The NHS Counter Fraud Authority (NHSCFA), created in November 2017 to replace NHS Protect, has published its business plan for 2018-2019.
Within the business plan are the areas of fraud in the NHS where the NHSCFA plans to prioritise in terms of its fraud prevention efforts. These are:
1. Fraud in relation to NHS Help with Health Costs (patient charge evasion);
2. Pharmaceutical contractor fraud;
3. Fraud in relation to procurement and commissioning in the NHS, threats associated with post-contract invoice manipulation; and
4. Driving improvements in standards of counter fraud work in the NHS.
A crucial component of NHSCFA's business plan to tackle fraud in the NHS is to "thoroughly investigate allegations of fraud to the highest professional standards, and where appropriate seek the full range of civil, criminal and disciplinary sanctions."
In some cases, there may be concerns about improper invoicing and conduct by external contractors, but insufficient evidence to prove such conduct to the criminal standard of proof. However, in such scenarios, civil action can often play a crucial role in deterring fraud and recovering losses for NHS bodies. Capsticks' Litigation team has experience acting for NHS bodies and working with NHS counter-fraud professionals to recover losses that may arise in such situations.
The month of April marks the beginning of the NHS Counter Fraud Authority’s (NHSCFA) first full financial year of activity. One of our very first actions in 2018-19 was to publish our business plan, which sets out our strategic priorities for the year