NHSCFA Business Strategy 2023-2026 and Business Plan 2023-2024 launched

Since the NHSCFA’s last Business Strategy was launched back in 2020, the changes witnessed in the wider world have been unprecedented. As a result, the NHS is under more pressure than ever to treat patients, save lives and save money.

Healthcare expenditure in 2021 was estimated at £277 billion and remains a target for fraudsters. The NHSCFA has assessed that, in the context of a 2021 to 2022 NHS budget in England of almost £150.614 billion, the NHS is vulnerable to fraud, bribery and corruption to an estimated value of £1.198 billion.

A complex system like the NHS, therefore, needs a shared strategy and a shared understanding of fraud risk. This is precisely why the NHSCFA exists – to fight fraud and save money – and why it will need to work in partnership to understand, find and prevent fraud in the NHS.

Following an extensive programme of collaboration, feedback and input from a wide range of key partners across the healthcare sector, the focus for the NHSCFA will be on four key pillars of activity. Those pillars describe the NHSCFA’s current and future approach to drive vulnerability down and increase the amount of fraud that’s detected, prevented and recovered.

These four pillars are Understand, Prevent, Respond and Assure and will form the basis of everything that the NHSCFA does. At the heart of this new approach is a new vision which will build upon partnership working. In short, working to understand, find and prevent fraud, bribery and corruption in the NHS.

NHSCFA CEO Alex Rothwell explained: “I’m delighted to launch our new Business Strategy, which will develop and evolve during its lifetime. I’m committed to strengthening our collaboration and engagement with key partners and that’s why the NHSCFA has undergone a significant transformation programme in order to ensure we have the right operating model to strengthen our counter fraud response across the health sector.”

Rothwell continued: “Data analytics and insight will be at the heart of our approach. The creation of a new Fraud Hub will also herald a new approach to support and enable alignment between the national and local counter fraud response and cuts across all four pillars of the strategy, generating a joined-up approach to tackling fraud, bribery and corruption within the NHS.”

Performance, planning and measurement

Tricia Morrison, director of performance and improvement at the NHSCFA, said: “During the development of our new Business Strategy, we’ve taken the opportunity to listen, re-measure, analyse and refocus every aspect of our operating model. This includes the systems that drive our performance, planning and measurement processes.”

Further, Morrison opined: “Collaboration with our key partners remains our focus. Setting out a clear delivery plan driven by our strategic intelligence assessment, targeting improved reporting of outcomes and giving health bodies the information they need in order to focus on impact. Our strategy reflects our ambition to continually develop the ways in which we work with our partners in the wider counter fraud community. It’s only by working together that we can make a difference in the fight against fraud.”

Tom Taylor, chair of the NHSCFA’s Board, stated: “The primary aim for the NHSCFA is ultimately to provide value for money for the public. This new Business Strategy clearly and concisely sets out how we intend to achieve this over the next three years. I would like to thank all of our colleagues and stakeholders for their considerable efforts in creating this document. It will form the basis of all of our work over the next three years.”

Sean Byrne, deputy director and head of counter fraud at the Department of Health and Social Care, noted: “The NHSCFA provides an essential function as part of the wider health family in the fight against fraud, ensuring taxpayer funds are used to deliver better patient care and not diverted into the pockets of fraudsters. This new three-year strategy will ensure that the NHSCFA understands and keeps pace with new and emerging threats and has the capabilities in place to deal with them.”

Unseen and underestimated problem

Mark Cheeseman OBE, CEO at the Public Sector Fraud Authority, said: “Fraud is an often unseen and underestimated problem. It takes money away from critical services on which the public rely. I welcome the new Business Strategy from the NHSCFA, which recognises the extent of the challenge faced and makes a commitment to real, meaningful and measurable action.”

Graham Dainty (Counter Fraud Wales), Donna Scott (Health and Social Care Northern Ireland), Gordon Young (NHS Scotland) and Tricia Morrison have also issued a short joint statement. “We have a collective determination to work together to find, report and stop NHS fraud across the UK. Understanding how each territory operates, we can continue to develop and deliver the most effective counter fraud measures across England, Scotland, Wales and Northern Ireland, thereby ensuring that NHS funds go to patient care and not into the hands of fraudsters.”

In conclusion, Michael Brodie OBE (CEO at the NHS Business Services Authority) said: “The NHS Business Services Authority has a lot of high-volume transactional work to transact. We are responsible for over £39 billion in NHS spend. We take tackling fraud and loss very seriously. Our in-house fraud team works closely with a range of counter fraud stakeholders including the DHSC Anti-Fraud Unit, the NHS England Counter Fraud Team and the NHSCFA. Working in partnership with the NHSCFA helps both organisations to maximise their potential.”