Countering Fraud in the NHS

Fraud, bribery and corruption within the NHS is unacceptable and diverts valuable resources away from patient care.

Measures to counter NHS fraud were established in 1998, and in 2006 the NHS Counter Fraud and Security Management Service (CFSMS) became part of the NHS Business Services Authority. From 2011 NHS Protect leads on a wide range of work to protect NHS staff and resources from crime; a link to NHS Protect is below.

Local Counter Fraud Specialists (LCFS) are established in all NHS organisations to assist in reducing fraud and corruption to the absolute minimum, and they can only do this with your help. If you are aware of potential fraud or corruption concerning anyone within the CCG, even if this is just a suspicion or a single piece of information, then it is your responsibility to pass this information to your LCFS. LCFS are also responsible for raising awareness of NHS fraud issues locally and are available to speak to staff groups and deliver presentations as appropriate.

By ensuring that we all understand what healthcare fraud may look like, we increase the chances of reducing the threat instead of feeling the effects. If you haven’t already, check out the Recognise What Fraud Looks Like video.

For more information about Countering Fraud in the NHS, please visit the NHS Protect website.

The Fraud Team

You can contact the Fraud Team at East Coast Audit Consortium, Crosskill House, Mill Lane, Beverley, HU17 9JB, tel (01482) 866800, fax (01482) 882992 or individually,

Shaun Fleming, Counter Fraud Manager, shaunfleming@nhs.net on 07919 545250 or
Nikki Cooper, Local Counter Fraud Specialist, nikki.cooper1@nhs.net on 07872 988939.

Alternatively, you can forward information to the National Fraud and Corruption Hotline by calling 0800 028 40 60 or you can complete an online reporting form.

The action that you take when you first suspect fraudulent activity may be crucial; do not try to investigate the matter yourself. Attempts to gather evidence by people who are unfamiliar with the law may destroy the case. You will not suffer any recriminations as a result of voicing a reasonably held suspicion. You can remain anonymous if you wish.

LCFS are also responsible for raising awareness of NHS fraud issues locally and are available to speak to staff groups and deliver presentations as appropriate.

Bribery Act 2011

On 1 July 2011 the Bribery Act came into force. This Act makes it a criminal offence for organisations to fail to prevent bribes being paid on their behalf. As a CCG it is important that we fully comply with this Act and that all our staff are aware of what their responsibilities are and the standards of behaviour expected of them.

Dr Peter Melton, Chief Clinical Officer, has produced a statement regarding the Bribery Act. There are also some guidelines from NHS Protect, the NHS Counter Fraud Service, explaining the Act at top level along with what you should do if you are concerned about any bribery within the CCG.

There are a number of key points that all staff should be aware of, and these are:

• The Act covers both the offer of a bribe and being bribed
• Bribery can be defined as “offering an incentive (usually monetary) to someone who can take a decision or action on behalf of others in order to influence that decision”
• It is an offence not only to give, offer, request or receive a bribe, but also to turn a blind eye to bribery within an organisation
• It is an offence to fail to prevent bribery
• Penalties for bribery are severe for both the individual and potentially the organisation

Fraud outside the NHS

For more information and to report other types of fraud, such as benefit fraud or tax evasion, please see:

Report benefit fraud
Report tax evasion
Report any other fraud concerns

Scams

The UK Border Agency have put together a list of the latest tricks and scams in use and gives you advice on protecting yourself. To view the scams, please visit http://www.ukba.homeoffice.gov.uk/aboutus/scams/

The tax office have details of phishing emails on their website, please see http://www.hmrc.gov.uk/security/examples.htm

Related pages

East Coast Audit Consortium Fraud Website
Met Police - Little Book of Big Scams
National Anti-Fraud Network
NHS Protect

Related downloads


Counter fraud presentation

Local Anti Fraud Bribery and Corruption Policy

NHS Protect fraud leaflets and posters

Rogue publishers - What to look out for

Eliminating Public Sector Fraud.pdf

The Sentinel Newsletter - Christmas 2015