Types of NHS Fraud, Bribery and Corruption Offences
There are many different types of NHS fraud, bribery and corruption; it can be committed by anyone, from all walks of life. The following provides some examples of different types of offences.
Patients:
Patients claiming free treatment and services when not entitled, such as prescriptions/ glasses/ dental treatment.
Overseas Visitors providing false personal details in order to gain free hospital treatment to which they are not entitled.
Patients, or people pretending to be patients, submitting false claims for payment under the NHS Healthcare Travel Costs Scheme (HTCS).
Patients amending prescriptions in an attempt to gain additional medication.
Patients, sometimes referred to as ‘hospital hoppers’ presenting at Emergency Department with false personal details and false medical history in an attempt to obtain drugs by deception and overnight hospital stays.
NHS Staff:
NHS staff dishonestly working in another job while they are off sick.
NHS staff dishonestly taking sick leave when they are not really sick.
NHS staff submitting false fit notes in order to get more time off work eg by altering the ‘to and from’ sickness dates their original fit note, or photocopying and resubmitting their original fit note several times by changing the dates on each copy; submitting a totally fake fit note purchased online.
NHS consultants dishonestly undertaking private work on NHS time.
NHS staff making false and inflated expenses, mileage, timesheet or bank shift claims.
NHS staff procuring goods and services for personal or private business use; including to sell on to others such as on internet auction sites or at car boot sales eg printer cartridges.
NHS management bypassing proper recruitment processes to provide NHS jobs/ promotions to their own friends, family or close colleagues.
Payroll, Procurement, or Finance staff setting up false staff, suppliers or contractors on NHS systems linked to bank accounts in their personal control in order to facilitate fraudulent payments to those accounts.
NHS staff stealing patient bank cards and then using them to make personal purchases.
NHS staff not declaring personal interests which directly conflict with the business of their NHS role.
Trust staff accepting payment by a company producing particular medical/ healthcare products, in exchange for patient personal details with a particular medical condition; with the intention of targeting the patients for sales purposes.
NHS Job Applicants:
Job applicants failing to disclose criminal convictions, or pre-existing medical conditions.
Job applicants, including illegal workers, providing false information about themselves in order to gain NHS employment, such as providing fake: references, skills & experience, qualifications, ID, passports, driving licences, proof of address, right to work documents.
A job applicant offering money to Trust staff with the intention of gaining Trust employment.
Primary Care:
Deliberately submitting claims for non-existent or ‘ghost patients’.
Deliberately claiming for treatment/ services not provided eg Medicines Use Reviews at Pharmacy; or dental/ optical treatment.
Contractors and Suppliers:
Contractors and suppliers to the NHS submitting false, inflated or duplicate invoices for payment, for work they have not done.
Inappropriate tendering, such as collusion and bribery between NHS staff and potential contractors and suppliers; such as dishonestly awarding an NHS contract to family or friends.
Businesses/ individuals offering extravagant gifts and hospitality to NHS ‘decision-makers’ with the intention of influencing them to purchase their particular brand of goods/ services/ pharmaceuticals, gain business, or to maintain an existing contract. Examples may include: cash/ cars/ jewellery/ free building work on NHS staff own property/ tickets to entertainment eg sporting events or concerts/ holidays/ lavish hotels and entertainment.
Organised Crime:
Organised criminal groups sending scam emails/ telephone calls/ letters/ texts/ faxes to NHS staff in order to trick them into handing over confidential and personal details. If via email, this often includes instructing the recipient to open an attachment or a click on a hyperlink within the email. Opening attachments could result in infecting a computer with malware which could be used to hold NHS data ‘to ransom’, as in the WannaCry ransomware attack in 2017. Clicking on a hyperlink could send you to a spoofed website (such as ESR) which asks you to input passwords/ personal details/ banking details etc which are then stolen by the fraudsters.
Organised criminal group purporting to be a genuine supplier to the NHS, sending a request to an NHS body’s Finance Department to change the bank details of the genuine supplier to a bank account controlled by the criminals. If successful, the next payment due by the NHS body to the genuine supplier would, instead, be unsuspectingly paid into the bank account controlled by the criminals.