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NEWSLETTER
FOR THE HEALTH AND SOCIAL CARE SECTOR
Contents
3 | Strategic Pillars
4 | NHS counter fraud authority results and risks 24/25
6 | NHS investigation leads to five convictions in £300,000 case
7 | Suspended sentence in NHS bribery case
8 | NHS practice manager ordered to repay funds after fraud conviction
9 | CALL 159 - A simple way to help beat bank scams
2 | SCRUTTON BLAND | COUNTER FRAUD
Introduction
Welcome to our Autumn 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. • 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. 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.
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NHS Counter Fraud Authority results and risks from 2024-2025
The NHS Counter Fraud Authority’s latest publications provide a full picture of recent fraud risks, preventive action, and outcomes for the NHS in England.
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Where are the main risks?
Key highlights Drawing on the Annual Report and Accounts 2024-2025 and the Strategic Intelligence Assessment 2025. An estimated £1.346 billion of NHS funding is vulnerable to fraud, bribery, or corruption this year. Although this is a numeric increase from last year, it actually represents a slightly smaller proportion of the NHS budget, now 0.72%, showing that counter fraud measures are starting to have an effect even as spending rises. The NHSCFA and the wider health group delivered £196.8 million in counter fraud outcomes for 2024–25, comfortably surpassing the annual target of £145.1 million. This figure includes results from direct enforcement, local counter fraud specialist (LCFS) work, technology projects, and partnership activities. Project Athena, NHSCFA’s in-house data analytics and machine learning initiative, alone contributed over £28 million to these outcomes in its first year. The NHSCFA received 6,462 reports of suspected fraud in 2024/25, which is an increase of 95 from the previous year.
Estimated Risk (£m)
Reports Received
Area
Procurement & commissioning fraud
£392.5
537
Patient exemption fraud
£230.2
1,238
Data manipulation fraud
£189.1
25
Community pharmaceutical contractor
£135.2
238
GP contractor fraud
£116.7
233
Optical contractor fraud
£90.7
41
Dental contractor fraud
£57.6
74
NHS staff fraud
£27.8
3,211
These figures reflect areas where funding is judged most at risk based on internal monitoring, referrals, and past incidents.
Key issues and trends this year Staff fraud remains the most reported category, particularly false claims about hours worked, dual working while on sick leave, and misuse during recruitment. Procurement fraud holds the highest estimated risk in monetary terms and continues to be a major area for policy and process improvement. Enhanced supplier checks and local proactive exercises, with over 390 undertaken in England in 2024-25, have already led to changes in NHS policy and procedures. Patient exemption fraud remains common, especially involving prescription charges and dental fees. Real-Time Exemption Checking technology is helping reduce financial loss. Emerging threats include people impersonating NHS workers to carry out bank shifts, as well as continued cyber-facilitated fraud like phishing and data breaches that target health data. Data-driven tools : Project Athena, launched at the start of 2024, now uses AI and machine learning to spot unusual activity faster and help teams focus their efforts. Collaboration : There has been wide cross- sector engagement between NHSCFA, NHS trusts, NHS England, and other partners to share intelligence and take targeted action.
What’s happening on the ground? Reporting levels are on the rise; 83.2% of all reports relate to staff fraud, patient exemptions, procurement, or access to care by overseas visitors. Over 390 local prevention exercises were run across England, especially targeting procurement systems. Policy changes and improvements in internal controls are being put in place at both national and local organisation level based on findings from real cases and proactive work. Looking ahead The NHSCFA is focusing next on further supporting staff fraud prevention, increasing data-driven detection, and helping health and care teams turn intelligence into real, practical controls. There’s also a newly established working group focusing specifically on NHS staff fraud in view of its consistently high reported numbers. Every staff member can make a difference by staying informed about fraud risks, being confident in reporting suspicions, and using available prevention tools. NHS teams continue to protect both patient care and public funding. The full SIA and Annual Report provide more intelligence and advice to help all parts of the health and care community meet the challenge and can be read online here:
Four areas dominate reporting:
NHS staff fraud : 3,211 reports
Patient exemption fraud : 1,238 reports
Procurement/commissioning fraud : 537 reports
Fraudulent access to NHS care by overseas visitors : 387 reports
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NHS counter fraud investigation leads to five convictions in £300,000 case
An NHSCFA investigation has resulted in five convictions connected to a £300,000 NHS fraud case.
A former NHS credit controller has been convicted of fraud by abuse of position and money laundering following an investigation by the NHS Counter Fraud Authority (NHSCFA). The individual admitted to fraud by abuse of position in September 2025 during a trial at Southwark Crown Court. The trial began on 1 September 2025 and lasted six weeks. proceedings. One defendant pleaded guilty to four counts of money laundering, and the jury found three further NHS employees guilty of the same offence. All five defendants had previously entered not guilty pleas at a hearing in November 2023 and have been Four others were convicted of money laundering offences during the same released on unconditional bail ahead of sentencing, which is due in January 2026.
The offences were uncovered by staff within the finance department of an NHS Foundation Trust, after irregularities were noticed in refund requests for funds held on behalf of patients and clients. Internal checks identified the involvement of a member of staff with authorised access to secure financial systems. Further investigation linked this individual to bank accounts receiving fraudulent payments. NHSCFA investigators used their powers under the Proceeds of Crime Act 2002 to trace the movement of funds. The investigation established that fraudulent refund claims were submitted, and the proceeds were transferred to accounts connected to the other defendants. During a subsequent search, documentation relating to these refund transactions was recovered from the individual’s home address. The person declined to comment during interview.
The total identified fraud exceeded £218,000, with a further £84,000 in attempted claims prevented, taking the overall value of the fraud to more than £302,000. Financial analysis confirmed substantial sums were shared among the co-defendants, with many of the payments ultimately returned to the primary offender and some associates. The Head of Operations at the NHSCFA said the case demonstrated how this was a sophisticated internal fraud that abused access to confidential financial systems. They noted that the outcome reflected close collaboration with the trust’s finance team and the commitment to pursue and recover stolen NHS funds wherever the evidence may lead.
6 | SCRUTTON BLAND | COUNTER FRAUD
Suspended sentence in NHS bribery case
An NHS Counter Fraud Authority investigation has resulted in a suspended prison sentence for bribery related to NHS patient transport contracts valued at £189,000.
A company director received a 16-month sentence suspended for two years after admitting to bribery at Wood Green Crown Court in August 2025. Sentencing took place in October 2025 and included a requirement to complete 150 hours of community service. The case centred on allegations that, between September 2021 and May 2022, payments totalling £73,000 were made to an NHS employee in return for awarding contracts for patient transport services.
Charges under the Bribery Act 2010 were authorised against both individuals by the Crown Prosecution Service. Legal proceedings continued at Highbury Corner Magistrates Court, though only one defendant attended; it was subsequently confirmed that the NHS employee had been found deceased before further hearings could proceed.
NHSCFA investigators are now taking steps under the Proceeds of Crime Act 2002 to recover the funds involved in the bribery. The Head of Operations at the NHSCFA commented that the outcome delivers a strong message against corrupt practices in the NHS and highlights the commitment to defending NHS resources and pursuing those responsible for fraud.
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NHS practice manager ordered to repay funds after fraud conviction
An investigation conducted by the NHSCFA Wales resulted in a former NHS GP practice manager receiving a suspended sentence and an order to repay £25,000 to the affected practice. The individual appeared at Swansea Crown Court in September 2025 for a compensation hearing and was instructed to repay £5,000 at a rate of £200 per month over two years, in addition to £20,000 already returned in July 2025.
In August 2025, this former manager was sentenced at Swansea Crown Court to two years’ imprisonment, suspended for two years, and required to complete 25 days of rehabilitation alongside 200 hours of unpaid work. The individual had previously admitted to fraud by abuse of position at Swansea Magistrates’ Court in May 2025.
The person confessed to misappropriating £49,213.08 from the GP practice, having worked there between April 2019 and March 2023 until being dismissed for gross misconduct. The investigation began after the practice’s accountants raised concerns, revealing that the business bank account had been used for personal purchases and funds were transferred to the manager’s own account under references such as “petty cash” or “advance”.
A financial investigator used the Proceeds of Crime Act 2002 to access the individual’s accounts, substantiating the fraudulent transactions. Most of the stolen funds were spent on daily living costs and gambling activities.
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STOP, HANG UP, CALL 159 A simple way to help beat bank scams
If you ever receive a call out of the blue about your bank account, it’s important to know how to stay safe. Scammers are getting more sophisticated, but there’s a simple step anyone can take - just remember 159.
What is 159? 159 is a special phone number that quickly connects you straight to your bank if you think you might be getting scammed. It’s designed to be easy to remember, just like 101 for the police or 111 for the NHS. If someone is pressuring you to hand over money or personal details, stop what you’re doing, hang up the call, and dial 159.
How does it work? When you call 159, you’ll be safely redirected to your own bank’s customer service team. All you’ll need to do is say the name of your bank when prompted and you will be automatically connected. More than 20 major banks and building societies use the service, including Barclays, HSBC, Lloyds, NatWest, Santander, and more. Most big telephone providers support 159, so it’s available to almost everyone in the UK. Why should you use it? Scammers rely on catching you off guard and keeping you talking. Calling 159 breaks the scam “journey” at the most critical moment, allowing you to check if the real bank is trying to contact you, before you share any sensitive details or make a payment. Over a million people have already used 159 to protect themselves from fraud.
What does it cost? The cost of calling 159 is usually the same as a national rate call. Check with your phone provider to confirm. The bottom line If you get a suspicious or unexpected call about your bank, always STOP, hang up, and CALL 159 to speak with your real bank safely. Share this advice with friends, family, and colleagues to help break the scam cycle and keep everyone’s money safe.
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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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