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NHS Counter Fraud Service Wales

The NHS Wales counter fraud strategy aims to:

  • Reduce fraud in NHS Wales to a minimum;
  • Hold it permanently at that level; and thus,  
  • Release resources for better patient care.

 

Joint Working Relationship

The strategy involves a joint working relationship between the Welsh Government and NHS Protect in England. This led to the recruitment in 2001 of a specialist NHS Counter Fraud Service (CFS) Wales Team who investigates fraud and corruption issues in NHS Wales. CFS Wales is funded by the Welsh Government and they are operationally managed via NHS Protect.

CFS Wales largely rely upon Welsh Government Directions on Counter Fraud Measures to gain access to relevant internal information. The Directions state that Welsh health bodies must report all fraud and corruption concerns to CFS Wales and also ensure that CFS Wales have access to NHS Wales’ employees and practitioners and any relevant NHS documents and information.

The Directions also stipulate that NHS Wales' health bodies must nominate a suitable person to act as their Local Counter Fraud Specialist (LCFS).

 

CFS Wales

The CFS Wales team consists of experienced investigators who deal with large scale, complex frauds and all corruption issues in NHS Wales. The six person team works closely with other investigative bodies including the Police and are authorised to conduct covert surveillance work (under RIPA) and financial investigation work (under POCA).

The CFS Wales Team also provide support and guidance to the network of Local Counter Fraud Specialists (LCFS) who are based at health bodies in Wales. The LCFS’ usually investigate smaller value fraud cases within their own health bodies. The LCFS’ work with CFS Wales to help develop a robust counter fraud culture and secure criminal, civil and disciplinary sanctions when appropriate.

 

Sanctions

All potential criminal cases are reviewed by the Crown Prosecution Service and the full range of criminal, civil or disciplinary sanctions are considered on all suitable cases. 

The CFS Wales team had investigated a total of 153 high value referrals by 31.12.12 while the network of 18 LCFS had investigated an additional 1168 referrals. The investigations have led to the recovery of over £5.1 million for NHS Wales and secured 133 criminal sanctions, 204 civil recoveries and 208 disciplinary actions via NHS employers and professional bodies. 

 

Reporting Fraud

Any potential concerns regarding fraud or corruption in NHS Wales or requests for additional information should be referred to CFS Wales, or reported to your health bodies LCFS, or reported to the free phone Fraud and Corruption Reporting Line Tel: 0800 028 40 60.

 

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