Fraud happens when someone makes a deliberate attempt to dishonestly make a gain for themselves or another or cause a loss to another.
This may include any person who makes a false representation or dishonestly fails to disclose to another person information which they are under a legal duty to disclose, or commits fraud by abuse of position, including any offence as defined in the Fraud Act 2006. Examples of NHS fraud offences are provided below. Further information can be found in our Fraud, Bribery and Corruption Policy (CORP06).
Bribery refers to the giving or receiving of an inducement, in return for a person committing an improper function. It is an offence to give or receive a bribe, or even offer or accept, even if the briber is never paid. A bribe is any inducement, financial or not, to encourage or reward someone to do something they should not do.
What does NHS fraud look like?
- By health professionals: Fraud by NHS professionals includes claiming for treatment or services not provided (e.g. Medicines Use Reviews at pharmacies, dental treatment or optical services not carried out) and working elsewhere while on sick leave.
- By managers and staff: Fraud by NHS managers and staff includes submitting fraudulent claims for grants and payments (e.g. false or inflated travel or subsistence claims, and fraudulent applications for funding and training).
- By contractors and suppliers: Contractor and supplier fraud includes charging for items of a higher quality or greater quantity than those supplied and using inappropriate tendering processes.
- By patients: Patient fraud includes claiming for free or reduced cost treatment and services when not entitled and using aliases to get prescription drugs.
Reporting fraud
The first steps are being aware of the risk and remaining vigilant. You should also know how to report any suspicions or concerns you may have about fraud and/or bribery.
You can report fraud against the NHS in England and Wales by using the NHS Counter Fraud Authority online reporting form or calling freephone line 0800 028 4060 (available 24/7).
Visit the NHS Counter Fraud Authority website for more information and examples of recent cases.