The NHS Standard Contract published by NHS England, should be used by Clinical Commissioning Groups (CCGs) and NHS England when commissioning NHS funded services including acute, ambulance, care home, communitybased, high secure and mental health and learning disability services. CCGs must also use the NHS Standard Contract for all community-based services provided by GPs, pharmacies and optometrists that have been previously commissioned as Local Enhanced Services.

The counter fraud clauses are set out in Service Condition 24 and place the follow obligations on providers of NHS services:

Contractual arrangements are subject to final confirmation after the results of NHS England’s consultation

  • Service Condition 24.1 The Provider must put in place and maintain appropriate ,measures to prevent, detect and investigate fraud, bribery and corruption, having regard to NHSCFA Requirements.
  • Service Condition 24.2 If the Provider
    • 24.2.1 is an NHS Trust; or
    • 24.2.2 holds licensed by Monitor's Licence (unless required to do so solely because it provides Commissioner Requested Services as designated by the Commissioners or any other commissioner),
    it must take the necessary action to meet NHSCFA Requirements, including in respect of reporting via the NHS fraud case management system.
  • Service Condition 24.3 If requested by the Co-ordinating Commissioner, or NHSCFA or any Regulatory or Supervisory Body, the Provider must allow a person duly authorised to act on behalf of NHSCFA, on behalf of any Regulatory or Supervisory Body or on behalf of any Commissioner to review, in line with the NHSCFA Requirements, the counter-fraud measures put in place by the Provider.
  • Service Condition 24.4 The Provider must implement any reasonable modifications to its counter-fraud arrangements required by a person referred to in SC24.3 in order to meet the NHSCFA Requirements within whatever time periods as that person may reasonably require.
  • Service Condition 24.5 On becoming aware of any suspected or actual bribery, corruption or fraud involving NHS-funded services, the Provider must promptly report the matter to its nominated Local Counter Fraud Specialist and to NHSCFA.
  • Service Condition 24.6 On the request of the Department of Health and Social Care, NHS England, NHS Improvement, NHSCFA, any Regulatory or Supervisory Body or the Co-ordinating Commissioner, the Provider must allow NHSCFA or any Local Counter Fraud Specialist nominated by a Commissioner, as soon as it is reasonably practicable and in any event not later than 5 Operational Days following the date of the request, access to:
    • 24.6.1 all property, premises, information (including records and data) owned or controlled by the Provider; and
    • 24.6.2 all Staff who may have information to provide,
    relevant to the detection and investigation of cases of bribery, fraud or corruption, directly or indirectly in connection with this Contract.

The standards referenced in Service Condition 24.2 are explained in the NHS requirements section.