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Help to stamp out NHS fraud

Report any suspicions of corruption to the NHS Counter Fraud Service, urges Ahmer Kunwar

Fraud in the NHS is a serious problem and takes resources away from patient services. Now in its fourth year, Fraud Awareness Month started yesterday and runs until 9 December.

The NHS Counter Fraud Service (NHS CFS) developed the awareness month to persuade staff, patients and professionals that NHS fraud exists and to encourage them to report instances of suspected fraud. This year local counter fraud specialists have identified and are targeting areas in England and Wales where fraud and corruption awareness might be low and an anti-fraud culture needs to be developed.

During the month, the local specialists will provide doctors, including GPs, with details about how to report suspicions of fraud and illustrate the role they can play in its prevention. The NHS CFS has found instances of fraud in many areas of the NHS and general practice is no exception (see case study below).

We hope that by taking tough action we will deter potential fraudsters.

Instances of fraud

The vast majority of GPs and practice managers are honest, but there are individuals who try to defraud the health service. Instances of fraud committed by GPs include working while ‘off sick’, registering ghost patients and creating non-existent practice employees.

By working together with practices, the NHS CFS’s aim is to reduce fraud and corruption to the absolute minimum.

Over the next month, there will be local fraud awareness seminars for NHS staff and professionals.

Other activities include handing out leaflets to staff and patients and posting messages on local intranet sites. Posters for notice boards are available — contact your primary care organisation if you want to attend a seminar or get publicity materials for your practice.

The NHS CFS can recognise where a process is susceptible to fraud and take measures to prevent it happening again.

The NHS CFS has already achieved a great deal. Between 1999 and 2005 our activities produced a total financial benefit of £675 million to the NHS and cut overall losses from patient fraud by £171 million to £78 million a year.

Success rate

Our successful prosecution rate is a remarkable 96 per cent.

We have given more than 1,400 fraud awareness presentations to key NHS staff. Close to a million NHS staff and professionals are now covered by counter fraud charter agreements to work with the NHS CFS against fraud and corruption.

Last year, the fraud awareness month reached a total audience of 13 million people.

This year, it is expected to have a bigger impact nationally and internationally.

It will run alongside the European Healthcare Fraud and Corruption Awareness Campaign.

The last day of the campaign, 9 December, is also the United Nations Anti-Corruption Day which calls upon governments to take action against corruption. In 2004, 110 countries signed up to the UN Convention against Corruption.

The NHS CFS can do more than before to protect vital NHS resources.

To do so it is essential that you report any suspicions that you may have.

Ahmer Kunwar is internal and external communications manager at the NHS Counter Fraud Service, www.cfsms.nhs.uk

NHS Fraud and Corruption Reporting Line 0800 0284060

Case study: Practice manager jailed for £266,000 payroll fraud

A London practice manager was jailed for for two and a half years in July 2006 for paying herself a vastly inflated salary estimated at £266,000. She also made out practice cheques to herself.

The manager was responsible for all the practice’s financial records and for the staff payroll. When she retired, the new practice manager became suspicious of the previous expenditure on staff salaries and contacted the NHS CFS.

Its investigation revealed that the ex-manager had not only paid herself two salaries over the course of four years, but that both salaries were higher than she was entitled to. She covered up her crimes by falsifying records in order to spread the overpayments across other staff members’ salaries.

Between December 2003 and July 2004, she also made out eight practice cheques to herself totalling over £25,000. She entered most of the cheques in the practice accounts as payments to HM Revenue and Customs (formerly the Inland Revenue).

She was charged in March 2006 and pleaded guilty to 14 counts of obtaining a money transfer by deception and eight charges of false accounting. A further 45 deception offences were taken into consideration.

You can report any suspicion of fraud by contacting your LCFS or by calling the NHS Fraud and Corruption Reporting Line (0800 0284060) in confidence from Monday to Friday, 8am to 6pm. You can also email us at nhsfraud@cfsms.nhs.uk.

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