On a basic level, fraud is deception carried out for personal gain, usually for money. Fraud can also involve the abuse of a position of trust. By ‘NHS fraud’ we mean any fraud where the NHS is the victim. We all recognise that fraud is a growing threat both internally and externally. Fraud costs the NHS £1.27 billion each year. The Trust is dedicated to reducing the level of fraud to an absolute minimum and to taking action against those who have committed fraud.
Fraud is defined as any dishonest false representation, failure to disclose information or abuse of position (Fraud Act 2006).
Bribery and corruption are where someone is influenced by bribery, payment or benefit-in-kind to unreasonably use their position to give some advantage to another.' (Bribery Act 2010)
Anyone can commit fraud against the NHS. People investigated include doctors, nurses, administration staff, managers, health care professionals, dentists, opticians, pharmacists, patients, directors, GPs and overseas patients.
Examples of fraud (list not exhaustive)
The types of fraud investigated in the NHS include the following:
- false time recording (overtime, flexi time, enhanced hours etc)
- false qualifications/professional registrations
- working while sick
- claiming additional or fictitious expenses
- false charge exemptions
- mandate fraud
- contractor claims
- employees not having the correct or legitimate right to work documents
- employees having expired right to work documents
- procuring of goods and services in an non-transparent and dishonest manner
- commissioners claiming for services in respect of factious or ghost patients
- false identity
What to do:
- Tell someone who knows what to do with your allegation (LCFS/NHSCFA)
- Be aware of fraud and bribery issues
- Make a note of any concerns
- Keep a record or copy any documentation that arouses your suspicion
What not to do
- Confront the individual
- Try to investigate the matter yourself
- Contact the police directly
- Convey your suspicions to anyone other than those with proper authority to investigate
The trust adopts a zero tolerance approach towards fraud being perpetrated. Therefore, if you have any concerns about fraud, bribery or corruption within the NHS, or need fraud related advice, you can contact your Local Counter Fraud Specialists (LCFS):
- Natalie Nelson on 020 3201 8358 or at firstname.lastname@example.org / email@example.com
- Matt Wilson on 07484 040 691 or at firstname.lastname@example.org / email@example.com
Alternatively, you can contact the NHS Fraud and Corruption Reporting Line on 0800 028 40 60 (this is a free phone service and lines are open Monday to Friday from 8am-6pm), via the online reporting form at NHS Counter Fraud Authority.
All referrals/discussions will be dealt with sensitively and in a professional and confidential manner.