A recent incident at an NHS foundation trust has highlighted the governance and patient safety risks that can arise when recruitment controls and qualification checks are not subject to adequate scrutiny.

At Blackpool Teaching Hospitals NHS Foundation Trust, an individual worked as a cognitive behavioural therapist (CBT) for around ten months despite not holding the required qualifications for the role. The issue was identified through internal reporting processes and classified as a patient safety event.

According to internal documentation, the incident was attributed to insufficient scrutiny of qualifications during recruitment. Patients who received CBT sessions from the individual were contacted earlier this year and informed of the situation.

The trust reviewed the impact of the incident and reported that no patient harm was identified. It has since strengthened its recruitment processes, and the individual no longer works for the organisation.

Why this matters

Although the issue was identified and addressed internally, the case highlights wider risks for healthcare providers, including:

  • Patient safety and safeguarding concerns
  • Regulatory and compliance exposure
  • Reputational damage and loss of public trust
  • Increased scrutiny from regulators and commissioners

In safety‑critical roles, robust assurance over qualifications, accreditation and ongoing eligibility is essential. Even isolated gaps in recruitment controls can have serious consequences.

Recruitment assurance as a governance issue

This incident demonstrates that recruitment should be treated as a core governance and risk management function, not solely an operational process. Common areas of vulnerability include manual credential checks, unclear ownership between HR and clinical teams, and limited independent oversight—particularly in pressured workforce environments.

Fraud

Individuals who falsely claim to possess qualifications may be committing a criminal offence of fraud under the Fraud Act 2006.  In the NHS your Anti-Crime Specialist (ACS) also known as Local Counter Fraud Specialist (LCFS) can assist with investigating concerns involving previous work experience and or qualifications.  Further information can be found here:  What is NHS Fraud | Fraud prevention | NHS Counter Fraud Authority | NHSCFA

How TIAA can help

TIAA supports NHS trusts and healthcare providers to strengthen recruitment governance and reduce workforce‑related risk through independent assurance and advisory services, including:

  • Internal audit of recruitment, onboarding and credential‑checking processes
  • Reviews of controls over professional qualifications, accreditation and revalidation
  • Assessments of agency, bank and temporary workforce governance
  • Assurance aligned to CQC expectations and wider regulatory requirements
  • Practical recommendations to strengthen accountability, oversight and audit trails

By proactively reviewing recruitment and workforce controls, organisations can reduce the risk of patient safety incidents, demonstrate strong governance, and maintain confidence among regulators, staff and patients.

For more information or to report any suspicions of fraud or arrange a fraud awareness session for your team, contact your counter fraud specialist or fraud@tiaa.co.uk

Alternatively, suspicions of fraud can be reported to the NHS Counter Fraud Authority at Report NHS Fraud | Home | NHSCFA  or by calling the 24/7 freephone line 0800 028 4060.

Source – HSJ