Brian Sims
Editor
Brian Sims
Editor
A FRAUDULENT dentist who owned practices in London and Surrey has been sentenced at Southwark Crown Court following a fraud investigation led by the NHS Counter Fraud Authority (NHSCFA). Dr Sheena Lalani, 46, of Kennington Road in London defrauded the NHS out of over £74,000.
Lalani was sentenced to 20 months’ imprisonment suspended for two years, ordered to carry out 250 hours of unpaid work, given a 20-day rehabilitation order and ordered to pay £662.00 of NHSCFA costs within three months.
Dr Lalani fabricated claims in order to increase the money she was paid by the NHS in respect of real patients and also backdated claims. The dentist earlier pleaded guilty at Westminster Magistrates’ Court. The Crown Prosecution Service charged Dr Lalani with fraud by abuse of position. This is an offence under the Fraud Act 2006.
The investigation started thanks to a call to the NHSCFA’s Fraud and Corruption Reporting Line, which is run by Crimestoppers. The dentist was reported as only attending her Westminster surgery named ‘Gentle Dental Care’ for two days per week when it advertised dental services being available five days per week.
Lalani paid back the money shortly before sentencing, and only when the NHSCFA was about to start a confiscation investigation under the Proceeds of Crime Act (POCA) 2002. The payback figure was raised to £87,298.37 to account for inflation. Lalani would have had to pay this amount under POCA, but that process is no longer necessary. Thus there’s a saving for the public purse.
Scale of the problem
Dr Lalani held contracts with the NHS to provide dental services from her two practices: ‘Gentle Dental Care’, based at 12 Chapter Street, Westminster in London and ‘The Maycroft Dental Centre’, located at Chobham Road in Woking, Surrey. Subsequent to the fraud investigation beginning, Lalani relinquished ‘The Maycroft Dental Centre’ contract.
When interviewed by NHS investigators, Lalani argued that, if she owed the NHS money, it was only due to poor administrative practices and her record-keeping being in ‘confusion and disarray’ at times and not down to dishonesty.
However, this did not explain the scale of the problem. When the investigation compared payments data with patient records from ‘Gentle Dental Care’, it showed Lalani had submitted 378 fraudulent claims over three financial years (from April 2014 to March 2017). Thus, she gained (and the NHS lost) over £74,000 to which she was not entitled.
The majority of Lalani’s false claims were for procedures that attract the top rate of payment to a dentist from the NHS. The evidence indicated a calculated exercise by Lalani to boost her revenue from the NHS with false claims. It could not have happened through error.
Evidence gathered
Examples of evidence gathered included:
*Alteration of dates on record cards, treatment plans and other documents
*Claimed appointments and treatments without supporting documentation
*Witness statements from patients who never received claimed treatments
*Dental laboratories unable to provide evidence of making devices for which Lalani claimed
*Five times the normal number of top-rate claims for payment from the NHS
*Excessive claims right at the end of the financial year for five years running
*Claimed to have performed 45 treatments in one day
Richard Rippin, head of operations at the NHSCFA, said: “The majority of dentists are skilled, honest and hardworking professionals who put their patients first. When Dr Lalani abused her trusted position by falsifying claims and claiming for work not done, she not only defrauded the NHS, but also let down the dental profession. It’s quite possible that, had she not been caught, the scale of the debt and the crime would have increased exponentially.”
Rippin added: “Over the last 18 months, the NHS has been subjected to unprecedented pressure, with resources being stretched to the limit. We, and our partners in the NHS, work hard to ensure that these NHS resources are protected. This result shows the dedication of the NHSCFA’s National Investigation Service, bringing those who abuse the NHS to justice. We are here to detect and investigate those who commit fraud and will seek all forms of redress. We urge anyone who suspects someone of defrauding the NHS to report the detail to us.”
The sentencing Judge expressed the view that the NHSCFA had done “a great deal of work… Lalani’s fraud was sophisticated, well thought out and well executed.”