In 2016-17 losses to fraud in the NHS were estimated at £1.25 billion per annum – enough money to pay for over 40,000 staff nurses, or to purchase over 5,000 frontline ambulances. This is taxpayers’ money that is taken away from patient care and falls into the hands of criminals. When we say ‘fraud’, we refer to a range of economic crimes, such as fraud, bribery and corruption or any other illegal acts committed by an individual or group of individuals to obtain a financial or professional gain.
How does the CCG fight fraud?
Auditone works closely with the CCG to combat fraud with a team of experienced Counter Fraud Specialists delivering a full range of counter fraud, bribery and corruption services including prevention, detection and investigation. Our professionally qualified Counter Fraud Specialists work to identify potential fraud, bribery and corruption risks through policy and system reviews and suggests remedial action to reduce and mitigate these risks. We are experienced in carrying out timely criminal investigations, from referral to prosecution.
Auditone is an NHS consortium providing counter fraud services to 33 NHS organisations across the North of England. It is hosted by Northumberland, Tyne and Wear NHS Foundation Trust and is a not for profit organisation.
Fraud Insight Newsletter – July 2021
Fake Covid Fund Scam – November 2021
Counter Fraud Newsletter – Christmas 2021
Who are the CCG’s Counter Fraud Specialists?
- Paul Bevan
- Rebecca Napper
The CCG’s Counter Fraud Champion is Lynne Walton.
How can you help tackle fraud?
If you suspect fraud is occurring, you can help by reporting your suspicions confidentially to the fraud hotline.
Follow these simple guidelines when reporting your suspicions:
- Do make an immediate note of your concerns
- Do deal with the matter promptly if you feel your concerns are warranted
- Don’t do nothing
- Don’t be afraid to raise your concerns
- Don’t approach or accuse individuals yourself
- Don’t try to investigate the matter yourself
How to report fraud
Contact our Counter Fraud Specialists
Our Counter Fraud Specialists deal with all reports of suspected fraud in the strictest confidence. You will be informed of the progress of the investigation and you will not suffer any recriminations from voicing reasonably held suspicions.
Contact details
Fraud Hotline: 0191 441 5936
Email: counterfraud@audit-one.co.uk
Contact the National Fraud and Corruption reporting line
Alternatively, you can phone the National Fraud and Corruption reporting line: 0800 028 40 60
All calls are made in strictest confidence and no attempt will be made to persuade you to provide your personal details if you want to remain anonymous. You will be given a call reference number which you can quote if you phone again with additional information.
National Fraud Initiative 2020
As an NHS organisation, the CCG participates in the Cabinet Office’s National Fraud Initiative which is a data matching exercise to assist in the prevention and detection of fraud. As part of the National Fraud Initiative, key payroll data and personal identifiers such as contact details may be provided to bodies responsible for auditing, administering public funds or where undertaking a public function for the purposes of preventing and detecting fraud.
The Cabinet Office is responsible for carrying out data matching exercises. 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 data protection legislation or the General Data Protection Regulation (GDPR). Data matching by the Cabinet Office is subject to a Code of Practice.
Should you wish to know more information on this Fair Processing Notice please see the more detailed full text. Any questions relating to the National Fraud Initiative should be directed to NECS HR at necsu.ccgsupport@nhs.net.
Relevant links
Bribery Act
The Bribery Act 2010 came into force on 1 July 2011, reforming the criminal law of bribery and corruption making it easier to tackle these offences proactively. It creates specific criminal offences which carry custodial sentences of up to 10 years and potentially unlimited fines. It also introduces a corporate offence which means that the majority of organisations across the public, private and charitable sectors will be exposed to criminal liability, punishable by an unlimited fine, for failing to prevent bribery.
The Department of Health Legal Service has advised that NHS bodies are deemed to be a relevant corporate body and will become liable unless they put in place adequate ‘preventative procedures’, for acts of bribery and corruption committed by persons associated with it, in the course of their work. This is a collective, NHS wide initiative.
Bribery may be considered to be…
An inducement or reward offered, promised or provided to someone to perform their functions or activities improperly in order to gain a personal, commercial, regulatory and/or contractual advantage.
Zero Tolerance
Bribery is a criminal offence. Our CCG does not, and will not, pay bribes or offer improper inducements to anyone for any purpose; nor do we, or will we, accept bribes or improper inducements. This approach applies to everyone who works for us, or with us. To use a third party as a conduit to channel bribes to others is a criminal offence. We do not, and will not, engage indirectly in, or otherwise encourage, bribery.
Proactively combating bribery has clear benefits for this CCG and the wider NHS. It helps prevent:
- Adverse damage to or criticism of the organisation’s reputation and funding
- The potential diversion and/or loss of resources from NHS care
- Unforeseen and unbudgeted costs of investigations and/or defence of any legal action
- A negative impact on patient/stakeholder perceptions