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Anti-Fraud and Corruption

The Clinical Commissioning Group has an Anti-Fraud Team you can contact if you suspect NHS Services are subject to fraud or corruption.

How to Report Fraud

There are a number of ways that you can report any concerns you have concerning the Clinical Commissioning Group. You can report your concerns directly to the Anti-Fraud Team or to the Nominated Anti-Fraud Lead for the Clinical Commissioning Group:

Anti-Fraud Team Contact Details:
Telephone: 02476 536880
Email: antifraudteam@cwaudit.org.uk

Nominated Anti-Fraud Lead for the Clinical Commissioning Group Contact Details:
Telephone: 07774 332 914
Email: caine.black@cwaudit.org.uk or caine.black@nhs.net (secure)

Alternately you can report your concerns to the NHS Counter Fraud Authority, (the National Body responsible for combating fraud and economic crime across the NHS):

Telephone: 0800 028 40 60 (24 hours).
Alternately you can complete the online anonymous reporting form: https://cfa.nhs.uk/reportfraud.

When You Report Your Concerns:

  • All reported concerns will be treated sensitively and in the strictest of confidence.
  • You can report your concerns anonymously.
  • All concerns will be investigated, and where appropriate, the offenders prosecuted. It may be necessary to involve the police in any investigation.
  • Fraud and corruption in the NHS reduces the resources available and can affect the services provided to patients and the quality of care.

Anti-Fraud and Corruption FAQs

What is Fraud?
For an offence to have occurred, the person must have acted dishonestly with the intent of making a gain for themselves or for anyone else, or inflicting a loss (or risk of loss) on another. In January 2007 The Fraud Act came into force and introduced three main fraud offences:

  • False representation
  • Failure to disclose information
  • Fraud by abuse of position

Offences proven under the Fraud Act carry strong sentences on Summary conviction; (Magistrates Court) imprisonment up to a maximum of 12 months or an indictment (Crown Court) imprisonment up to a maximum of 10 years. Fines can also be imposed by either court. When investigating offences against the Clinical Commissioning Group, the Anti-Fraud Team will also rely on other legislation including, the Theft Act 1968, Computer Misuse Act 1990, Criminal Procedure and Investigation Act 1996, and the Police and Criminal Evidence Act 1984, when establishing if an offence has occurred.

What is Bribery?
The Bribery Act reforms the criminal law of bribery, making it easier to tackle this offence proactively in the public and private sectors. In July 2011 The Bribery Act came into force and introduced three main bribery offences:

  • Offering, promising or giving a bribe to another person
  • Requesting, agreeing to receive or accepting a bribe
  • Failure of a commercial organisation to prevent bribery (Corporate Offence)

Corporate Offence is a strict liability offence and an organisation and its senior management can be found guilty of attempted or actual bribery on the organisation’s behalf, if the organisation fails to have in place proper procedures to prevent bribery taking place. Like the Fraud Act the Bribery Act also imposes strong sentences on conviction. The first case has been heard by the Court, and for receiving a £500 bribe the defendant was sentenced to 6 years in prison.

NHS Counter Fraud Authority
The NHS Counter Fraud Authority is a special health authority charged with identifying, investigating and preventing fraud and other economic crime cross the NHS in England. The NHS Counter Fraud Authority is focused entirely on counter fraud work, and is independent from other NHS bodies and directly accountable to the Department of Health. The purpose of the NHS Counter Fraud Authority is to lead the NHS in protecting its resources by using intelligence to understand the nature of fraud risks, investigate serious and complex fraud, reduce its impact and drive improvements. You can find out more about the NHS Counter Fraud Authority by visiting their website.

What should you do if you suspect an offence is taking place?
If you suspect a fraud you must:

  • Make a note of your concerns in as much detail as possible.
  • Note all relevant details, such as what was said, the date and time, names of all parties involved, or a description of individuals involved.
  • If legal to do so, keep a record or copy any documentation that arouses your suspicion.
  • Report your concerns immediately as any delay might cause the Clinical Commissioning Group to suffer further financial loss.

You can report your concerns directly to the Anti-Fraud Team or alternately you can report your concerns to the NHS Counter Fraud Authority (the National Body responsible for combating fraud and economic crime across the NHS in England).

Do not:

  • Investigate it yourself as all evidence must be gathered in a legally admissible manner
  • Confront the individual
  • Convey your suspicions to anyone other than those with proper authority to investigate
  • Do nothing!

What are the types of fraud?

Managers and Staff:

  • Alteration of timesheets or travel expenses
  • Abuse of Trust equipment
  • Working elsewhere whilst sick
  • Misappropriation of funds
  • Making false statements on application forms and references

Professionals:

  • Alterations of records
  • False claims for work
  • Creating ghost patients
  • Private work on NHS time
  • Working elsewhere whilst sick

Patient Fraud:

  • Prescription fraud (altering of prescriptions, wrongfully claiming exemption from fees)
  • Multi registration patients
  • False travel expense claims
  • Overseas visitors claiming to be eligible for NHS services

Contractors and Suppliers:

  • Submission of bogus invoices
  • Price fixing

Compliments, Complaints and Feedback

If you have any compliments, complaints or general feedback that you would like us to know about, please get in touch with us:

NHS Shropshire Clinical Commissioning Group
William Farr House
Mytton Oak Road
Shrewsbury SY3 8XL

Tel: 01743 277586 or Freephone 0800 032 0897

Email: SHRCCG.CustomerCare@nhs.net
(please make the topic of your enquiry clear and your email will be directed to the correct place)



For more information on the complaints process please click here.

 

Complaints process

Complaints

All of our staff work hard to get things right, but sometimes things don’t go as well as we would like them to.

We can learn from you to improve services and prevent any future issues.

We would also love to hear from you if things went well and if you have any feedback or compliments relating to our services.  Please contact us using the details listed below.


Who to complain to

Where possible, complaints should be raised directly with the organisation which provided your care (the ‘provider’).  They are best placed to investigate and address your concerns and will have access to information such as your medical records.  If you do not wish to complain directly to the provider, however, you can choose to raise your complaint with the commissioner of the service.

NHS Shropshire Clinical Commissioning Group is the commissioner for services such as the local hospital trusts, the mental health trust and the community trust.

NHS England is the commissioner of primary care services, including GP services, dental services, optometrists (opticians) and pharmacists.

Information about these services can be found on the Local Services page of this website.

Contact details for the CCG and NHS England complaints teams are listed below.  If you are in any doubt about who to contact, please do not worry as you will be re-directed to the right place if necessary.


How do I make a complaint?

Shropshire Clinical Commissioning Group Complaints Contact Details

For complaints about hospital services, mental health services, community services, please contact us via any of the methods below and we will be happy to help.

By Post:
NHS Shropshire Clinical Commissioning Group
William Farr House
Mytton Oak Road
Shrewsbury
SY3 8XL

Phone: 01743 277500
Email: SHRCCG.CustomerCare@nhs.net.

 

NHS England Complaints Contact Details

NHS England – for complaints about primary care services, including GP services, dental services, optometrists (opticians) and pharmacists, and prison services.

By Post:
NHS England
PO Box 16738
Redditch
B97 9PT

Telephone: 0300 311 22 33
Email: england.contactus@nhs.net.

Will I be treated fairly?

We understand that some people worry that their treatment might be adversely affected because they have raised a complaint.  Please do not worry about this.  We also appreciate that those using the services we commission have different needs and we want to make sure that you do not face any unnecessary barriers to raising a complaint.  Staff will be happy to discuss this with you to ensure that you are not disadvantaged in any way.

When should I make a complaint?

You should raise your complaint as soon as possible and within 12 months of you becoming aware of an issue.  We appreciate that this is not always possible.  Therefore, if this time period has passed, we would still like you to speak to us.

How will you deal with my complaint?

We will contact you within three working days of getting your complaint.  We will then agree with you how we will look into your complaint and what you can expect.  We will also propose a timescale for the completion of the investigation and resolution.  After your complaint has been thoroughly investigated, we will send you a full written response from our Clinical Accountable Officer .

I need help to make my complaint, who do I contact?

If you would like help making your complaint including help with writing your letter, you can contact the Independent Health Complaints Advocacy Service.  This service is provided by Healthwatch Shropshire and offers free, independent, confidental and progressional advice about the NHS complaints process:

Address: freepost Healthwatch Shropshire 
Telephone: 01743 237884
Emailenquiries@healthwatchshropshire.co.uk
Website: www.healthwatchshropshire.co.uk

Leaflet: Independent Health Complaints Advocacy Service [pdf] 1MB

What if I am unhappy with the way in which the NHS has handled my complaint?

You can ask the Parliamentary and Health Service Ombudsman to consider it further:

Telephone Helpline: 0345 015 4033
Email: phso.enquiries@ombudsman.org.uk
Website: www.ombudsman.org.uk

Any information you give us will be treated as strictly confidential.  We may need to collect personal information from you in order to provide the best possible service.  However, we will not give your personal details to anyone without your consent.

Freedom of Information

The Freedom of Information (FOI) Act 2000 gives people a general right of access to information held by or on behalf of public authorities.

Anyone has the right to ask Shropshire CCG for any information, although there are some exemptions that may prevent it being released.

To make a Freedom of Information request please e-mail: MLCSU.foiteam@nhs.net

You can expect a response within 20 working days.

Further information is available on the Freedom of Information Act - Advice for Organisations - ICO website.

Postal address:
Freedom of Information Officer
NHS Shropshire Clinical Commissioning Group
William Farr House
Mytton Oak Road
Shrewsbury SY3 8XL

General enquiries

NHS Shropshire Clinical Commissioning Group
William Farr House
Mytton Oak Road
Shrewsbury SY3 8XL

Tel: 01743 277500 (main switchboard)

Email: SHRCCG.ShropshireCCG@nhs.net

Please make the topic of your enquiry clear and your email will be directed to the correct place.

Please do NOT send personal information to this mailbox.

GP practices

A list of all GP practices in the Shropshire area is available here: GP practices

Patient Advice and Liaison Service (PALS)

PALS is a free, informal, confidential help and advice service for patients, carers and their families.  It is there to help you when you need advice, have concerns or don’t know where to turn.

All NHS trusts (for example hospitals, community services, mental health trusts) have their own PALS department.  However you can also contact PALS at the CCG with queries relating to any of the above services and you will be offered advice or signposted to the appropriate place.

PALS enquiries relating to primary care services (GP services, dentists, optometrists and pharmacists) should be directed to NHS England.

PALS will:

  • Help you get the information you need about the NHS
  • Listen and respond to your concerns, suggestions or queries
  • Sort out problems quickly on your behalf in an informal and friendly manner
  • Use your feedback to help improve the services that we deliver

How to contact PALS

You can access contact details for local PALS teams as follows:

NHS Shropshire CCG

Address:
NHS Shropshire Clinical Commissioning Group
William Farr House Site
Mytton Oak Road
Shrewsbury 
Shropshire
SY3 8XL

NHS England (for PALS enquiries relating to primary care services): 

Address:

NHS England
PO Box 16738
Redditch
B97 9PT


Any information you give us will be treated as strictly confidential. We may need to collect personal information from you in order to provide the best possible service.  However, we will not give your personal details to anyone without your consent.


 

Press Office

If you are a member of the media and have an enquiry about NHS Shropshire Clinical Commissioning Group please contact the Communications and Engagement Team: