NHS Counter Fraud Authority outlines four priority action areas for 2019-2020

Each year, the NHS Counter Fraud Authority (NHSCFA) sets a number of priority areas for action based on the organisation’s latest evaluation of available intelligence on the fraud risks facing the NHS. The Authority’s strategic intelligence assessment based on data for the 2017-2018 financial year forms the basis for its four priority action areas for 2019-2020, which are pharmaceutical contractor fraud, procurement and commissioning fraud, fraud in relation to general practice contractors and improving fraud outcomes within the NHS.

In terms of pharmaceutical contractor fraud, the NHSCFA will work in collaboration with the NHS Business Services Authority to identify key areas of loss to fraud and identify potential fraud by contractors providing community pharmacy services.

When it comes to procurement and commissioning fraud, the Authority determines to work with NHS organisations to measure fraud risk vulnerability indicators in the area of procurement fraud and develop updated prevention guidance. By working collaboratively with colleagues across the NHS, the NHSCFA aims to deliver work that will lead to a measurable reduction in procurement fraud.

The priority area of fraud in relation to general practice contractors will have a keen focus on GP capitation fees. The NHSCFA will work with colleagues in NHS primary care to increase confidence in assessments of the losses to fraud in this area and form a basis for fraud prevention activity.

Collaboration and engagement

Collaboration and engagement with those who manage delivery and support counter fraud provision in the NHS will be focused on the effectiveness of this work in terms of the financial impact of enforcement activity. There will be a drive to increase the number of sanctions imposed as a result of local counter fraud work and improve the quality of referrals enabling enforcement action to be taken..

Sue Frith, interim CEO of the NHSCFA, has explained that collaboration is a theme common to the organisation’s approach to all four priority areas. “By setting clear goals based on the national intelligence picture of fraud risks and working with colleagues across the NHS to deliver them, we can make absolutely sure that counter fraud work at both the national and local levels is focused on achieving measurable outcomes. In order to measure the impact of NHS counter fraud work, we will use a set of financial targets, which for the first time this year include a measure of the value of prevented fraud.”

The headline targets for 2019-20 are £22 million in detected fraud, £100 million in prevented fraud and £5 million in recoveries from fraud losses.

These priorities and targets are best understood alongside the NHSCFA’s 2019-2020 Business Plan, with its clear objectives around a number of core business activities.

Frith concluded: “We hope that measuring local and national counter fraud work against these targets will highlight the positive impact that tackling fraud has on NHS resources. By preventing fraud, identifying it and tackling it effectively where it occurs, and by seeking to recover moneys lost to fraud, we can ensure that precious NHS funds are used for their intended purpose of patient care.”

About the Author
Brian Sims BA (Hons) Hon FSyI, Editor, Risk UK (Pro-Activ Publications) Beginning his career in professional journalism at The Builder Group in March 1992, Brian was appointed Editor of Security Management Today in November 2000 having spent eight years in engineering journalism across two titles: Building Services Journal and Light & Lighting. In 2005, Brian received the BSIA Chairman’s Award for Promoting The Security Industry and, a year later, the Skills for Security Special Award for an Outstanding Contribution to the Security Business Sector. In 2008, Brian was The Security Institute’s nomination for the Association of Security Consultants’ highly prestigious Imbert Prize and, in 2013, was a nominated finalist for the Institute's George van Schalkwyk Award. An Honorary Fellow of The Security Institute, Brian serves as a Judge for the BSIA’s Security Personnel of the Year Awards and the Securitas Good Customer Award. Between 2008 and 2014, Brian pioneered the use of digital media across the security sector, including webinars and Audio Shows. Brian’s actively involved in 50-plus security groups on LinkedIn and hosts the popular Risk UK Twitter site. Brian is a frequent speaker on the conference circuit. He has organised and chaired conference programmes for both IFSEC International and ASIS International and has been published in the national media. Brian was appointed Editor of Risk UK at Pro-Activ Publications in July 2014 and as Editor of The Paper (Pro-Activ Publications' dedicated business newspaper for security professionals) in September 2015. Brian was appointed Editor of Risk Xtra at Pro-Activ Publications in May 2018.

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