Strengthening Internal Controls within Healthcare Organisations
Healthcare organisations can significantly reduce the risk of fraud by reflecting on recent cases and embedding robust controls into their daily practice based on lessons learnt. The following provides some examples of key areas of weakness identified, and how these can be improved.
Sickness Absence Documentation When an employee returns from sickness absence, during the return-to-work interview managers should ask about any work, training or study undertaken during the absence, and also ensure that the individual’s response is documented. Relying on verbal confirmation is not sufficient. Action - Require completion and secure storage of self-certification forms for every period of sickness, ensuring all mandatory questions are answered and evidence of the responses provided is retained.
Annual Leave Management Failings in recording and reconciling annual leave entitlements can lead to staff taking more leave than permitted. For example, system errors may result in incorrect annual leave settings or unexpected hours being deducted. This may require recouping leave through salary deductions, which is both time-consuming and potentially contentious. Action - Regularly review electronic rostering systems to confirm annual leave entitlements are correctly set. Managers should double-check that approved leave matches scheduled working hours.
Effective Use of Workforce Information and Declarations A situation occurred where a former employee, under investigation for fraud, was able to secure another role within the same organisation because the hiring manager was not informed of the previous investigation, despite the individual disclosing this information in a standard declaration. Action - Establish a procedure whereby, if a prospective hire declares a prior investigation or similar concern, resourcing or HR teams inform the hiring manager after all checks are completed but before their appointment is confirmed. This can help ensure safer, more informed hiring decisions. Internal controls rely not just on having policies, but on implementing them consistently and communicating clearly between teams. A culture that prioritises documentation, regular system reviews, and open sharing of relevant information between departments can make a real difference in preventing fraud.
8 | SCRUTTON BLAND | COUNTER FRAUD
Made with FlippingBook Learn more on our blog