£300m of NHS fraud was prevented over past four years, agency says

The agency charged with dealing with fraud in the NHS has estimated that over the past four years it has prevented £300m ($500m; €430m) worth of fraud committed by patients and healthcare professionals. The NHS Counter Fraud and Security Management Service, formerly the NHS Counter Fraud Service, published its figures last week for 1999 to 2003. Its report, Protecting your NHS , shows that losses attributable to fraud by patients have fallen by over a third over that period—from £171m to £109m. Fraud committed by health professionals has fallen by up to 40% in some professions. The service's specific targets were a halving of prescription charge evasion by 2002-3, the prevention of losses of £9m in contractor prescription fraud by 2001-2, and the recovery of £6m by 2001-2. The value of fraud between 1998 and 2003 that has been detected and investigated so far is £31m million, and almost 1500 cases have been detected. Almost £13m worth of fraud was detected for 2002-3 alone. Over 150 successful prosecutions have been made and more than 200 civil and disciplinary sanctions applied, in addition to almost 54 000 penalty charges levied against patients for prescription fraud. The service believes that for every case investigated and prosecuted a great deal of potential fraud is prevented further down the line, and it estimates that through closing loopholes it has saved a total of £300m. Recent high profile cases include a Nottingham dentist who was ordered to repay the NHS £1.6m for fraudulent recalled attendance fees, a chief executive of an NHS trust who falsified his mileage expenses to the value of £40 000, and a nurse who forged her time sheets at a cost to the NHS of £134 000. To achieve these figures the service has required a burgeoning army of professionally trained counter-fraud specialists, now totalling 432. The service has run 782 fraud awareness presentations since its inception in 1998. Local NHS resources invested in fighting fraud amounted to £5.5m in 2002-3. But the service says that the expenditure is justified, as it shows a ratio of return on investment for the NHS of 15 to 1. And it has just signed a charter with the healthcare workers' union UNISON that commits more than 440 000 NHS staff members to working with the service to tackle fraud and corruption in the NHS. Speaking at the third annual conference for NHS counter-fraud professionals in London last week, chief executive Jim Gee said the service aimed to maximise the extra government funds invested in the NHS. "We need to ensure that [the NHS's] resources are protected and spent on the delivery of patient care," he said, adding that there was still plenty more to be done. Bill Darling, chairman of the service, said, "Very few organisations have ever reduced fraud by as much and as quickly as in the NHS over recent years, and I think there are major lessons to be learned here across both the public and private sector." More information is available on the service's website, www.cfsms.nhs.uk