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NHS Requirements

This section lists each of the individual components of the new Government Functional Standard 013 Counter Fraud and provides detailed information on how they are to be applied across the NHS and wider health group.

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Component 1: Accountable individual

Have an accountable individual at board level who is responsible for counter fraud, bribery and corruption.
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Component 2: Counter fraud bribery and corruption strategy

Have a counter fraud, bribery and corruption strategy that is submitted to the centre.
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Component 3: Fraud bribery and corruption risk assessment

Have a fraud, bribery and corruption risk assessment that is submitted to the centre.
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Component 4: Policy and response plan

Have a policy and response plan for dealing with potential instances of fraud, bribery and corruption.
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Component 5: Annual action plan

Have a policy and response plan for dealing with potential instances of fraud, bribery and corruption.
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Component 6: Outcome-based metrics

Have outcome-based metrics summarising what outcomes they are seeking to achieve that year. For organisations with ‘significant investment’ in counter fraud or ‘significant estimated’ fraud loss, these will include metrics with a financial impact.
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Component 7: Reporting routes for staff, contractors and members of the public

Have well established and documented reporting routes for staff, contractors and members of the public to report suspicions of fraud, bribery and corruption and a mechanism for recording these referrals and allegations.
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Component 8: Report identified loss

Will report identified loss from fraud, bribery, corruption and error and associated recoveries, to the centre in line with the agreed government definitions.
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Component 9: Access to trained investigators

Have agreed access to trained investigators that meet the agreed public sector skill standard.
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Component 10: Undertake detection activity

Undertake activity to try and detect fraud in high-risk areas where little or nothing is known of fraud, bribery and corruption levels, including loss measurement activity where suitable.
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Component 11: Access to and completion of training

Ensure all staff have access to and undertake fraud awareness, bribery and corruption training as appropriate to their role.
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Component 12: Policies and registers for gifts and hospitality and COI

Have policies and registers for gifts and hospitality and conflicts of interest.
  • Functional Standard
  • Introduction and overview
  • NHS Requirements
  • NHS Standard Contract
  • NHSCFA Quality Assurance Programme
  • Mapping previous NHS counter fraud standards
  • Obligations of independent providers
  • Glossary of terms
  • Relevant pages
  • Protecting the NHS from fraud during COVID-19
  • Read our Covid-19 related fraud prevention advice and guidance
  • Request forensic computing work and services from the FCU
  • NHS pensions
  • NHS employees

We estimate that the NHS is vulnerable to £1.21 billion worth of fraud each year.

Report any suspicions or concerns about fraud against the NHS to the NHSCFA.

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