Fraud

Local Counter Fraud Specialist

We have a Local Counter Fraud service provided for Wye Valley NHS Trust who hold the required accreditation to undertake such work.

The Trust is responsible for the administration of public funds for the purpose of providing health care to the community we serve. It is recognised that the existence of fraud and corruption threaten to prevent these funds providing maximum benefit to patients. The Trust takes a robust response to these threats as reflected in the Counter Fraud and Corruption Policy and by developing an organisational culture that is intolerant of fraud and corruption.

Suspicions of fraud and corruption may be referred by staff, patients, visitors or others in any instance where the NHS has been defrauded either internally or externally. The Local Counter Fraud Specialist will undertake an investigation and look to gather evidence that can be used to support a criminal prosecution.

Background of Counter Fraud & Security Management Service

Historically, NHS bodies were required to put in place arrangements to counter fraud and manage security under Secretary of State Directions. Provisions introduced under the Health and Social Care Act 2012 mean that such arrangements will now be set out in the NHS standard commissioning contract rather than in Secretary of State Directions. Given that the commissioning contract applies to all providers, irrespective of size, the clauses in the contract need to be applicable to providers of all sizes.

Fraud in the NHS is governed by the NHS Counter Fraud Authority (previously NHS Protect). Any concerns you may have in relation to a potential fraud at the Trust can be directed to our Local Counter Fraud Specialists at the contact details located below.

Trust Board Statement: Counter fraud and bribery

To read the Trust Board statement regarding Counter fraud and bribery click here.

How to report Fraud

To report fraud contact our local counter fraud specialist Manjit Sandhu, email Manjit.Sandhu@rsmuk.com or call on 07483 965116.

The National NHS Fraud and Corruption Reporting Line is a confidential reporting line operated by trained staff between 8am and 6pm - 0800 028 4060.  More information can be found by visiting the NHS Counter fraud Authority website. 

Data matching

We are required by law to protect the public funds we administer. We may share information provided with other bodies responsible for auditing or administering public funds, in order to prevent and detect fraud. The Cabinet Office is responsible for carrying out data matching exercises.

Data matching involves comparing computer records held by one body against other computer records held by the same or another body to determine the extent of the match. This is usually personal information. Computerised data matching allows potentially fraudulent claims and payments to be identified. Where a match is found it may indicate that there is an inconsistency which requires further investigation. No assumption can be made as to whether there is fraud, error or other explanation until an investigation is carried out. 

We participate in the Cabinet Office's National Fraud Initiative: a data matching exercise to assist in the prevention and detection of fraud – see guidance https://www.gov.uk/guidance/taking-part-in-national-fraud-initiative

The processing of data by the Cabinet Office in a data matching exercise is carried out with statutory authority under its powers in Part 6 of the Local Audit and Accountability Act 2014. It does not require the consent of the individuals concerned under data protection legislation or the General Data Protection Regulation (GDPR).  For further information on the reasons why it matches particular information, see https://www.gov.uk/government/publications/fair-processing-national-fraud-initiative/fair-processing-level-3-full-text  

For further information on data matching at Wye Valley NHS Trust please contact Manjit Sandhu Local Counter Fraud Specialist, by emailing manjit.sandhu@rsmuk.com. Further information on how the NFI has assisted the NHS and other public sector organisations can also be found at https://www.gov.uk/government/publications/national-fraud-initiative-case-studies/nfi-public-sector-case-studies