed to declare a criminal conviction when they applied to go on the ophthalmic lists.

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.

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