NHS fraud costs more than £1.2 billion a year, report reveals

Henry Bodkin
Primary care accounted for £88 million - Getty Images Contributor

The NHS is losing more than £1.2 billion to fraud each year, according to a new report which found that GPs are inventing patients in order to make extra money.

“List inflation”, where practices claim they are treating more patients than they are, fraud through self-prescribing and the filing of duplicate timesheets by agency staff are among a range of “sharp practices” investigators have uncovered.

They blamed a “high trust” environment leaving “considerable scope for manipulation”.

As well as fraud by staff, patients falsely claiming to be exempt from paying for prescriptions is estimated to be costing £341.7 million each year.

The NHS has a strategy for dealing with this, however earlier this year a report by the National Audit Office found this was unnecessarily scaring innocent patients with Penalty Charge Notices.

Fraud within the GP sector accounted for £88 million.

Another significant area of concern was from dentists with NHS contracts, some of whom are suspected of charging for “phantom appointments”.

In 2018 NHS England set up a specialist counter fraud team to deal with the problem. The report said: “Fraud, bribery and corruption are complex, hidden crimes that represent losses to NHS England and therefore impact the care which can be provided to patients.

“Whilst the nature and extent of the losses are not fully understood, it is clear that any loss as a result of dishonesty is too much.

“This is of particular relevance in a time of economic challenges when the NHS is redesigning the delivery of services to make the required efficiencies to provide a sustainable future.”

It went on: “There are considerable gaps in intelligence with reference to fraud risks in primary care areas, a significant proportion of current work and future priorities therefore relate to primary care.”

Primary care services as a whole, including pharmacy and dentistry, contributed to 58 per cent of the estimated £1.29bn losses. A further £2.2m is estimated to be lost from NHS pensions each year.