| Term | Definition / Responsibility |
|---|---|
| NHS Requirements | The NHS Requirements are the expected, agreed levels of responsibilities and outcomes of counter fraud activity needed to meet the Government Functional Standard GovS 013: Counter fraud. |
| Counter Fraud Functional Standard Return (CFFSR) | The organisation shall produce an annual summary of counter fraud work conducted over the previous twelve months to meet the requirements of the Functional Standard. This will be submitted to NHSCFA by a specified deadline. |
| Independent Healthcare Provider (IHP) | An IHP is a provider of health care services that is neither owned or managed by the NHS. However, if contracted by the NHS to provide healthcare services and meet the criteria of SC24 of the NHS Standard Contract by having a monitor licence and receive over £10 million in NHS income each year under the NHS Standard Contract, they must meet the NHSCFA Requirements for Fraud, Bribery and Corruption. |
| Nominations process | The process required for a Local Counter Fraud Specialist, Chief Finance Officer / Director of Finance, Audit Committee Chair and Counter Fraud Champions to become recognised by the NHSCFA as the responsible person(s) for the assigned role. The nomination process grants the nominated person(s) access to NHSCFA IT systems as required for their nominated role. |
| Engagement | This includes all interactions between the NHSCFA and organisations that require a response or activity to be conducted by the Organisation, CFO / DOF or LCFS. |
| Fraud | Refers to a range of economic crimes, such as fraud, bribery and corruption or any other illegal acts committed by an individual or group of individuals to obtain a financial or professional gain. |
| Counter Fraud Champion | A person who is senior within the organisation and has enough influence to raise awareness of fraud, at a minimum of an NHS band 8a role. They must be directly employed by the organisation that they represent. The role is to promote and support the fight against fraud at a strategic level. |
| Counter Fraud Strategy | A defined approach for how the organisation will counter fraud, bribery and corruption over a 2 to 5 year period. |
| Approved NHS Fraud Case Management System | This is the only case management system that is to be used to record all NHS counter fraud work. It will be used for the purpose of benchmarking and/ or the provision of data to stakeholders including: Cabinet Office, Department of Health and Social Care and Ministers. This is a service condition of the NHS Standard Contract. |
| Allegation Report | An initial report which may concern an allegation of fraud against the NHS. |
| Investigation | An incident which has been promoted to an investigation as it meets the threshold for a criminal investigation. |
| Proactive work | Proactive work is defined as anything other than reactive work (investigations) and results from an organisational specific risk assessment identifying counter fraud activity required to deter, detect or prevent fraud, bribery and corruption. |
| Reactive work | Investigations |
| Local fraud risk assessments | Organisational specific detailed risk assessments of fraud bribery and corruption using the Government Counter Fraud Profession (GCFP) fraud risk assessment methodology. |
| Local proactive exercise | An organisational specific risk assessment based exercise designed to deter, detect or prevent fraud, bribery and corruption. |
| Fraud Risk Knowledge Hub | for all things relating to fraud risk assessment and the impact that they can have. |
Glossary of terms
An alphabetical list of terms and phases specific to the Functional Standard and NHS Requirements
Published: 16 December 2022