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NEWSLETTER
FOR THE HEALTH AND SOCIAL CARE SECTOR
Contents
3 | Strategic Pillars
4 | Former NHS healthcare assistant sentenced for fraud
5 | Former NHS doctor sentenced for £268k NHS fraud
6 | Suspended sentences issued after NHS fraud involving inflated timesheets
8 | Former NHS credit controller sentenced after large financial fraud
10 | Internal control failures in a high‑pressure environment: What recent fraud trends mean for the NHS
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Introduction
Welcome to our Winter 2026 Counter Fraud Newsletter. The NHS Counter Fraud Authority (NHSCFA) estimates that the NHS is vulnerable to over £1.3 billion worth of fraud each year.
Fraud is deception carried out for personal gain, usually for money. Fraud can also involve the abuse of a position of trust. By ‘NHS fraud’ we mean any fraud where the NHS is the victim. While those who commit fraud against the NHS are a small minority, their actions have a serious impact on us all.
Fraud against the NHS could be committed by anyone. This includes members of staff, patients, contractors, suppliers, medical professionals and external parties, such as cybercriminals.
The Strategic Pillars The NHSCFA 2023-2026 Strategy: ‘Working together to understand, find and prevent fraud, bribery and corruption in the NHS’ focuses on four key pillars: Understand, Prevent, Respond and Assure . • Understand how fraud, bribery and corruption affects the NHS.
Fraud takes taxpayers’ money away from patient care and into the hands of criminals. Everyone has a part to play in fighting fraud and being aware of the risk and remaining vigilant are the most important first steps, followed by knowing how to report fraud. Contact details for reporting fraud in confidence are included at the end of this newsletter so if you have any suspicions that fraudulent activity may be occurring, please report this at the earliest opportunity.
• We will ensure the NHS is equipped to take proactive action to prevent future losses from occurring.
• When we know that fraud has occurred, we are equipped to respond .
• We can assure our key partners, stakeholders and the public that the overall response to fraud across the NHS is robust.
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Former NHS healthcare assistant sentenced for fraud
A former NHS healthcare assistant has been ordered to repay £6,000 to an NHS trust and will complete a 12‑month community order after admitting to fraud.
T he individual, aged 24, was sentenced at Newcastle upon Tyne Magistrates’ Court in November 2025, following earlier guilty pleas in October 2025 to two charges of Fraud by False Representation. They must also complete 15 days of rehabilitation activity and cover £279 in additional costs.
In December 2023, their employing trust began an internal review into their ability to work, after which the individual resigned. A representative of Newcastle upon Tyne Hospitals NHS Foundation Trust commented that the fraud resulted in a financial loss to the NHS that should have been directed towards patient care. They added that the wrongdoing was identified quickly and reported to the fraud team, ensuring the matter was addressed and the individual was held responsible. They also noted that this conduct does not reflect the behaviour of the vast majority of NHS staff, and that the case highlights the trust’s commitment to tackling fraud and safeguarding public funds.
Over a four‑month period in late 2023, the individual was absent from their role at Newcastle upon Tyne Hospitals NHS Foundation Trust, supported by four GP‑issued fit notes. During this same timeframe, they worked 20 shifts as a bank nursing assistant for Northumbria Healthcare NHS Foundation Trust and had been allocated a further 44 shifts.
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Former NHS doctor sentenced for £268k NHS fraud
A former NHS resident doctor has received a three‑year prison sentence after admitting to defrauding the NHS of more than £268,000, following an investigation carried out by the NHS Counter Fraud Authority (NHSCFA).
T he individual, aged 61 and from Orpington in Kent, was sentenced at Woolwich Crown Court in November 2025. They had previously entered guilty pleas in September 2025 at the same court to four charges of Fraud by False Representation. They had been working as a trust grade specialist registrar in obstetrics and gynaecology at a hospital in London. This role is a type of resident doctor, formerly referred to as a junior doctor. From October 2018 to December 2021, they undertook on‑call and night duties at three other NHS trusts, despite having told their employer that they were unable to perform such work. These shifts were carried out while they were either on sick leave or on reduced duties from their main employer.
In June 2022, the local counter fraud team interviewed the individual under caution, during which they declined to answer questions. After further investigation by the NHSCFA, they were charged with four counts of Fraud by False Representation. During sentencing, the judge stated that the individual had lied to occupational health, colleagues, and their employer, and emphasised that the public does not expect medical professionals to act dishonestly for personal benefit. A representative from the NHSCFA stated that the case showed a deliberate breach of trust by someone who knowingly ignored the conditions of their employment for personal gain. They added that the individual’s actions diverted significant NHS funds that should have supported patient care, and that the authority remains committed to identifying and taking action against those who exploit NHS resources.
As well as paying the individual their full salary, the trust was required to hire locum staff to cover the work they claimed they were unable to complete. In November 2021, the trust received information indicating that the individual had been working night shifts at a different hospital. Checks by the local counter fraud team confirmed that they had completed several on‑call shifts there. Further enquiries by the trust and NHSCFA gathered witness evidence showing that the individual had also worked for three other trusts while they were supposed to be operating under reduced duties for their main employer. The trust provided records confirming that the individual had not sought, nor been granted, approval for any secondary employment. Timesheets and payroll information from the other three trusts demonstrated that most of their additional work involved night and on‑call duties, despite their claims that they were not fit to undertake such tasks.
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Suspended sentences issued after NHS fraud involving inflated timesheets A former NHS locum paramedic and a recruitment consultant have each received suspended prison sentences after defrauding the NHS of more than £60,000, following an investigation by the NHS Counter Fraud Authority (NHSCFA).
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O ne individual, was given a 22‑month prison term, suspended for two years, at Wolverhampton Crown Court in February 2026. They were also instructed to complete a year‑long mental health treatment programme and take part in 62 days of rehabilitation across two schemes. They had admitted both counts of fraud by false representation at the same court in November 2025. The second individual was also handed a 22‑month sentence, suspended for two years, in February 2026. They were additionally required to undertake a three‑month alcohol treatment programme, complete ten days of rehabilitation, and carry out 175 hours of unpaid work within a year. They had previously pleaded guilty to the same two offences in November 2025. Between 2017 and 2024, the first individual worked as a locum paramedic for a private clinical staffing agency, managed by the second individual, who was responsible for NHS clients and staffing placements in the Midlands. In September 2022, the paramedic began working for an Integrated Health and Care NHS Trust. From that point until June 2024, they submitted timesheets that had been altered, exaggerated, or completely falsified, following instructions from the recruitment consultant.
to change timesheets and add extra shifts.
The paramedic was placed at two GP practices. Between September 2022 and March 2024, they submitted 69 falsified timesheets claiming for additional shifts not worked, totalling £34,386. Between March 2024 and June 2024, they continued to put in weekly paper timesheets despite no longer working for the trust. They amended dates on previously authorised documents and added new dates for weeks in which they had not worked, creating a further fraudulent claim of £29,449. The staffing agency has already made repayments to the NHS relating to these losses. Although the recruitment consultant did not receive direct payments from the paramedic, they earned commission for keeping the paramedic in post. It is estimated that £1,224 of this commission was linked to the fraudulent timesheets. NHSCFA Financial Investigators are now using powers under the Proceeds of Crime Act 2002 to identify and recover the remaining money. A representative of the NHS Counter Fraud Authority stated that the outcome reflects the thorough work of investigators, who pieced together evidence from banking records, telecommunications and detailed interviews. They noted that the paramedic submitted false claims over nearly two years under the direction of their manager, emphasising the need for strong checks on timesheet processes. They added that the NHSCFA will continue to pursue those who misuse NHS resources and ensure they face the consequences of their actions.
The total loss to the NHS amounted to £63,835.
The trust reported the matter to the NHSCFA due to concerns about fraudulent activity. Investigators examined banking information, confirming that the paramedic had been paid the inflated amounts. Both individuals were interviewed voluntarily under caution, and witness accounts were collected. Telecommunications obtained from the paramedic showed the recruitment consultant directing them
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Former NHS credit controller sentenced after large financial fraud
An investigation by the NHS Counter Fraud Authority (NHSCFA) has resulted in a former NHS credit controller receiving a custodial sentence after they, along with four others, defrauded the NHS of more than £300,000.
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O ne individual was sentenced to three years and eight months in prison at Southwark Crown Court in January 2026. They had previously entered a guilty plea to fraud by abuse of position in September 2025 during proceedings at the same court. The four additional defendants also received their sentences at Southwark Crown Court in January 2026. A second individual received a prison sentence of three years and two months, having earlier admitted four counts of money laundering in September 2025. A third individual was given a 12‑month sentence, suspended for two years, and ordered to pay £1,000 in costs by 31 December 2026. They had been found guilty of money laundering in October 2025 and were working for the NHS at the time. A fourth individual received an 18‑month sentence, suspended for two years, along with an order to pay £1,000 in costs by 31 December 2026. They had previously been found guilty of money laundering. A fifth individual also received an 18‑month suspended sentence and had been found guilty of money laundering in October 2025. The fraud came to light within the finance department at the trust for which they worked, after staff noticed unusual patterns in refund requests relating to funds held on behalf of patients and clients. Internal checks identified that an employee of the trust had been involved, and that this individual had access to confidential financial systems. Further examination linked them to accounts where the fraudulent payments had been directed.
NHSCFA financial investigators used their powers under the Proceeds of Crime Act 2002 to track the movement of the stolen money. The investigation established that the individual had submitted fraudulent refund claims and that the proceeds had been transferred to accounts associated with the other defendants. Upon arrest, the individual gave a “no comment” interview. Documents relating to refund activity were later found at their home address. The investigation uncovered over £218,000 in fraudulent refunds that had been successfully processed, with a further £84,000 in fraudulent claims prevented, giving a total fraud value of more than £302,000. Financial analysis showed that all four co‑defendants received notable sums from the scheme, much of which was subsequently passed back to the main defendant and two of the others. A representative from the NHSCFA stated that the sentencing highlighted the seriousness of abusing a trusted role within the NHS for personal gain. They noted that the individual had misused their access to key financial systems to carry out a fraud aimed at funds belonging to patients, with others knowingly involved in laundering the proceeds. They added that swift action by the trust’s finance team, together with investigators’ use of Proceeds of Crime Act powers, led to significant losses being identified and further fraud prevented.
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Internal control failures in a high‑pressure environment: What recent fraud trends mean for the NHS
In recent months, several high‑profile fraud and audit incidents have drawn attention to a pattern that is highly relevant to the NHS.
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W hen teams work under pressure, internal controls become easier to bypass, overlook or override. This issue is not unique to healthcare, but the scale and complexity of the NHS make it particularly vulnerable, especially when operational pressures limit the time available for proper scrutiny. While NHS fraud cases often focus on local issues, such as timesheet manipulation, procurement abuse or misuse of purchasing systems, wider trends offer useful lessons about how fraud emerges when systems are strained.
2. High workloads increase the chance of control gaps Organisational pressure, including tight deadlines, staffing challenges and increasing service demands, can create blind spots that enable fraud to develop unnoticed. In the NHS, these pressures are well‑documented in national reporting on system performance and workforce strain, which directly affects the robustness of internal processes. Under pressure, controls that normally operate well can begin to weaken. Examples include:
4. Why this matters now
The NHS Counter Fraud Authority (NHSCFA) has repeatedly highlighted the level of financial risk the NHS faces, estimating over £1.3 billion of NHS funding is vulnerable to fraud, bribery and corruption each year. In an environment where resources are already stretched, the consequences of control failures can be far‑reaching. At the same time, newer initiatives such as Project WISE (Workforce Integrity and System Efficiency) show that data‑driven approaches are increasingly being used to identify vulnerabilities and detect emerging patterns of fraud more quickly across NHS systems. These developments highlight the need for organisations to treat internal control resilience as a core part of patient‑facing service protection, not simply as an administrative function.
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approvals being rushed through
1. Warning signs are still being missed
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audit trails becoming incomplete
Recent sector news shows that major audit failings often stem from not reviewing core financial records in enough depth, overlooking inconsistencies that should prompt further investigation, and insufficiently challenging information provided by those being audited.
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reliance on single individuals for key tasks
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reduced oversight of temporary, agency or remote staff
5. What NHS organisations can do
Fraudsters often exploit these gaps, knowing that overstretched teams may not have capacity to challenge irregularities.
NHS fraud cases frequently show that:
Even in high‑pressure environments, there are practical steps organisations can take to strengthen control effectiveness:
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paperwork was approved without review
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Reinforce expectations around verification – encourage managers to challenge inconsistencies and avoid relying solely on trust or habit. Protect segregation of duties – ensure no single individual is responsible for end‑to‑end financial processes. Prioritise high‑risk areas – such as timesheets, payroll, procurement, asset management and system access. Support staff with targeted training – especially those responsible for authorising claims, overseeing budgets or managing system access. Review workloads – if key control points sit with staff who have little capacity, risk increases. Adjusting workloads can be a strong fraud‑prevention measure. Use data proactively – simple trend analysis, exception reporting or comparisons with expected activity can highlight early signals of fraud.
3. Fraud within NHS operational processes reflects the same themes Recent NHS fraud cases echo the wider trends seen in the corporate sector, whereby controls were present on paper but not consistently applied in practice. Cases reported in late 2025 and early 2026 include unauthorised shift changes, manipulation of rostering systems and misuse of positions of trust, enabled by weak oversight or excessive reliance on individual staff members with system access. Similarly, there have been instances where insufficient checks on identity, timesheets or financial transactions allowed misconduct to continue for extended periods before being detected. These cases demonstrate that even basic controls, such as authorisation checks, segregation of duties, and verification of records, can falter when workloads are heavy or when roles are not clearly defined.
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managers relied on verbal assurances
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reconciliations were skipped due to time pressure routine oversight became informal when teams were short‑staffed
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This indicates that even experienced staff can overlook warning signs if the working environment encourages speed over scrutiny.
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Teams should feel empowered to take the time needed to apply controls properly, even when demand is high.
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Reporting Fraud
Everyone has a part to play in fighting fraud. If you work for the NHS and suspect any fraud, bribery, or corruption against the NHS, please contact your Local Counter Fraud Specialist. Alternatively, please contact the NHSCFA 24-hour reporting line by calling 0800 028 4060 , or by completing the online reporting form . All reports are treated in confidence, and you have the option to remain anonymous.
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