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Fraud costs NHS England over £1bn a year


1 November 2017

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NHS England lost £1.25bn to fraud and various economic crimes in 2016/17, according to new figures.

With an NHS budget of £100bn a year, the estimated lost amount of money represents 1% of the funding.

To tackle fraud and understand the risks better, the NHS created a new expert intelligence-led authority, NHS Counter Fraud Authority (NHSCFA), which replaces its predecessor NHS Protect.

NHS England lost £1.25bn to fraud and various economic crimes in 2016/17, according to new figures.

With an NHS budget of £100bn a year, the estimated lost amount of money represents 1% of the funding.

To tackle fraud and understand the risks better, the NHS created a new expert intelligence-led authority, NHS Counter Fraud Authority (NHSCFA), which replaces its predecessor NHS Protect.

The new organisation will ensure that NHS funding is directed to front line patient care, instead of being diverted for personal use, and raise awareness.

Less money for care

Simon Hughes, NHSCFA interim chair, said: ‘Fraud affecting the NHS is a blight, taking public funds away from patient care and into the pockets of criminals.

‘As we develop our strategic, tactical and operational responses to fraud across the health service, we will become better able to target weaknesses that fraudsters are exploiting.'

Sue Frith, NHSCFA chief executive officer, said that the money lost is enough to fund more than 40,000 staff nurses and purchase more than 5,000 frontline ambulances.

Fraud is often underreported, due to difficulties to identify it and fear of casting unfavourable light on the affected organisation.

The 2017-2020 strategy document Leading the fight against NHS fraud, published by the NHSCBA, reveals that the most common area of finance loss is patient fraud, costing around £400m a year.   

Prescription fraud alone costs the NHS £217m every year, allowing fraudsters to get away without paying the prescription charge of £8.60 per item.

But acts of fraud are not limited to patients.

Last year, payroll and identity frauds represented around £90m, while dentists claimed £73m for work they did not carry. 

Vital funding

With a current overstretched system, the NHS can’t afford to lose more funding, vital for frontline care.

Mr Hughes said: ‘The government has made it clear that it will root out these unacceptable activities wherever they occur, in order to preserve scarce public resources and to maintain the public’s confidence in the NHS.’

‘The more successful we are in minimising fraud losses, the more resources will be available to provide patients with the highest quality of care.'

The NHSCFA will produce an annual assessment, summarising current and emerging fraud risks and identifying what areas need improvement. 

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