Feature / Lines of defence

From April 2011, NHS Protect took on national responsibility for leading work to protect NHS staff and resources from crime and to ensure the most appropriate anti-crime arrangements are put in place within an evolving NHS.

It has responsibility for tackling fraud, bribery, violence, corruption, criminal damage, theft and other unlawful action, such as market fixing. The organisation, which also provides NHS anti-fraud services to the Welsh government, has five organisational aims:

• To provide national leadership for all NHS anti-crime work by applying a strategic, co-ordinated and intelligence-led approach
• To support and work with the NHS, Department of Health, NHS Commissioning Board and stakeholders to tackle crime at the earliest possible opportunity
• To establish a safe and secure environment that protects NHS staff from violence and NHS property and assets from theft or misappropriation
• To quality assure the delivery of anti-crime work to ensure the highest standard is consistently applied
• To centrally investigate serious, organised and/or complex financial risks and losses, including fraud, bribery and corruption within a clear professional and ethical framework.

Tackling crime within the NHS is not new. Built on the foundations of the former NHS Counter Fraud and Security Management Service (CFSMS), NHS Protect inherits a wealth of knowledge and experience. Between 1999 and 2010, CFSMS recovered more than £65m of NHS money and prevented millions more being lost to fraud.

But changes to the fraud and corruption landscape, alongside reforms to the NHS, demanded radical change.

Although the NHS reform programme will present new challenges for anti-crime work, NHS Protect’s approach is designed to put local arrangements in place now, ensuring the process for protecting the NHS can evolve along with the organisational structure. 

Effective communication and joint working with key stakeholders is central to any anti-crime strategy. NHS Protect will work in partnership with the NHS, the Department, the NHS Commissioning Board and stakeholders including the police, Crown Prosecution Service, Monitor and local authorities.

Local accountability

There will be a greater shift towards local accountability, harnessing the talent of 300 local counter fraud specialists – every health body in England and Wales is required to have one. They report to their organisation’s director of finance and are professionally trained and accredited by NHS Protect.

By placing its emphasis on local accountability, NHS Protect can focus on co-ordinating, regulating and maximising the benefit of localised investments to tackle crime, as well as dealing with complex and cross-boundary matters that cannot be dealt with locally.

The local staff will be supported by area anti-fraud specialists, who will offer advice on local work to prevent and deter fraud; and give guidance and support in the progress of investigations and the pursuit of prosecutions and financial recoveries.

While it is expected that the training and support made available to local practitioners will result in the highest possible standards of anti-fraud work, NHS organisations will want assurance that their anti-fraud provision is effective locally. NHS Protect’s quality assurance process helps NHS organisations assess their anti-fraud provision and, where shortfalls are identified, we will work with them to obtain the desired standard.

NHS Protect’s national investigation service (NIS) leads investigations into serious, organised and/or complex financial risks and losses including fraud, bribery and corruption within a clear professional and ethical framework. The services provided by NIS are free to trusts that encounter serious or complex cases of fraud that cannot be investigated locally.

A more comprehensive and strategic approach to financial investigations is evident in the increased use of Proceeds of Crime Act (POCA) powers, which allow for the recovery of property obtained through unlawful conduct. From 1 April NHS Protect engaged a small team of POCA-accredited financial investigators who devote their time to dealing with the recovery of funds that had previously been lost to the NHS. This complements work already undertaken through the civil courts, where we have been able to return funds to the NHS by selling property bought with fraudulently obtained money.

In addition, NHS Protect’s forensic computing unit provides a comprehensive and professional forensic computing service to recover digital evidence for use in criminal, civil and disciplinary proceedings. It also provides a data recovery service for lost documents, password-cracking capability and an auditing service to help ensure compliance with corporate policies.

This joined-up approach to tackling crime will enable the proper use of valuable resources and a safer, more secure environment in which to deliver and receive NHS care. n

l To report an incident of suspected fraud in the NHS call the Fraud and Corruption Reporting Line, 0800 028 40 60 or visit www.reportnhsfraud.nhs.uk