FOI/2025/26/220

Request

Q1 – Referrals to the NHSCFA

I am requesting referrals made by the NHS organisation/LCFS to the NHSCFA (i.e., originating from the organisation).

Please exclude referrals made directly to NHSCFA by third parties that the organisation does not hold.

 

Q2 – Number of suspected fraud incidents

Please provide the count of suspected fraud incidents recorded by the organisation/LCFS in your records for each financial year. This should include matters reported to you by any route (including those shared with you by NHSCFA), but does not require incidents that NHSCFA handled without sharing with the organisation.

 

Q3 – Number of proven fraud incidents (disciplinary or criminal)

Yes—please count incidents that resulted in a disciplinary finding for fraud and/or a criminal outcome (e.g., conviction/caution). Cases resolved without a fraud finding should not be counted as “proven.”

 

Q4 – £ value lost (total)

Please include the total £ value of losses attributable to fraud/suspected-fraud cases recorded in LCFS/organisation records for each year. If your data distinguishes between fraud and non-fraud overpayment/irregularity, a brief split would be helpful; otherwise a single total with a note of scope is fine.

 

Q5 – £ value recovered (total)

Please include the total £ value recovered in relation to the above fraud/suspected-fraud cases (e.g., repayments, civil recoveries). If possible, please indicate whether recoveries include amounts from non-proven cases or from prior-year cases received in the year; a simple note or split is helpful but not essential.

Response

Please find the response below, please note that the case management system hosted by the NHS Counter Fraud Authority and required to be used by Local Counter Fraud Specialists was changed in early 2021, and access to this system is now limited, therefore for the period of the FoI prior to this we have compiled all available data through other systems and records to provide the most comprehensive information available within the required response timeframe.

 

 

 

	2016/17	2017/18	2018/19	2019/20	2020/21	2021/22
Referrals to the NHS Counter Fraud Authority (count)	Not RSM client	15	15	11	18	10
Number of suspected fraud incidents	Not RSM client	15	15	11	18	10
Number of proven fraud incidents (disciplinary or criminal)	Not RSM client	0	3	1	2	0
£ value lost (total)	Not RSM client	£0	£0*	£0*	£0*	£0
£ value recovered (total)	Not RSM client	£0	£0*	£0*	£0*	£0