NHS Counter Fraud and Security Management Service
Encyclopedia
The Counter Fraud and Security Management Division protects the staff, assets and resources of the National Health Service
in England
and Wales
. Since 1 April 2006 it has been a division of the NHS Business Services Authority
, a special health authority
of the Department of Health
of the United Kingdom
. It was formerly known as the NHS Counter Fraud and Security Management Service (NHS CFSMS).
The NHS CFSMS comprises the NHS Security Management Service (NHS SMS) which develops strategy for improving security in the NHS, and the NHS Counter Fraud Service (NHS CFS), which implements policy on protecting NHS
resources from fraud.
under the leadership of Jim Gee. The organisation set about discovering the scale of fraud against the NHS, what types of crime were involved and how much money might be being lost to the NHS. The next step was to set up an operational department to investigate cases of fraud and help the police and Crown Prosecution Service
bring them to justice.
It was discovered that fraud was being carried out by patients, NHS staff and professionals and contractors. Examples included patients using false identities to gain large numbers of prescriptions for drugs, NHS staff members claiming for shifts they had not done, managers inflating expenses and contractors such as opticians and dentists claiming for services they had not provided.
From 1999-2006 it was estimated that counter fraud work in the NHS benefited the public purse by £811 million. This could pay for 53,000 kidney transplants or 35,000 nurses for a year.
Successes include the investigations into a General practitioner
who did private work while off sick from the NHS, who was jailed for 12 months, a manager at a major hospital trust who was jailed for four years for creating fake employees in order to claim their salaries and a bogus psychiatrist
who faked his qualifications, jailed for ten years. He lived a lavish lifestyle which included a 5 bedroom house, 30 Armani suits and a Ferrari. Under contravertial plans, he was allowed back on duty and maintain the organisations £59 million budget.
The NHS Counter Fraud Service has also helped the NHS to fraud proof its systems leading to much lower rates of fraud than occurred in the past.
The NHS SMS set about ensuring that every health body appointed a Local Security Management Specialist, trained and accredited by the NHS SMS, so that health bodies would be able to focus on the issues that affected them locally. In addition, the NHS SMS set up a Legal Protection Unit which provides cost effective legal advice to the NHS on pursuing sanctions against offenders and if necessary can pursue prosecutions. In 2004-2006, the rate of prosecution for people who assault NHS staff had gone up to 16 times what it had been in 2002-2003 (850 against 51), and increased again to 869 in 2006-2007.
In November 2007 it was revealed that there had been 55,709 physical assaults against NHS staff in England, 2,986 fewer than 2005-2006 and 4,586 fewer than 2004-2005.
In April 2004, the NHS SMS launched the biggest ever training programme in NHS history. Conflict Resolution Training aims to train 750,000 frontline NHS staff members in techniques to manage and prevent violence, looking at methods of communication, cultural awareness, environment and how to de-escalate violent situations as well as how to avoid being physically assaulted if de-escalation fails.
The NHS SMS has also contributed to trials of technology to help protect NHS staff and assets. This includes assisting with the Safer Hospitals Programme to develop environments which can help to reduce violence, and trialling a device for lone workers which will enable them to discreetly call for help to a response centre if in danger and give details as to their location, as well as recording evidence that can be used to prosecute offenders.
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
in England
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
and Wales
Wales
Wales is a country that is part of the United Kingdom and the island of Great Britain, bordered by England to its east and the Atlantic Ocean and Irish Sea to its west. It has a population of three million, and a total area of 20,779 km²...
. Since 1 April 2006 it has been a division of the NHS Business Services Authority
NHS Business Services Authority
The NHS Business Services Authority is a special health authority of the National Health Service in England and Wales. It was created on 1 October 2005 following a review by the Department of Health of its "arm's length bodies". It began operating on 1 April 2006, bringing together five...
, a special health authority
NHS Special Health Authority
A special health authority is a type of NHS trust which provide services on behalf of the National Health Service in England. Unlike other types of Trust, they operate nationally rather than serve a specific geographical area....
of the Department of Health
Department of Health (United Kingdom)
The Department of Health is a department of the United Kingdom government with responsibility for government policy for health and social care matters and for the National Health Service in England along with a few elements of the same matters which are not otherwise devolved to the Scottish,...
of the United Kingdom
United Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
. It was formerly known as the NHS Counter Fraud and Security Management Service (NHS CFSMS).
The NHS CFSMS comprises the NHS Security Management Service (NHS SMS) which develops strategy for improving security in the NHS, and the NHS Counter Fraud Service (NHS CFS), which implements policy on protecting NHS
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
resources from fraud.
The NHS Counter Fraud Service
The NHS Counter Fraud Service was set up in 1998 as part of the Department of HealthDepartment of Health (United Kingdom)
The Department of Health is a department of the United Kingdom government with responsibility for government policy for health and social care matters and for the National Health Service in England along with a few elements of the same matters which are not otherwise devolved to the Scottish,...
under the leadership of Jim Gee. The organisation set about discovering the scale of fraud against the NHS, what types of crime were involved and how much money might be being lost to the NHS. The next step was to set up an operational department to investigate cases of fraud and help the police and Crown Prosecution Service
Crown Prosecution Service
The Crown Prosecution Service, or CPS, is a non-ministerial department of the Government of the United Kingdom responsible for public prosecutions of people charged with criminal offences in England and Wales. Its role is similar to that of the longer-established Crown Office in Scotland, and the...
bring them to justice.
It was discovered that fraud was being carried out by patients, NHS staff and professionals and contractors. Examples included patients using false identities to gain large numbers of prescriptions for drugs, NHS staff members claiming for shifts they had not done, managers inflating expenses and contractors such as opticians and dentists claiming for services they had not provided.
From 1999-2006 it was estimated that counter fraud work in the NHS benefited the public purse by £811 million. This could pay for 53,000 kidney transplants or 35,000 nurses for a year.
Successes include the investigations into a General practitioner
General practitioner
A general practitioner is a medical practitioner who treats acute and chronic illnesses and provides preventive care and health education for all ages and both sexes. They have particular skills in treating people with multiple health issues and comorbidities...
who did private work while off sick from the NHS, who was jailed for 12 months, a manager at a major hospital trust who was jailed for four years for creating fake employees in order to claim their salaries and a bogus psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...
who faked his qualifications, jailed for ten years. He lived a lavish lifestyle which included a 5 bedroom house, 30 Armani suits and a Ferrari. Under contravertial plans, he was allowed back on duty and maintain the organisations £59 million budget.
The NHS Counter Fraud Service has also helped the NHS to fraud proof its systems leading to much lower rates of fraud than occurred in the past.
The NHS Security Management Service
The NHS Security Management Service was set up alongside the NHS Counter Fraud Service to build on the successes of the latter by extending the remit to security issues. As part of a new Special Health Authority the NHS SMS has begun to introduce the first ever national strategy for security in the NHS, which involves measures to protect staff in England against violence and abuse, prevent theft and damage to equipment and property, ensure the security of drugs and medicines and protect maternity and paediatric units.The NHS SMS set about ensuring that every health body appointed a Local Security Management Specialist, trained and accredited by the NHS SMS, so that health bodies would be able to focus on the issues that affected them locally. In addition, the NHS SMS set up a Legal Protection Unit which provides cost effective legal advice to the NHS on pursuing sanctions against offenders and if necessary can pursue prosecutions. In 2004-2006, the rate of prosecution for people who assault NHS staff had gone up to 16 times what it had been in 2002-2003 (850 against 51), and increased again to 869 in 2006-2007.
In November 2007 it was revealed that there had been 55,709 physical assaults against NHS staff in England, 2,986 fewer than 2005-2006 and 4,586 fewer than 2004-2005.
In April 2004, the NHS SMS launched the biggest ever training programme in NHS history. Conflict Resolution Training aims to train 750,000 frontline NHS staff members in techniques to manage and prevent violence, looking at methods of communication, cultural awareness, environment and how to de-escalate violent situations as well as how to avoid being physically assaulted if de-escalation fails.
The NHS SMS has also contributed to trials of technology to help protect NHS staff and assets. This includes assisting with the Safer Hospitals Programme to develop environments which can help to reduce violence, and trialling a device for lone workers which will enable them to discreetly call for help to a response centre if in danger and give details as to their location, as well as recording evidence that can be used to prosecute offenders.