Reporting 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.

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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.

The role of the LCFS

Humber Teaching NHS Foundation Trust has a dedicated Local Counter Fraud Specialist (LCFS). The role of the LCFS has several strands, and is overseen by the Executive Director of Finance at a local level, and by the NHSCFA at a national level. Your LCFS will ensure your employer is meeting the standards set by the NHSCFA that policies and procedures are fraud proof, and that staff are encouraged and enabled to learn more about NHS fraud. The LCFS is also responsible for investigating allegations of fraud, bribery and corruption. Your LCFS is here to help. If you have concerns about fraud affecting the NHS, please do get in touch with them for advice.

Your Local Counter Fraud Specialist

Nikki Cooper
Email: nikki.cooper1@nhs.net
Tel: 01482 866800 / 07872 988939  

Reporting fraud

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

  • Directly to your LCFS using their contact details listed above
  • Directly to the Executive Director of Finance, Pete Beckwith
  • By contacting the NHS Counter Fraud Authority reporting line on 0800 028 4060
  • By completing an online report: https://reportfraud.cfa.nhs.uk/ 

All reports will be dealt with confidentially. Please note that the best route for reporting is to speak to your LCFS. If you would prefer to make an anonymous report via the NHSCFA hotline or web form, please provide as much detail as possible as the LCFS 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.

How to arrange a presentation/awareness session

One of the simplest ways you can help to counter fraud in the NHS is to organise a fraud awareness presentation for your team. We are always happy to speak to different teams across the NHS. We can tailor our presentations to cover the specific fraud risks you are most likely to encounter, and will fit around your team’s availability. If you would like to arrange a session, please contact Nikki using her contact details above.

A list of the training sessions we can offer

  • Fraud Awareness 30 minutes – suitable for all departments and staff groups
  • Fraud Awareness 60 minutes – a more in depth look at fraud in the NHS, suitable for all staff
  • Recruitment Fraud Awareness – for HR teams and recruiting managers
  • Procurement Fraud Awareness – Procurement/Finance Teams
  • Mandate Fraud and Phishing Refresher – suitable for all staff but most applicable to finance teams
  • We would be happy to deliver any other bespoke training for you, or to pop along to a team meeting for an informal chat. We are able to offer training remotely via Microsoft Teams. Please contact your LCFS to discuss any training needs and we would be happy to help

The role of the fraud champion & who the Fraud Champion is

  • The role of the Fraud Champion is to raise awareness of fraud, to understand the risks posed by fraud, and to understand best practice in countering fraud. TheFraudChampionandtheLCFS work closely to ensure that efforts are coordinated and effective.TheFraudChampionforHumber Teaching NHS Foundation Trust is:
    • Name Iain Omand, Deputy Director of Finance and Contracting
    • Contact email iain.omand@nhs.net

Think FRAUD:

  • F – Find the contact details for your LCFS
  • R – Report your concerns
  • A – Ask the LCFS to talk to your team
  • U – Use your LCFS for advice and information
  • D - Don’t try to investigate the matter for yourself

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