COUNTERING FRAUD AND BRIBERY...• This first general offence is referred to as active bribery and...
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COUNTERING FRAUD AND BRIBERY Camden CCG Patient and Public Engagement Meeting Gemma Higginson, 6 June 2016
What is fraud?
• For an offence to have occurred, the person must have acted dishonestly with the intent of making a gain for themselves or anyone else, or inflicting a loss (or a risk of loss) on another.
• Person must have acted dishonestly
• Three main offences
• All require the element of dishonesty to be established.
Offences under the Fraud Act 2006.
Fraud Act 2006
Abuse of position
Failure to Disclose
The Bribery Act 2010
The offences • This first general offence is referred to as
active bribery and this constitutes the offering, promising or giving of a bribe
• The second general offence is referred to as passive bribery and constitutes requesting, agreeing to receive or the accepting of a bribe
• There is also a specific offence of bribing a foreign public official
Give a bribe
Receive a bribe
Bribe a foreign public official
Negligently fail to
prevent a bribe
Penalties: individual and corporate
• Maximum of 10 years imprisonment
• Unlimited fine
• Potential risk of disbarment from EU
• Directors struck off
• Massive reputational damage
Role of the Local Counter Fraud Specialist
Inform and Involve
Hold To Account
Prevent and Deter
Examples of NHS fraud cases
Prescription fraud • A CCG undertook a fraud investigation into a long standing and trusted member of
the reception team at a GP Practice, who abused her position by taking advantage of poor IT policy procedures and adherence to those procedures.
• Raised false prescriptions on elderly patients’ records who were in receipt of repeat
prescriptions. • Supplied the fraudulent prescriptions to unknown 3rd parties who then presented
them at out of area pharmacies. • Sentenced to 12 months Conditional Discharge and ordered to pay costs and
Examples of NHS fraud cases
Doctor – falsifying records
• A doctor who stole over £62,000 from the NHS was sentenced to 9 months’ imprisonment (suspended for 18 months) and must pay £50,000 costs.
• He admitted to falsifying the records of 1,703 patients to hit targets and increase
payments from the NHS to his practice and pleaded guilty to two offences under the Fraud Act.
• In just three days he manipulated the practice’s patient records system over 7,000 times in order to hit financial targets. He falsely claimed for patient checks he had not carried out.
What can You do?
DO Tell someone
Be aware of fraud issues
Make a note of your concerns
Keep a record or copy any documentation that arouses your suspicion
DO NOT x Confront the individual
x Try to investigate the matter yourself
x Contact the police directly
x Convey your suspicions to anyone other than those with proper authority to investigate
x Do nothing
Counter Fraud Team Gemma Higginson Kirsten Quinn Chaya-orna Diamond
: 07800 718 680 : 07436 268 340 : 07528 970 114
• Chief Finance Officer: Ian Boyle
• National Fraud Reporting Line : 0800 028 40 60
• Online reporting form at: www.reportnhsfraud.nhs.uk
• Public Concern at Work: 0207 404 6609
Thank you for your time and attention
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