The NHS Counter Fraud Authority is driving improvements in NHS procurement practices.
Procurement is one of the most significant areas of fraud risk in the NHS, with an estimated annual fraud loss of £351m – this is why procurement fraud is a priority for the NHSCFA in 2019-20.
The NHSCFA has presented at HCSA’s 2018 and 2019 conferences to raise the profile of its work on preventing fraud in the NHS. Our key messages have been around raising awareness about the vulnerabilities that exist within current systems, so that organisations and staff are better prepared to spot and report fraud. We also aim to improve upon existing systems and encourage best practices.
The national proactive exercise
The vehicle for this work has been the National Proactive Exercise (NPE) on the prevention of procurement fraud, which launched in May 2019. As part of the exercise, all NHS providers were requested to provide information in relation to three fraud risk areas: disaggregate spend, contract management, and purchase order (PO) vs non-PO spend.
To date, the exercise has seen an 81% participation rate from NHS provider organisations. The NHSCFA is currently working through the analysis on the three fraud risk areas. The initial findings have highlighted fraud risk vulnerabilities in NHS contract management, particularly around underperformance in existing contracts. As a result, NHS procurement staff have undertaken further internal investigation on performance of these contracts and implemented measures to hold suppliers to account. In a few instances, contracts were terminated. A key theme to emerge from our analysis is the correlation between high frequency end-user involvement and positive performance around contract management.
Another interesting area of note was around PO vs non-PO spend. The analysis identified that there are some areas of spend that are universally higher than others when it comes to non-PO spend, as a percentage of total spend. The eClass categories of note were transportation and staff & patient consulting services and expenses. These are service-led intangible commodities which would make the fraud vulnerability risk high. Intangible services had the highest proportion of non-PO spend in comparison to tangible items such as equipment, fixtures and clothing.
We are currently exploring ways in which to provide feedback to participants of the NPE on the information provided on the three fraud risk areas. This will most likely take place after the completion of the exercise in 2020 (please see below).
Procurement fraud quick guides
In July 2019, a series of eight procurement fraud quick guides were published on the NHSCFA website. The purpose of the quick guides is to alert NHS staff to known fraud risks and provide clear and practical information on effective measures staff and managers can take to identify and stop fraud and improve their own systems. Each guide includes a brief overview of the fraud risk, along with information on how to spot fraud, how to stop it and how to report any suspicions of fraud.
What happens next
The final stage for this exercise will commence in 2020, when the NHSCFA will repeat the exercise during the months of May through to July, collecting summary information again on the three baseline areas to assess the impact of the work on NHS organisations’ systems.
Authors: Lorraine Harris, Fraud Prevention Lead &
Oliver Stopnitzky, Senior Fraud Prevention Officer
Source: NHS Counter Fraud Authority