New development: From blanket coverage to patchwork quilt—rethinking organizational responses to fraud in the National Health Service in England

IMPACT

This article will be of value to those working across the National Health Service (NHS) and particularly to those engaged in counter fraud activities across the public sector. As well as having national value, this article will be of international relevance as it speaks to the responsible guardianship of public funds. This article evidences the ways in which counter fraud services across the NHS in England are disjointed and some of the causes for such disjointedness. Official reports estimate that at least £1.2 billion, approximately 1% of the NHS budget, is annually lost to fraud. At a time when the NHS is facing unprecedented demand on its resources due to austerity policies, Brexit and the global pandemic, and with no clear indication of significant additional investment, any loss of NHS funds could have significant impact on patient care and so a better understanding of counter fraud responses in the NHS is potentially pivotal to future responsible handling of public money.

ABSTRACT

This article presents first-hand experience of those delivering counter fraud services, demonstrating the extent of disjointedness in responses to fraud against the National Health Service (NHS). This sample study of local counter fraud specialists working across England, indicates that the current counter fraud landscape creates the structure and conditions for reduced ‘effectiveness’ of counter fraud provisions, including great variability across regions and across types of fraud. This article evidences the need for future research to better understand and strengthen counter fraud provision across the NHS.

KEYWORDS:

• Continuing professional development
• counter fraud
• financial accountability
• financial crime
• fraud
• National Health Service
• public sector fraud
• safeguarding of public money

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Cerian Griffiths

Cerian Griffiths is an Assistant Professor in the Law School at Northumbria University, UK, specializing in the investigation and prosecution of financial crime.

Alan Doig

Alan Doig is a UK-based consultant in corruption, fraud and public ethics and has extensively published on fraud investigation and financial crime in the public sector.

Jackie Harvey

Jackie Harvey is Emeritus Professor in the Business School at Northumbria University, UK, specializing in money laundering.

Katie Benson

Katie Benson is Lecturer in the School of Social Sciences Criminology at the University of Manchester, UK, and conducts research in the areas of money laundering and organized financial crimes. She is an Associate Fellow at the RUSI Centre for Financial Crime and Security Studies.

Nicholas Lord

Nicholas Lord is Professor of Criminology in the School of Social Sciences at the University of Manchester, UK. His research includes bribery and corruption, fraud, corporate and white-collar crime, illicit finance and money laundering, regulation theory and comparative criminology.