NHS Fraud

Fraud 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 2003 the NHS Counter Fraud and Security Management Service (CFSMS) was established.

Local Counter Fraud Specialists (LCFS) are established in all NHS Trusts 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 against the NHS, even if this is just a suspicion or a single piece of information, please pass it on to:

What is Fraud and how does it impact the NHS

Fraud is committed when a person deliberately makes a dishonest representation in order to make a gain or to cause a loss to someone else. For example, if someone stated on their expenses claim that they had travelled 50 miles when really they had only travelled 10, this would be fraud. The person has made a false representation in order to make a gain.

Fraud comes in many different forms. The NHS Counter Fraud Authority (NHSCFA) has produced a reference guide which provides loads of different examples of how the NHS can be affected by fraud – you can find the full guide here. At the latest estimate, it is believed that the NHS loses over £1.2 billion a year to fraud. NHS fraud diverts public funds away from the services that we all pay for, and into the pockets of dishonest people.

Reporting NHS fraud

If you have concerns about fraud you can report it through the following channels:

All reports will be dealt with confidentially. If you would prefer to make an anonymous report via the NHS Counter Fraud Authority hotline or web form, please provide as much detail as possible as the local team will not be able to get back in touch with you to ask for any further information or clarification about your concerns.

Examples of types of fraud

  • Patient Travel Expenses – a patient in receipt of qualifying benefits may claim travel expenses for secondary care appointments. If the person submits claims for additional journeys that they didn’t actually take, this would be fraud.
  • Mandate Fraud – a fraudster contacts an NHS finance team pretending to be a genuine supplier. They request that the suppliers’ bank details are updated, and the next payment made to the supplier is diverted into the fraudster’s bank account.
  • Working Whilst Sick – a person is signed off sick from their NHS role but then works elsewhere during their sick leave.

Fraud outside the NHS

Report tax evasion

Report benefit fraud

Report fraud and cyber crime

Scams

UK Visa and Immigration 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 https://www.gov.uk/government/publications/frauds-tricks-and-scams/fraud-tricks-and-scams.

The Metropolitan Police have released the 4th edition of their Little Book of Big Scams. They have also released a booklet called Little book of Cyberscams.

Who Pays for NHS Fraud

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