Countering fraud in the NHS
Impact of fraud on the NHS
It is estimated that the NHS loses £1.198 billion per year to fraud. Fraud takes taxpayers’ money away from patient care and puts it into the hands of criminals. The financial loss is enough to pay for over 40,000 staff nurses, or to purchase over 5,000 frontline ambulances.
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.
How does the Trust fight fraud?
AuditOne, the Trust’s counter fraud provider works closely with the trust to combat fraud. We have a team of experienced counter fraud specialists delivering a full range of counter fraud, bribery and corruption services including prevention, detection and investigation. Our professionally qualified counter fraud specialists work to identify potential fraud, bribery and corruption risks through policy and system reviews and suggest remedial action to reduce and mitigate these risks. We are experienced in carrying out timely criminal investigations, from referral to prosecution.
AuditOne is an NHS consortium providing counter fraud services to 15 NHS and independent healthcare provider organisations across the North of England. It is hosted by Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and is a not-for-profit organisation.
Who is the trust’s counter fraud specialist?
Counter Fraud Specialist
How we tackle fraud
The Trust has a suite of policies that focus on staff and organisational behaviour. By following these policies, staff working in or associated with the trust can help prevent fraud. These policies include:
The NHS Counter Fraud Authority (NHSCFA) has produced some useful reference and prevention guidance documents for NHS organisations. There are several fraud reference guides available which cover the following areas:
- NHS staff - This relates to a person working in, or for, the NHS in any capacity. This includes salaried employees, retired employees receiving an NHS pension, agency staff, trainees, contractors such as GPs, dentists, pharmacists, opticians and their organisations and any other contractors who work for the NHS in the same manner as an employee
- NHS patients - This relates to a patient, that is someone obtaining treatment, services or medication from the NHS. It may relate to someone using the NHS (either in the UK or abroad) to obtain medical, dental, optical or pharmacy services
- NHS suppliers - This relates to a person or organisation providing goods and/or services to the NHS. This can include contractors (individuals or companies), suppliers, or other organisations
- NHS systems - This relates to fraud in relation to financial accounting, performance, incentives or penalties or any other financial issue
- Third parties - This relates to a person or organisation not linked to the NHS but trying to gain financially from it. This would include a third party making unsolicited requests for payment from the NHS or someone using an NHS facility to which they are not entitled
There are also eight quick guides which covering different types of procurement frauds to aid prevention of these types of fraud:
How to report fraud
If you suspect fraud is occurring, you can help by reporting your suspicions confidentially to the counter fraud specialist.
Follow these simple guidelines when reporting your suspicions:
- Do make an immediate note of your concerns
- Do deal with the matter promptly if you feel your concerns are warranted
- Don’t do nothing
- Don’t be afraid to raise your concerns
- Don’t approach or accuse individuals yourself
- Don’t try to investigate the matter yourself
Contact our Counter Fraud Specialist
The trust’s counter fraud specialist can be contacted via the following:
Fraud Hotline: 0191 441 5936
You can also report suspicions of fraud to the director of finance, Tarryn Lake.
Contact the National Fraud and Corruption reporting line
Alternatively, you can phone the National Fraud and Corruption reporting line on 0800 028 40 60.
All calls are made in strictest confidence and no attempt will be made to persuade you to provide your personal details if you want to remain anonymous. You will be given a call reference number which you can quote if you phone again with additional information.
Counter Fraud Champion
Each NHS organisation is required to nominate a counter fraud champion (CFC) whose role is to support the counter fraud specialist in promoting awareness of fraud across the trust. The trust’s CFC is Judith Hurrell who is the Associate Director of Financial Services. Staff should be aware that CFCs are not authorised to investigate allegations of fraud, therefore, staff should not report suspicions of fraud to their CFC.
Fraud Insight newsletter - July 2023
Fraud awareness videos: