Catch me if you can

September 5, 2014

Fraudulent activity

I attended a meeting this week and one of the speakers was our local NHS Counter Fraud Officer. Whilst we assume we know where fraud could possibly be committed in Practice, mainly around prescriptions and medicines management, I was quite shocked to learn about other NHS fraud cases that could quite easily occur without us knowing until it was too late.

One of the most shocking recent cases was a group who diverted £642,000 of NHS cancer care money into their own personal bank accounts. Following a fraud investigation led by NHS Protect and supported by the Metropolitan Police Economic Crime, the group were sentenced to a total of over 14 years’ imprisonment.

Do you carry out checks?

Whilst this is an example of fraud on a substantial scale, it was surprising to learn how easy it is to be fooled by a fraudster on a day to day basis. How many of you actually check directly with a supplier when they notify you that they are changing their bank account details? There have been cases of fraudulent companies, or even employees sending written confirmation to customers using company paper but changing the usual bank details to a rogue bank account. It’s quite easy to assume that this is legitimate but it’s always advisable to check with the supplier.

NHS Protect

NHS Protect leads on work to identify and tackle crime across the health service. Their aim is to protect NHS staff and resources from activities that would otherwise undermine their effectiveness and their ability to meet the needs of patients and professionals. Ultimately, this helps to ensure the proper use of valuable NHS resources and a safer, more secure environment in which to deliver and receive care.

Under the NHS Standard Contract for 2014/2015, all organisations providing NHS services must put in place, and maintain, appropriate counter-fraud and security management arrangements.

Standards for providers

There are two documents which set out NHS Protect’s standards for fraud, bribery and corruption, and for security management. Both documents provide a detailed explanation of each standard and what providers need to comply with it. They also include an explanation of the background to the NHS Standard Contract 2014/2015, an overview of the standards, and an explanation of the quality assurance process.

Questions you should be asking about your Practice are:

How does the organisation ensure that the appropriate policies and procedures are fraud proofed and how is the success of fraud proofing measures in reducing fraud, bribery and corruption risks evaluated?
How does the organisation analyse information sources to identify risk?
How effectively does the organisation comply with fraud prevention statements and how is compliance monitored?
How does the organisation implement and evaluate pre and post employment checks for permanent, bank and agency staff?
How does the organisation put in place, and evaluate the success of, measures to mitigate potential frauds committed by staff, contractors and patients?