Counter Fraud Team

Counter Fraud

Fraud against the NHS means that the money intended for patient care, and funded by the taxpayer, ends up in the pockets of those who did not legitimately earn it. It means fewer resources are available to be spent on frontline health services such as patient care, health care facilities, doctors, nurses and other staff.

Fraud, bribery, corruption and other illegal acts committed to obtain financial or professional gain, cost the NHS billions of pounds every year. In 2018-19 it was estimated by the NHS Counter Fraud Authority that the cost to the NHS was around £1.27 billion per annum, enough money to pay for over 40,000 staff nurses or to purchase over 5,000 frontline ambulances.

Suspicions and concerns should be reported to the Local Counter Fraud Specialist, Gemma Higginson on 07800 718680 or at gemma.higginson1@nhs.net / gemma.higginson@rsmuk.com. Alternatively, you can call the NHS Counter Fraud Authority’s 24-hour reporting line anonymously on 0800 028 4060, or report confidentially online at www.cfa.nhs.uk/reportfraud.

National Fraud Initiative (NFI)

This Trust is required by law to protect the public funds it administers. It may share information provided to it with other bodies responsible for auditing or administering public funds, or where undertaking a public function, in order to prevent and detect fraud.

We participate in the Cabinet Office’s National Fraud Initiative: a data matching exercise to assist in the prevention and detection of fraud. We are required to provide particular sets of data to the Minister for the Cabinet Office for matching for each exercise.

Data matching involves comparing computer records held by one body against other computer records held by the same or another body to see how far they match. This is usually personal information. Computerised data matching allows potentially fraudulent claims and payments to be identified.

Where a match is found it may indicate that there is an inconsistency which requires further investigation. No assumption can be made as to whether there is fraud, error or other explanation until an investigation is carried out.

The use of data by the Cabinet Office in a data matching exercise is carried out with statutory authority under Part 6 of the Local Audit and Accountability Act 2014. It does not require the consent of the individuals concerned under the Data Protection Act 2018, however the Cabinet Office set out how your data will be used and your rights here. Data matching by the Cabinet Office is subject to a Code of Practice.

For further information on data matching at this Trust please contact the Local Counter Fraud Specialist, Gemma Higginson on 07800 718680 or at gemma.higginson1@nhs.net / gemma.higginson@rsmuk.com