The Scalpel's Blog

31.03.20

NHSCFA: Never get bored of fraud

Matthew Jordan-Boyd, Director of Finance & Corporate Governance, NHS Counter Fraud Authority (NHSCFA)

I have written several articles about the work of NHSCFA and that tends to be from my fairly technical angle as a figures person, an accountant who has worked in the NHS for almost 20 years.

When I discuss the need to be more vigilant with fellow finance professionals and leaders in the NHS, and to take more vigorous action to prevent fraud, it can help to speak in their language, which comes naturally to me. This may mean looking at the issue a bit drily, suggesting that they undergo a cost-benefit analysis to recognise the significant impact it would have for their organisations, and recognise that spending adequately on counter-fraud measures is an investment that pays dividends in other areas of business.

Now that is all true. But I am equally aware of the need to be fluent in other languages – moral, ethical or medical, for example. NHSCFA is constantly looking for new ways to drive home the anti-fraud message and avoid “fraud fatigue” – people will stop hearing the counter fraud message otherwise.

Because it is a hidden crime by definition, involving skulduggery (does that word wake you up more than “deception”?), victims tend to have already suffered a financial loss by the time they spot it.

Well into our third year of operation, NHSCFA is currently shaping our 2020-2023 strategy, from which all our business plans must flow.

While I cannot pre-empt the publication of this strategy, which is not far away, a few key issues are already clear.

The fight against health service fraud is not getting any easier.

Fraud is an evolving threat, with criminals constantly monitoring the NHS to exploit any possible weaknesses, updating their methods accordingly. We estimate the NHS loses over a billion pounds a year to fraud, and was never a ‘victimless crime’. It impacts directly on patient care.

The damage done to things like trust and confidence in an NHS service matters too. These things still count, even if they are harder to quantify than pounds and pennies.

Opinions differ about whether NHSCFA should keep shouting about the scale of the problem or speak more about, and be an integral part in the implementation of the solutions. We must do both.

Since our establishment in November 2017, working in partnership with the wider NHS counter fraud community and beyond that, other law enforcement bodies, has been a powerful weapon against the criminals. We need to continue this, and do more.

Wherever possible, we have reduced fraud losses through effective prevention and enforcement action, and strengthened our intelligence gathering to sharpen our knowledge of fraud risks and the best ways to curb fraud.

There are many examples of NHS organisations fully shouldering their responsibilities – doing so with a passion that goes far beyond ticking the boxes they are “marked on” by NHSCFA.
Yet, more needs to be done.

Not all NHS bodies consistently apply a proactive, risk-based approach to counter fraud. When they do, the quality and effectiveness of counter fraud provision will rise further.

Our 2020-2023 work plan will contain pioneering new initiatives and ramp up the shift in culture that is still needed. And in NHSCFA we’ll be leading by example in getting the most out of our people, our greatest asset. Watch this space!

This article originally featured in the March/April 2020 edition of NHE. Subscribe online today by clicking here!

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