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Examples of Fraud

Below are a few examples of the types of circumstances that are considered to be NHS fraud that are being investigated by LCFSs throughout England Wales.

Staff

  • Use of false qualification certificates and references in order to gain employment;
  • Claiming for hours not worked;
  • Working whilst off sick;
  • Claiming for travel and other expenses not incurred;
  • Managers obtaining goods and services for personal use;
  • Creation of ghost employees.

GP Contractors

  • Creating ghost patients;
  • Claiming for services provided to ghost employees including production of false prescriptions;
  • Claiming for services not provided (enhanced services);
  • Raising false prescriptions for self-medicating;
  • Accepting bribes to register overseas visitors.

Other Contractors

  • Pharmacists claiming for medication not dispensed;
  • Pharmacists claiming for services not provided;
  • Failure to declare prescription charges collected;
  • Creation of claims for ghost patients – (dentists and opticians)
  • Dentists claiming for higher number of Units of Dental Activity than provided;
  • Optician claiming NHS allowances for individuals who are not entitled.

Patients

  • Amending prescriptions to gain additional medication;
  • Gaining multiple registrations with GP’s in order to obtain additional medication;
  • Overseas visitors using false documents in order to gain NHS services;
  • Patients selling their medication.

Newspaper Articles

Express and Star Newspaper
e&s

Birmingham Evening Mail

bem

Many more examples of fraud and cases that have been successfully prosecuted can be viewed by visiting www.nhsbsa.nhs.uk/Protect.aspx