Counter Fraud and Security Management Service

COUNTERING FRAUD IN THE NHS

The NHS Counter Fraud Service (NHS CFS) was  established in September 1998, with the remit to counter all fraud and corruption wherever it exists throughout the NHS.

From April 2003, the remit of the NHS CFS was  expanded to include  Security Management work and is  part of a Special Health Authority – the NHS Counter Fraud and Security Management Service (CFSMS).

THE STRATEGY

To reduce fraud & corruption in the NHS to an absolute minimum, hold it there permanently and free up resources for patient care and services

Via:

DEVELOPING AN ANTI- FRAUD CULTURE;

MAXIMUM DETERRENCE OF FRAUD;

SUCCESSFUL PREVENTION

of fraud which cannot be deterred;

PROMPT DETECTION

of fraud which cannot be prevented;

PROFESSIONAL INVESTIGATION

of detected fraud;

Effective:

SANCTIONS,

 including appropriate legal action against people committing fraud;

and effective methods for seeking:

REDRESS

in respect of money defrauded.

Reporting Fraud

In reporting a case of suspected fraud and/or corruption in the NHS, some dos and don’ts;

Do:

·         Ring the NHS Fraud and Corruption Reporting Line on 08702 400 100; or

·         Report your suspicions to your Local Counter Fraud Specialist named on this leaflet .

·         Report your suspicions as soon as possible

·         Remain vigilant at all times.

·         Remember that fraud and corruption can make victims of us all

Don’t:

·         Ignore your suspicions

·         Investigate anything yourself

Always remember:

·         Your calls to the NHS Fraud and Corruption Reporting Line will be treated in strict confidence

·         We all have a responsibility to report any suspicions of fraud and/or corruption

·         Arrangements are in place for the proportionate, independent and professional investigation of allegations of fraud and/or corruption in the NHS

Some Examples of NHS Fraud

Health Bodies

This may include payroll fraud, time sheet or contractor fraud, I.T. and telecommunications abuse, patients or staff making false claims for expenses.

Pharmaceutical Fraud

May include false prescription charge exemption claims, fraudulent invoicing by appliance contractors, pharmacists or GPs claiming for work not undertaken, alterations of prescriptions by patients or pharmacists.

Dental Services Fraud

May include over-claiming, claiming for work not undertaken, recalled attendance fraud, creating ghost patients for increased fees.

Optical Services Fraud

May include claiming for eye tests not undertaken, extra tints, small frames, domiciliary visits.

General Medical Services Fraud

May include out of hours visits not undertaken, manipulation of fees and allowances, fraudulently claiming for advice not given or treatment not made; and research fraud.

Countering Fraud in the NHS

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

Do you have a suspicion of a fraud taking place within the NHS? If so, any genuine information which you may have can be given to a Fraud & Corruption Reporting Line on 08702 400 100.

All calls received will be treated in confidence by trained staff and any information professionally assessed and evaluated.

For further information and/or to report a suspected fraud:

NHS Counter Fraud Service
Central Unit
Weston House
246 High Holborn
London WC1V 7EX

email:
www.cfsms.nhs.uk

 Or

The NHS Counter Fraud Service Regional Office at:

Or

Your Local Counter Fraud Specialist at:

More information can also be found on the Counter Fraud and Security Management Service (CFSMS) website: www.cfsms.nhs.uk

Last Modified: September 2004