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