Breaking finance and business news, tax information, jobs and more for finance directors and senior finance professionals.

While it is only a tiny minority of people who defraud the NHS, their actions are estimated to cost the service up to one per cent of the NHS budget could be lost annually.

This means as much as £50 million - £100 million may be filtered out of the NHS by fraudsters each year.

Sturgeon set out a range of new measures which not only aim to help identify and combat fraud by staff, clinicians, contractors and patients, but importantly act as deterrents.

Damage

NHSScotland Counter Fraud Services (CFS), set up to deter, detect and investigate cases of potential NHS fraud, has estimated that £14 million in NHS fraud savings have been made since the agency was established in July 2000.

This is the equivalent of almost 750 extra nurses or 120 additional consultants. Alternatively, it could pay for more than 2000 hip replacements operations or 93000 MRI scans or pay for nearly 163,000 attendances at Accident and Emergency.

Sturgeon said that NHS fraud takes money away from where it is needed most, whether committed by staff, patients, clinicians or contractors.

She added that protection against fraud must begin at the earliest stages when healthcare policies, systems and procedures are being designed, before they are finally agreed and rolled out.

"At the other end of the spectrum, we need to engage with those who work in, and use the services of, the NHS and ensure that they understand the damage caused by fraud and the need to protect our NHS,” according to Sturgeon.

Triple tracking 

The Royal College of Nursing Scotland and the General Medical Council have signed a Counter Fraud Charter and the Memorandum of Understanding in a joint determination to tackle fraud.

The new NHS Counter Fraud Strategy (CFS) has a strong focus on deterrence. NHSScotland Counter Fraud Services will develop a new e-learning package for use in the induction of NHS staff.

It will also create a DVD to help NHS managers identify types of staff behaviour which may signal fraudulent activity.

For maximum deterrence, methods such as 'triple tracking', which reflect modern thinking in the counter fraud world will be employed, engaging criminal, disciplinary and civil action where appropriate.

Sturgeon has also called for 'counter fraud champions' to be identified at senior level in health boards to raise awareness among staff of NHS fraud and their individual responsibilities for tackling it.

The Scottish Government has recently joined the European Healthcare Fraud and Corruption Network, which will facilitate the exchange of experiences, ideas and lessons across bodies in Europe who are tackling healthcare fraud.

NHSScotland Counter Fraud Services operates a free phone fraud hotline (08000 15 16 28) and website which may be used by anyone who wishes to report any incident of potential fraud in or against NHSScotland.

Private work

Types of fraud at patient level include claims to be exempt from NHS charges for dental treatment, optical vouchers and prescription charges, falsifying prescriptions in an attempt to obtain more drugs and using false names and medical information.

Fraud committed by NHS staff includes claiming travel and subsistence expenses for journeys not taken or inflating mileage, claiming overtime payment for hours not worked, staff clocking colleagues on shifts not worked and misuse of NHS credit cards and fuel cards.

Other examples of ways in which NHS workers allegedly defraud the service include working elsewhere whilst off sick and claiming payments for private work undertaken on NHS time and/or NHS premises.

Medical reception staff were found to have printed off prescriptions for drugs under patients names, deleting the transaction from the computer system, then using the drugs for their own use.

Inappropriate relationships 

Dentists are topping up their wages by claiming for gold crowns and inlays when non-precious ones were supplied, claiming payment for opening the surgery after hours for emergencies when surgery was still open and by falsifying claims for dental rates by inflating the percentage amount of NHS work being carried out by the practice.

Pharmacists put in claims for expensive brand name drugs when cheaper alternatives dispensed, and for smaller packs of medications when larger quantities supplied.

Opticians are similarly alleged to help themselves to a share of NHS dosh by claiming two pairs of glasses where only one was provided.

Even GPs are at it, according to NHS Counter Fraud Strategy, making duplicate payment claims, claiming for treatments that were not provided, claiming for home visits which were not taken, falsifying references and qualification certificates and even claiming for patients who do not exist.

NHSScotland also accused GPs and hospital staff of inappropriate relationships with medical sales reps, leading to misuse of prescribing branded names when cheaper alternatives available.

Related articles

• Everything you always wanted to know about fiddling expenses
• White collar crime is spreading like the flu
• How to combat fraud and corruption on UK business
• Finance director stole to fund lifestyle
• Do you know who you are employing?
• Carlsberg accountant jailed for theft 

Related links

• The Scottish Government
• NHSScotland Counter Fraud Services