This fact sheet sets out the Department of Health and Social Care’s response to claims that the NHS has lost £7.5bn to fraud in the last six years.
Statement from 17 February 2023
A government spokesperson said:
“These claims are incorrect as they are based on fraud estimates, rather than actual identified losses to fraud in the NHS.
“We are taking firm and coordinated action across government to clamp down on fraud, including investing in counter fraud expertise, which helps detect and prevent fraud.
“We have set up the Anti-Fraud Unit and the NHS Counter Fraud Authority to tackle fraud, bribery, and corruption across the health sector, helping to protect taxpayers’ money for better patient care.”
How much has the NHS lost over the last five years?
- The actual identified amount lost to fraud in the NHS over the last five years is £69.3m. We recently set this out in a parliamentary question on 9 February.
- The claim that the NHS has lost £7.5bn to fraud is misleading, as it uses the annual Strategic Intelligence Assessment fraud estimates and presents them as actual fraud losses.
- The Strategic Intelligence Assessment fraud estimates are designed to estimate the NHS’s vulnerability to fraud, in order to target resources more effectively. They do not represent actual losses to fraud.
What is the government and NHS doing about fraud in the NHS?
- The NHS Counter Fraud Authority was established in 2017, a dedicated special health authority leading the fight against fraud in the NHS in England.
- A network of local counter fraud specialists is in place across the NHS in England to also help hold those who commit fraud to account.
- The COVID-19 pandemic caused the NHS Counter Fraud Authority to revise down their annual targets between 2020 and 2022 but they are on track to meet the overall three-year target of preventing, detecting and recovering £400m.
What is the Department of Health and Social Care doing specifically to prevent fraud?
- Counter fraud work at a national level is led by the DHSC Anti-Fraud Unit (DHSC AFU). Its goal is to prevent and deter fraud, corruption and bribery by raising awareness and working in partnership with all parts of DHSC, its ALBs and companies.
- The DHSC AFU sets the counter fraud policy and strategy for the Department and the wider health group, the latest strategy covers the period 2020 – 2023. We are refreshing that strategy for 2023-26.
- DHSC AFU seeks to ensure fraud risks are assessed and fraud prevention and detection are supported by effective monitoring. Work to continually minimise risk is built in to DHSC policy development at the earliest possible stage and promotes awareness of fraud risks across the health group.
What is the NHS Counter Fraud Authority?
- NHSCFA carries out the Secretary of State’s counter fraud functions in respect of the health service in England.
- As a Special Health Authority, established in November 2017, it is tasked to lead the fight against fraud, bribery, and corruption in the NHS, in England