Counter-fraud requirements unveiled

by Seamus Ward

05 February 2021


From April, finance directors and audit committees will be required to oversee new counter-fraud actions across 12 categories.

The government functional standard on counter fraud replaces previous NHS standards for fraud, bribery and corruption. The standard has now been interpreted by the NHS Counter Fraud Authority (NHSCFA), producing a list of 12 requirements that will apply from 1 April. The authority estimates the NHS is vulnerable to more than £1.2bn worth of fraud each year.Paul Tiffen landscape

The new requirements apply to all NHS-funded bodies in England and Wales. This includes NHS trusts, foundation trusts, clinical commissioning groups, health boards, ambulance trusts, some independent sector providers, NHS England and NHS Improvement. If they meet qualifying criteria, trust subsidiary companies may also be subject to the new requirements.

Each NHS-funded body must provide details of their performance against the standard annually, which the authority will use to provide assurance to the Cabinet Office of NHS action against fraud, bribery and corruption.

The 12 components NHS bodies must meet include producing a counter-fraud, bribery and corruption strategy that is submitted to the centre; introducing outcome-based metrics; and having an accountable board-level individual.

The NHSCFA has mapped its previous counter-fraud standards to the new requirements to achieve the functional standards.

NHSCFA quality and compliance manager Paul Tiffen (pictured), urged NHS-funded services to read the new requirements on its website. ‘With endorsement from the Cabinet Office, we have interpreted the functional standard so it is clearer and easier for the NHS to understand what it needs to do to comply,’ he added. ‘The roll-out of the requirements is a positive step that will mean that NHS-funded services are working to a common counter fraud standard, which can only enhance the collective effort to identify, prevent and prosecute frauds.

‘The NHSCFA is responsible for providing assurance to the Department of Health and Social Care and the Cabinet Office regarding overall compliance with the functional standard across the sector, and will be working collaboratively with NHS bodies to enable them to comply with the requirements themselves.’