The NHS Counter Fraud Authority’s priority action areas for 2019-20 include the identification of potential community pharmacy frauds.
It is based on the NHS fraud squad’s latest evaluation of available intelligence on fraud risks.
The Counter Fraud Authority would work in collaboration with the NHS Business Services Authority to identify key areas of loss to fraud by community pharmacy contractors.
The priority area related to the GP frauds would focus on capitation fees. The authority would also work with NHS primary care to increase confidence in their assessment of the losses to fraud in this area and form a basis for fraud prevention activity.
The other two priority areas are procurement and commissioning fraud, and improving fraud outcomes in the NHS.
“By setting clear goals based on the national intelligence picture of fraud risks and working with colleagues across the NHS to deliver them, we can make sure counter fraud work at both national and local level is focused on achieving measurable outcomes,” said Susan Frith, Interim CEO of the investigative body.
For the first time this year, it would use a set of financial targets that include a measure of the value of prevented fraud.
The headline targets for 2019-20 are £22 million in detecting fraud, £100 million in prevented fraud and £5 million in recoveries from fraud losses.
“By preventing fraud, by identifying it and tackling it effectively where it occurs, and by seeking to recover money lost to fraud we can ensure that precious NHS funds are used for their intended purpose of patient care,” Frith added.