Counter fraud

Arrangements for tackling fraud in the NHS were established in 1998 when it was recognised that fraud was a major issue for the NHS. NHS fraud is committed by staff, professionals, patients, contractors and managers but the fact is, no matter who it is committed by, it is damaging the Health Service as funds are being diverted away from patient care. 

On the 1st November 2017 a new special health authority charged with identifying, investigating and preventing fraud and other economic crime cross the NHS in England was launched. The NHS Counter Fraud Authority replaces the work undertaken by NHS Protect. 

The NHS Counter Fraud Authority is focused entirely on counter fraud work, and is independent from other NHS bodies and directly accountable to the Department of Health.

The purpose of the NHS Counter Fraud Authority is to lead the NHS in protecting its resources by using intelligence to understand the nature of fraud risks, investigate serious and complex fraud, reduce its impact and drive improvements.

The NHS Counter Fraud Authority have estimated that losses to fraud and other economic crime in the NHS exceeded £1.29 billion. These are funds that if available could pay for over 40,000 staff nurses, or to purchase over 5,000 frontline ambulances. 

To help combat fraud, the CCG is required to have a nominated Counter Fraud Specialist (CFS) who is dedicated to investigating fraud and implementing the national fraud strategy. To date, the work of CFSs around the country has found fraud in every area of the NHS and the work that they have undertaken has resulted in hundreds of millions of pounds being recouped and many fraudsters being prosecuted. 

Please contact Fiona Dwyer our Local Counter Fraud Specialist if you would like to raise a concern or if you have any questions:

Fiona Dwyer
Counter Fraud Specialist
Accredited Security Management Specialist

Mobile: 07552 290964
Tel: 02476 536880

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CCG staff personal data such as contact details may be provided to bodies responsible for auditing, administering public funds or where undertaking a public function for the purposes of preventing and detecting fraud. This is done in line with the Cabinet Office’s National Fraud Initiative, a data matching exercise that is carried out with statutory authority under Part 6 of the Local Audit and Accountability Act 2014.

Information that was held previously by NHS Herefordshire CCG, NHS Redditch and Bromsgrove CCG, NHS South Worcestershire CCG and NHS Wyre Forest CCG was transferred to NHS Herefordshire and Worcestershire CCG on 1 April 2020.

The new CCG is the the new data controller. Any questions about the use of data (including patient data) by the new CCG should be directed to mlcsu.ig@nhs.net.