Procurement and commissioning fraud accounts for £266m of the £1.29bn lost to the NHS in England every year due to economic crime, according to a report.
NHS England’s report Tackling Fraud, Bribery and Corruption Economic Crime Strategy 2018-2021 said the possibility for procurement fraud existed because of “potential for conflict of interest, bribery offences, contract splitting, bid rigging and tender manipulation”.
The report said that there were gaps in intelligence with regards to procurement fraud – and many other types of fraud.
However it added that reviews had been undertaken by internal auditors and the Procurement Improvement Programme had been put in place to combat fraud.
NHS England was working collaboratively with key external partners and internal stakeholders to tackle the problem, said the report.
“The decision to establish an in-house counter fraud team is key to embed awareness of fraud risks, how to report fraud and ensure a counter fraud culture permeates throughout NHS England,” said the report.
“In early 2018 the visible presence of the counter fraud team is already developing communication networks with internal and external stakeholders and this is expected to be enhanced with time.”
In general practice £88m could be lost annually because of list inflation, claiming for services not provided, payments manipulation, conflicts of interest and self-prescribing, said the report.
It raised the possibility that audit teams could be brought in to carry out “forensic” checks on primary care payments – with a view to clawing back money from providers.
Of the £750m of potential fraud losses identified in the report relating to primary care, around £126.1m was linked to dental contractors, £79m to optical contractors and £111m to pharmaceutical contractors.
Primary care services are provided on the whole by independent contractors, which means they are “high trust environments” and present considerable scope for manipulation and sharp practice, the report said.
The report added that NHS England “will always aim to fraud-proof and design out weakness from new or existing policies”.
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