Anti-Fraud and Corruption
NHS Shropshire 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
Counter Fraud Lead for the Clinical Commissioning Group Details:
Telephone: 07545 502400
Email: firstname.lastname@example.org or email@example.com
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).
- 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
- Alterations of records
- False claims for work
- Creating ghost patients
- Private work on NHS time
- Working elsewhere whilst sick
- 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