Areas of Fraud
There are 13 key areas of fraud:u00a0
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Procurement and commissioning: Fraud within the pre-tender stages of the procurement of commissioning process, or intentionally inflate or duplicate invoices in the post-tender stage.
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Pharmaceutical Contractor: Making false claims for the dispensing of items or for one of the enhanced services offered at a pharmacy
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Help with Health costs: A person who is not entitled to free NHS treatment, services, or medication but purports to be exempt from paying costs of prescription charges, optical services, or dental treatment
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NHS Staff: An employee inflates or falsifies income, expenses, or working hours for financial gain
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National tariff and performance data manipulation: Intentional falsification of data and the Payment by Result (PbR) system
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General Practice: Manipulation of income streams or activities that violate contractual terms perpetuated by practitioners or staff
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EHIC fraud: An overseas visitor claims treatment under EHIC when they are not entitled to do so
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Optical contractor: Optical contractors submit fraudulent claims to the NHS for services provided to patients
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Dental contractor: Dental contractors submit fraudulent claims to the NHS for services provided to patients
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Access to NHS Care: Foreign nationals obtain free healthcare they are not entitled to
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NHS Pension: A person falsifies their circumstances or fails to notify of a significant change in their circumstances to the pension administration
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NHS Resolution: Fraudulent accidents/insurance claims under the Liabilities to Third Parties Scheme or through clinical negligence
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Student Bursary: False applications or use of false documents to support a bursary application or other NHSu00a0funded training or financial support stream