United Kindgom
Business Services Organisation, Northern Ireland
Established in April 2009 the Business Services Organisation provides a broad ra
nge of regional business support functions and specialist professional services to the Health and Social Care sector in Northern Ireland.
Falling under the umbrella of the Operations Directorate, the remit of Counter Fraud and Probity Services (CFPS) includes:
· tackling fraudulent claims made by patients in respect of statutory dental and ophthalmic charges;
· the formal investigation of cases of suspected fraud across all Health and Social Care organisations. Examples include falsely claiming for travel subsistence or hours worked, the theft of cash or equipment and false accounting
· the delivery of a range of probity verification and assurance work in relation to Primary Care contractors. These verification checks can include post payment verification visits to practices, checking clinics and practice record reviews.
· Counter fraud and probity policy
· fraud awareness – this work involves raising awareness amongst HSC staff through the development of an elearning package and complimentary promotional materials and the creation of new fraud reporting tools for staff and the general public.
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Government of Scotland
The Government for Scotland is responsible for most of the issues of day-to-day concern to the people of Scotland, including health, education, justice, rural affairs, and transport.
The current administration was formed after elections in May 2007 and is committed to sustaining and improving the health and wellbeing of the people of Scotland - determined to combat NHS fraud wherever it arises and, in this way, ensure as far as possible that healthcare funding is used for legitimate patient care.
The Scottish Government and the anti fraud unit NHS Scotland Counter Fraud Services work together to develop effective relationships with other organisations in order to deliver an overall strategy.
To achieve maximum impact, both the Government and Counter Fraud Services have identified partners who are key in this area. Framework agreements which focus primarily on the practicalities of joint working have been, or are being, developed with many of these.Further information
NHS Scotland Counter Fraud Services
NHS Scotland Counter Fraud Services (CFS) provides a full service to NHS Scotland (NHSS) through a centrally based, professionally qualified team of specialists dedicated only to counter fraud work.
NHS Scotland has an annual budget of £10 billion. Using a conservative estimate of 1% as a measure of the potential fraud perpetrated against NHS Scotland, this would equate to £100 million being lost annually from NHSS.
Working in partnership with other NHSS organisations, Counter Fraud Services have successfully delivered savings in the region of £20 million for the NHS in Scotland.
Two regional teams investigate all cases of fraud within NHS Scotland on behalf of the NHS Bodies that have referred the cases, preparing reports for the Procurator Fiscal Service and other regulatory authorities to allow the appropriate application of sanctions.
A minority of professionals have been identified as making claims for treatment and services in a manner which was in contravention of the spirit and the letter of the regulations governing their professional conduct as contractors within NHS Scotland.
Unfortunately patients also defraud the NHSS. £450 million is spent annually on patient exemption charges for various primary care services and by using legislation on Penalty Charge Regulations, CFS will take action against patients who falsely claim free treatment or services.
CFS is committed to reducing fraud and corruption in the NHSS to an absolute minimum, and to building and promoting a culture in which staff, patients, contractors and the wider public regard fraud against the NHSS as totally unacceptable.
Further information