Fraud is a criminal offence as defined by the Fraud Act 2006.
Most commonly it occurs when a person dishonestly makes a false representation in order to gain for themselves or cause loss to another.
The type of offences for which a person could be prosecuted include:
- Fraud by False Representation – lying about something with the intention to cause a gain or a loss.
- Fraud by Failure to Disclose Information – not declaring something when you have a legal duty to do so with the intention to cause a gain or a loss.
- Fraud by Abuse of Position – where someone abuses a position of trust where there is an expectation to safeguard the financial interest of another and places another at financial risk or causes a loss.
In each instance the action must be shown to have been dishonest. It shouldn’t be possible to commit fraud accidentally; it must be shown that the individual’s actions would be considered to be dishonest by the average ‘man in the street’.
As well as being a criminal offence, if a person is found to have committed fraud it is likely that they will have also broken the terms of their contract of employment or professional codes of conduct.
What types of fraud can occur within the NHS?
The following are some examples of fraud that have been committed within or against the NHS:
- Staff submitting:
- claims for excess hours or overtime not worked.
- claims for expenses not incurred.
- duplicate claims for hours already claimed.
- Job applicants providing false information on an employment application including:
- work history.
- Employees working elsewhere whilst sick from the NHS.
- Employees ordering goods through the NHS and taking them home.
- Employees defrauding the finances of a patient.
- Employees manipulating budgets and accounts for their own gain.
- Patients using false identities to obtain extra drugs.
- The falsification or alteration of prescriptions.
- Contractors claiming for services not provided.
- Visitors to the UK using false identity papers or details to obtain NHS treatment.
- Submission of false invoices to the NHS.
- False requests to change the banking or contact details for a legitimate supplier.
- Emails impersonating directors or managers being sent to NHS employees requesting financial transactions.
In summary; fraud is a dishonest act which is committed with the intention of making a gain or causing loss or risk of loss to another. If you have a suspicion of fraud affecting the NHS you should report your concerns immediately.