Counter Fraud

Fraud happens when someone makes a deliberate attempt to dishonestly make a gain for themselves or another, or cause a loss, or risk of 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 the three main fraud offences are provided below.

This is the most common type of fraud investigated within the NHS. This normally involves a false declaration being made, such as working elsewhere whilst on sickness absence from your substantive post. The staff member has made a representation that they are too sick to work, but is then undertaking work elsewhere, whether that is in the NHS or otherwise.

This could be relating to any information where there is a legal duty to disclose.  For example, failing to disclose a criminal record, anything that could affect your Disclosure and Barring Service (DBS) checks or your right to work status. 

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.  The three main offences under the Bribery Act 2010 most relevant to the NHS are:

• Giving a bribe- offering, promising or giving a bribe to another person to perform a relevant function or activity;
• Receiving a bribe- requesting or agreeing to receive or accepting a bribe to perform a function or activity improperly; and
• Corporate offence- failure of a commercial organisation to prevent bribery.

Some common forms of bribery include: cash, facilitation payments, gifts, hospitality, political donations, charitable contributions, enhanced commissions, and employment of friends / family.

Further information about fraud and bribery can be found in our Counter Fraud, Bribery and Corruption Policy and Response Plan. 

The ICB is required by law to protect the public funds it administers.  It may share information provided to it with other bodies responsible for auditing or administering public funds, or where undertaking a public function, in order to prevent and detect fraud.

We participate in the Cabinet Office’s National Fraud Initiative: a data matching exercise to assist in the prevention and detection of fraud.  We are required to provide sets of data to the Minister for the Cabinet Office for matching for each exercise.

Data matching involves comparing computer records held by one body against other computer records held by the same or another body to see how far they match.  This is usually personal information. Computerised data matching allows potentially fraudulent claims and payments to be identified.

Where a match is found it may indicate that there is an inconsistency which requires further investigation. No assumption can be made as to whether there is fraud, error or other explanation until an investigation is carried out.

The processing of data by the Cabinet Office in a data matching exercise is carried out with statutory authority under its powers in Part 6 of the Local Audit and Accountability Act 2014.  It does not require the consent of the individuals concerned under data protection legislation or the General Data Protection Regulation (GDPR), however the Cabinet Office set out how your data will be used and your rights here.

For further information on data matching at the ICB please contact the Local Counter Fraud Specialist, Victoria Dutton; victoria.dutton@tiaa.co.uk or vdutton@nhs.net, telephone 07826 858 746.

Anyone can report concerns of fraud and bribery within the NHS.  Whether you are a member of the public, an NHS employee, a contractor, a supplier, from another government agency or someone else, your input can make a difference.  Counter Fraud provision is provided by TIAA for Buckinghamshire, Oxfordshire and Berkshire West ICB.

Suspicions and concerns can be reported, in absolute confidence, to the ICB’s Local Counter Fraud Specialist:

Victoria Dutton

Telephone: 07826 858 746

Email: victoria.dutton@tiaa.co.uk or vdutton@nhs.net

Alternatively, you can call the NHS Counter Fraud Authority’s 24-hour reporting line anonymously on 0800 028 4060, or confidentially online at www.cfa.nhs.uk/reportfraud.  More information about the NHS Counter Fraud Authority can be found here.  Concerns can also be raised with the ICB’s Director of Finance.

The BOB ICB Local Anti-Fraud Bribery Corruption Policy can be found here