Introduction
Published on 29 November 2023
In an era marked by technological advancements and evolving criminal tactics, the need for a robust and adaptive counter fraud strategy has never been more pressing. This document serves as a roadmap for our commitment to safeguarding NHSScotland from the threat of fraud, bribery, and corruption.
Our collaborative approach is at the heart of our strategy. The strategy will be implemented through annual delivery plans. This will allow us, through partnership working, to provide NHSScotland with the support, guidance, and tools to enable effective counter fraud responses at national and board level.
It is through this collaborative approach we will achieve our objectives. This strategy is a declaration of our intent and vision - “For an NHS which can protect its valuable resources from fraud.”
At the forefront of the delivery of this strategy will be our Service User Experience Mission Statement of: -
“Service users expect CFS to deliver timely, accurate and reliable services by experts who support them to provide the best possible care for their communities, now and in the future. Service users expect us to deliver these services in a way that is clear, professional and empathetic to their needs, highlighting that we listen to what matters to them.”
We will work with our key service users and our Scottish Government sponsor, the Directorate of Health Finance, Corporate Governance and Value to deliver against our strategic aims.
In 2022, we introduced the NHSS Counter Fraud Standard, a UK-wide framework that allows health boards to demonstrate that they are taking the fundamental steps to counter the threat of fraud and corruption. Effective counter fraud measures are an important part of ensuring that every pound spent on the NHS is used for its intended purpose, that of patient care. We will therefore continue to support the development of the Counter Fraud Functional Standard.
Underpinning the strategy is a desire to maximise the use of data and data analytical techniques, including the use of fraud risk assessments. This is the key to unlocking savings as can be seen in the significant increase in hard cash recoveries made by our Patient Claims Team. We will continue to develop new skills and techniques to ensure we keep abreast of an ever-changing digital environment.
Supporting the implementation of our strategy with clear annual delivery plans, combined with oversight of our progress and ongoing monitoring of impact and benefits will be key to achieving our vision and goals. This includes achieving financial targets in respect of fraud prevention, detection, and recovery.
It is clear there are significant benefits to be achieved from working across UK borders with our NHS colleagues in the other nations which is bringing greater understanding of both threats and responses. This collaboration is captured in our joint statement:
“We have a collective determination to work together to find, report and stop NHS fraud across the UK. Our joint agency approach involves exploring opportunities and sharing knowledge, skills, expertise, and intelligence. We know that by doing this and understanding how each territory operates we can continue to develop and deliver the most effective counter fraud measure across England, Scotland, Wales, and Northern Ireland, ensuring that NHS funds go to patient care and not into the hands of fraudsters.”
The result of this collaborative work is the creation of four key pillars of activity which will support the delivery of our vision and mission. These pillars – Understand, Prevent, Respond and Assure will form the basis of everything we do.
Regular feedback and evaluation will help us to evolve our operational objectives and be responsive to new opportunities and changing demands, ensuring we continue to develop and improve our counter fraud service.
This strategy has been prepared by NHS National Services Scotland (NSS) Counter Fraud Service (CFS). NSS works at the heart of the health service supporting customers to deliver their services more efficiently and effectively. CFS works in partnership with teams across NHSScotland and the Scottish public sector to provide a comprehensive service to reduce the risk of fraud.