The assessment provides an analysis on fraud, bribery and corruption against the NHS in England and provides intelligence around current and longer-term threats, plus recommendations for prevention activity. The SIA estimates that £1.316 billion in NHS funding is vulnerable to fraud, bribery and corruption, an amount that could make such a difference to the NHS and people’s health.

Key Points

Between 2023-2024 the NHS CFA received 6,367 reports alleging fraud, bribery and corruption against the NHS in England, compared to 5,048 reports for 2022-2023. 86% of these reports related to NHS staff fraud (2,963 reports), patient exemption fraud (1,404 reports), procurement and commissioning fraud (723 reports) and fraudulent access to NHS care from overseas visitors (405 reports).

Bribery and Corruption: Corruption is more likely to appear in reports received by the NHS CFA than bribery, due to bribery being a more discreet act which would normally occur between two parties within a closed environment. Staff fraud is the highest form of corruption reported relating to 69% of the reports, with allegations such as insider issues. Approximately 46% of all reports relating to procurement and commissioning were linked to staff collusion.

The threat of payment diversion fraud, or mandate fraud, remains prominent with continued reporting of incidents, although proactive activity has resulted in the prevention of NHS funds ending up in the hands of fraudsters due to mandate fraud.

Horizon scanning: The 2023-2024 financial year was the first to see the potential impact of Integrated Care Boards (ICBs) through the implementation of the Health and Care Act in July 2022. The new structure of the ICBs could increase the potential for abuse of positions and collusion within procurement and the New Hospital Programme (NHP) may provide opportunities for further pre-tender procurement fraud. In addition the new Procurement Act 2023 and the Provider Selection Regime will change the landscape of procurement within the NHS.

Data manipulation fraud: This includes falsifying data to meet targets, increase revenue or hide undesirable outcomes and encompasses the ‘2023-2025 NHS Payment Scheme (NHSPS)’. There is scope for the landscape of fraud to evolve further as additional modus operandi emerge in this area.

View the full SIA, which also includes primary care fraud, patient exemption fraud and fraudulent access to NHS care from overseas visitors at:

Strategic Intelligence Assessment 2024 | Corporate publications | NHSCFA

Action required

For information only to Audit Committees and Boards

For more information please contact:

Melanie Alfatt, Director – Operations (Anti Crime & IT Audit) Email: melanie.alflatt@tiaa.co.uk