SLIDE 1
Fraud in the NHS
Iain Flinn Counter Fraud Specialist March 2011
Areas Susceptible to Fraud
- Procurement
- Qualifications
- Sickness / Attendance / Time Recording
- Ghosts
- Salary payments
- Prescriptions
- Health Tourists
Fraud in the NHS Iain Flinn Counter Fraud Specialist March 2011 - - PowerPoint PPT Presentation
Fraud in the NHS Iain Flinn Counter Fraud Specialist March 2011 - - PowerPoint PPT Presentation
Fraud in the NHS Iain Flinn Counter Fraud Specialist March 2011 Areas Susceptible to Fraud Procurement Qualifications Sickness / Attendance / Time Recording Ghosts Salary payments Prescriptions Health Tourists
SLIDE 2
SLIDE 3
National / Local Strategies
- Counter Fraud Service
- Counter Fraud Specialists
- Trust Policies
- Pro active exercises
SLIDE 4
Scale of the problem
- 3605 New investigations in 09-10
- £3.4 million value
- £167k criminal compensation
- £2.04million civil recovery, voluntary
repayment
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Examples
- London Hospital manager - £200k fraud
- Ran private business using NHS funds
- Bypassing of ordering procedures
- E.g. £4000 CCTV system
- £8000 invoice for “NHS equipment”
- 33 month custodial sentence, confiscation
proceedings
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Ghost Care Home
- Senior manager - £117k fraud
- Invented care home and used real patient ID
numbers
- No procurement involvement
- Segregation of duties
- Authorisation of invoices
- 4 year custodial sentence
- Partner sentenced to 3 years for money
laundering
SLIDE 7
Hospital Engineer
- £80k fraud through collusion with supplier
- Bogus orders submitted for private use
- Segregation of duties
- Bypassing normal supplies ordering procedures
- Inappropriate supplier for type of equipment
- Asset register checks
- 30 month custodial sentence, £80k civil recovery
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Things to Consider
- What are the fraud risks for your area of
work?
- Are you working to Trust policy / best
practice or shortcuts / workarounds?
- If you suspect fraud… REPORT IT.
SLIDE 9