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Examples of fraud

Below are a few examples of the types of frauds that are being investigated across the NHS throughout England Wales by CFS.

Staff

  • Use of false qualification certificates and references in order to gain employment;
  • Claiming for hours not worked;
  • Working whilst off sick;
  • Claiming for travel and other expenses not incurred;
  • Managers obtaining goods and services for personal use;
  • Creation of ghost employees

GP Contractors

  • Creating ghost patients;
  • Claiming for services provided to ghost employees including production of false prescriptions;
  • Claiming for services not provided (enhanced services);
  • Raising false prescriptions for self-medicating;
  • Accepting bribes to register overseas visitors.

Other Contractors

  • Pharmacists claiming for medication not dispensed;
  • Pharmacists claiming for services not provided;
  • Failure to declare prescription charges collected;
  • Creation of claims for ghost patients – (dentists and opticians)
  • Dentists claiming for higher number of Units of Dental Activity than provided;
  • Optician claiming NHS allowances for individuals who are not entitled.

Patients

  • Amending prescriptions to gain additional medication;
  • Gaining multiple registrations with GP’s in order to obtain additional medication;
  • Overseas visitors using false documents in order to gain NHS services;
  • Patients selling their medication.
  • Newspaper Articles of Successful Prosecutions

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.