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Ahmer Kunwar, BA, CIPR, is internal and external
communications manager at the NHS Counter Fraud and Security
Management Service in London.
e-mail Ahmer.Kunwar@cfsms.nhs.uk
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Reporting NHS fraud
Those who suspect NHS fraud should report
it to their LCFSs or to the NHS fraud and corruption reporting
line (tel 0800 028 40
60). All calls will be addressed by trained staff and investigated.
Telephone lines are open weekdays from 8am–6pm. Fraud may
also be reported by sending an e-mail to nhsfraud@cfsms.nhs.uk
To find out more about fraud awareness month 2006 visit the NHS
CFS website or send an e-mail to cad@cfsms.nhs.uk |
This year fraud awareness month is taking place from 9 November to 9
December and it has become an established annual event in the NHS calendar.
Over the past three years, NHS counter-fraud specialists have organised
highly successful events at health organisations throughout England and
Wales, raising fraud awareness among NHS staff, professionals and the
public. This year local counter-fraud specialists (LCFSs) will identify
and target those areas within their health organisations where fraud
awareness may be still low and take action to develop an anti-fraud culture.
LCFSs who are responsible for carrying out all work to counter fraud
and corruption in their health organisations will lead work for the campaign
on a local level. They will conduct a range of activities to:
· Raise the level of fraud awareness among professionals within
the NHS
· Provide information on how NHS professionals
can report suspicions of fraud
· Illustrate the role that NHS professionals can play in preventing
fraud
The LCFSs have planned seminars to deliver presentations to NHS staff
and professionals in their local trusts. They will also be handing out
leaflets to staff and patients, placing messages on local intranet sites
and featuring articles in staff newsletters. In addition, a poster campaign
will be developed to heighten the awareness. Those who would like to
attend seminars or require any publicity materials should contact their
LCFSs.
Pharmacist fined for fraud
At Coventry Crown Court in April a pharmacist
was ordered to pay £14,200
or face prison. The pharmacist pleaded guilty to 21 counts of false
accounting after admitting to falsifying records for the supply of
drugs and was fined £200 per count. After discrepancies were
noticed at the pharmacy, an investigation revealed that the pharmacist
was claiming for items that had not been dispensed. He also claimed
to have dispensed large amounts of medicines in small packs, whereas
in fact they had been dispensed in large packs; this has an impact
on the cost to the NHS.
The pharmacist was ordered to pay £10,000 in prosecution
costs with the condition that if this and the fine were not paid
within
28 days, he would be subject to three months in prison. |
The NHS Counter Fraud Service (CFS) has found degrees of fraud
in many areas of the NHS, with pharmaceutical fraud being no exception.
Pharmaceutical
fraud has been committed by patients, hospital prescribers, hospital
dispensers, dispensing doctors, GPs, community pharmacists and appliance
contractors. The case study (see Panel, right) gives an example of
pharmaceutical fraud perpetrated against the NHS and subsequent action
taken by the
NHS CFS. The NHS CFS hopes that by taking tough action it will deter
potential fraudsters from carrying out such offences.
With a clear understanding of the risks faced by the NHS and a wealth
of experience in this area, the NHS CFS can recognise where a process
is susceptible to fraud. Once it recognises that a weakness exists,
it can take measures to prevent it from happening again. Most pharmacists
are honest, but there is a small minority who try to defraud the NHS
of its valuable resources. Fraud has been detected among a small minority
of pharmacists in various forms. Some of these include making false
endorsements
on a prescription sent to the Prescription Pricing Division, claiming
for drugs not dispensed, under-dispensing, abuse of the repeat prescribing
system, retaining and not declaring paid prescription charges on low
cost drugs, and illegal importation or exportation of prescription
drugs. Fraud has also been detected among patients who try to pass
stolen prescription
forms, engage in counterfeiting and forgery of prescriptions and use
multiple identities or registrations to obtain drugs.
By working together to reduce fraud and corruption to an absolute minimum
and holding it there permanently, counter-fraud services can release
these resources for better patient care. LCFSs and the NHS CFS can,
more than ever before, protect vital NHS resources but to do so it
is essential
that people report any suspicions that they have.
It is difficult to produce a model to address all types of pharmaceutical
fraud but the NHS CFS encourages all NHS staff and contractors to undertake
regular reviews of prescribing and dispensing trends, and to review
procedures and contracts annually. Should any suspicions be identified
during the
reviews they should be reported to the LCFS.
A telephone line has been set up for reporting
suspicions of fraud in the NHS
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The NHS CFS has already
achieved a great deal by raising awareness about fraud and sharing
best practice. Between 1999 and 2005: · It has provided a total financial benefit of £675m to the
NHS — a phenomenal 13:1 return on investment
· It has cut overall losses in the area of
patient fraud by 54 per cent from £171m to £78m a year
· It has had a remarkable 96 per cent success rate for prosecution
· Over 1,400 fraud awareness presentations have been delivered to
key NHS staff
· Over 980,000 NHS staff and professionals have been covered by
counter-fraud charter agreements to work with the NHS CFS to counter
fraud and corruption
Last year, fraud awareness month proved to be highly successful, reaching
a total audience of 13 million people. This year, it is expected to have
an even bigger impact — nationally and internationally — and
will coincide with the United Nations worldwide anticorruption day and
the European healthcare fraud and corruption awareness campaign (EHFCAC).
The EHFCAC was developed by the NHS CFS to persuade NHS professionals
that fraud exists, that it is serious and that it takes resources away
from important services.
The purpose of the EHFCAC is to develop an anti-fraud and anti-corruption
culture within health care systems among service providers, health care
suppliers, health care payers, health care users and ultimately among
all EU citizens.
The United Nations worldwide anti-corruption day marks an international
day to raise awareness worldwide and calls upon governments to take action
against corruption. In 2004,
110 countries signed up to the United Nations convention against
corruption.
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The
Pharmaceutical Journal