ANTI-FRAUD CLIENT BRIEFING 2

MIAA Anti-Fraud Service 30 April 2020

www.miaa.nhs.uk @MIAANHS MIAA MIAA

COVID-19 Fraud Threats & Advice

This is MIAA’s second Client Briefing covering the key fraud threats being identified and highlighted as a result of the current health emergency and how these are being managed both locally and nationally.

It also responds to some client concerns raised directly with MIAA as to how existing policies and procedures should be applied and interpreted at present, to avoid opportunities for abuse and exploitation. We begin and end this edition with some supplementary anti-fraud advice and guidance relating to matters raised in the recent HFMA briefing documents.

In the four weeks to the 12th April, overall crime figures dropped by 28%, with some crimes dropping nationally by over 50%. However one area where the figures are actually increasing is fraud.

PERSONAL SOLICITATION OF GIFTS & ONLINE FUNDRAISING CAMPAIGNS

In early April, HFMA published some excellent guidance addressing the management of gifts and donations during the COVID-19 emergency, reflecting the significant levels of public and corporate goodwill and largesse towards the NHS and care workers. This guidance (HFMA COVID-19 briefing, April 2020, ‘Checklist for accepting gifts or donations’) can be found here.

To supplement this guidance, MIAA’s Anti-Fraud Service is becoming aware of the increasing use of personal social media platforms (i.e.

Facebook, Instagram, personal websites) to both solicit specific items from local businesses or members of the public, as well as to fund raise for local community welfare projects related to the COVID-19 crisis. The majority of this activity is likely to be completely genuine and well-intentioned but, unfortunately, as always, there is a small minority who may look to exploit the current situation and the public’s generosity.

The HFMA guidance is clear on the possible benefit of establishing corporate ‘wish lists’ at this time, but it’s equally clear that the NHS England guidance on conflicts of interest does not support staff soliciting gifts (particularly cash) in a personal capacity, or being the direct beneficiaries of donations. Health bodies should remind staff that it is not appropriate to set up and manage personal ‘wish lists’ or to solicit gifts and donations via their own social media pages. This is particularly the case where staff clearly highlight their NHS role and/or the health body they work for, as donors may infer that this ‘wish list’ or solicitation is sanctioned by the NHS body when the employer has no oversight of what items are being requested or how they are to be used or by whom.

Equally, it’s important to note that individuals may set up such social media sites without having any association with the NHS at all and may have the sole intent of exploiting public goodwill. In highlighting to staff that their personal social media pages should direct readers to official NHS routes for giving gifts and donations, they can also emphasise that the local health body doesn’t endorse or sanction private solicitations and that any such social media sites should be viewed with caution and avoided. Whilst any losses to potential fraudsters would be on the public and businesses making donations, not the NHS, there is the reputational impact to be considered on the NHS in general, or a local health body in particular, if there is a perceived association with such potential ‘scams’.

Equally, we are also aware of individuals apparently employed by the NHS setting up fundraising campaigns for local community initiatives (i.e. to purchase old ambulances in order to run patients home from hospital as a means of supplementing official Patient Transport Schemes). The various online fundraising websites which most people are familiar with are being utilised for these campaigns. Whilst in the main such initiatives are likely to be very well intentioned and altruistic, once again, the suggestion that an individual is employed by the NHS or associated with a particular health body may persuade business and the public alike to donate to such campaigns. Again, the health

body has no control or oversight of such fundraising activity or how funds will actually be dispersed and it’s not the NHS who will suffer any financial loss by anyone looking to scam the public in such a way, but this activity could well have an adverse impact on the associated NHS organisation.

Any identification of social media or fundraising webpages set up along the lines of those described above should be reported to the local health body so that they can take appropriate action with the individual who set up the page to determine their NHS status (if any) and to ask them to amend their site content to redirect donations to official NHS charitable/donation routes and cease any implied association to the health body if there is no connection.

Where there is a failure by fundraisers to comply with a reasonable request to remove content that is falsely purporting to be raising money for a health body or the NHS, then consideration should be given to notifying the police and also the website owner (i.e. Justgiving, Gofundme etc).

It may also be prudent for local health bodies to update their own websites and social media platforms to highlight that it hasn’t sanctioned and does not endorse any personal solicitation of gifts or fundraising campaigns and to advise those wishing to make donations to treat such sites with caution and to go through the official NHS charity (NHS Charities Together) or to contact the local health body’s own charity or finance team contact points.

These measures may help reduce the opportunity for fraudulent fundraising scams to be set up and divert donations away from the intended NHS recipients.

COVID-19 FINANCIAL SUPPORT SCHEMES - COUNTER FRAUD MEASURES TOOLKIT (UK GOVERNMENT)

The Cabinet Office has formed a COVID-19 Counter Fraud Response Team (CRFT), as part of the ongoing UK Government’s Counter Fraud Function, to assist the government with its counter fraud response during the pandemic. Information about this work can be found here.

Their first newsletter (April 2020) is also available here. The Counter Fraud Function has also recently published: ‘COVID-19 Financial Support Schemes - Counter Fraud Measures Toolkit’. This can be accessed here.

The toolkit referred to and linked above details, across 25 pages, what services, data sets and information validation sources are available to public bodies from the CFRT during this health emergency in order to undertake both immediate, proactive counter fraud measures and checks, as well as retrospective payment verification controls which might be required once the crisis passes and emergency Covid-19 funding needs to be fully accounted for.

While primarily aimed at those administering COVID-19 emergency programmes on behalf of the government, the principles in the guidance have a wider application to counter fraud work across all

public bodies during the pandemic and offers potential access to some useful resources.

However, some of the measures highlighted in the toolkit – specifically around designing in fraud prevention controls, building in fraud and clawback clauses, and post-payment verification checks – are actions your Local Counter Fraud Specialist can assist with locally as part of their annual work plan.

WORKING WHILE SICK (WWS) FRAUD DURING COVID-19

This has always been the single most prevalent form of fraud against the NHS. Whilst relatively high volume in nature, the financial impact of this on NHS bodies is not material when considered against the potential and actual impact of other forms of fraud (i.e. mandate or procurement fraud).

However, during the current crisis, with significant numbers of new or former staff coming into the NHS, WWS fraud has a new, added dimension – namely staff who may be working elsewhere or avoiding work entirely, while supposedly shielding, off sick with COVID-19 symptoms or self-isolating. Indeed, we are already receiving referrals for investigation of NHS staff allegedly falsifying official shielding or self-isolating letters.

In the current context, this WWS fraud may inevitably place additional pressures and stresses on frontline colleagues who are already working long hours in extremely challenging and demanding circumstances, potentially impacting adversely on team morale.

MIAA appreciates that this can be a very sensitive matter; however, we will follow-up on any concerns or suspicions brought to our attention so please do continue to report all fraud, including WWS, to your Local Counter Fraud Specialist.

CURRENT SCAMS & CYBER FRAUDS

With fraud increasing during the coronavirus pandemic, we are working hard to keep our clients informed of the latest scams by releasing regular Coronavirus Information Alerts, read MIAA’s latest issue here. We have also been made aware of this latest email scam, based on PPE procurement.

The sender’s address, choice of wording and grammar give this away as an attempted fraud but others may be harder to spot so it is important to remain alert to cyber-fraud at all times.

Legitimate NHS suppliers are also finding that their customers are being targeted by fraudsters who are offering discount offers and bulk buying opportunities by appropriating their company name into phishing emails.

These emails can lead to what, on first glance, look like official websites. Check the URLs and email address of emails from suppliers. It is good practice to call the company using established contact details, or check its website (not the link supplied in the email) to check if an offer is genuine. Always double check, if an offer looks too good to be true, it probably is.

The media has also already reported individuals not connected with the NHS looking to exploit public and corporate goodwill, as can be seen in the linked article concerning an individual who conned a hotel out of free accommodation by claiming to be an NHS worker.

MIAA are also starting to hear increasing reports of the use of false NHS ID badges and lanyards - these have been utilised previously to swap genuine workers with other individuals covering bank shifts, but during the current crisis it seems they are being used to potentially facilitate access for others to the considerable NHS discounts currently available, as well as in order to access equipment and supplies such as PPE, Oxygen and pharmaceutical supplies/drugs. Security teams should be briefed on the increased risks and staff should be reminded to challenge unfamiliar faces in sensitive or secure areas.

NHS COUNTER FRAUD AUTHORITY COVID-19 GUIDANCE

NHSCFA’s immediate concerns, in financial terms, are payment diversion frauds. These can result in a significant loss to the NHS and stopping these attempts relies heavily on experienced staff being

trained to detect these and following procedure. Previous anti-fraud advice and guidance issued via your Local Anti-Fraud Specialist should continue to be followed at this time.

At present most of the reports the NHSCFA are receiving concern thefts of medical supplies and email frauds targeting members of the public mainly, but also the NHS.

The expectation is that there will be an increase in reports concerning:

• Working whilst sick. This is due to increased demand for healthcare workers within the NHS and other sectors. [As noted above, MIAA is already receiving such referrals.]

• Working elsewhere on NHS time. This pandemic may highlight long-term ongoing ‘working elsewhere’ frauds, where a subject is no longer able to cover multiple posts.

• Failing to disclose convictions and employment issues, with new or returning NHS personnel.

PRIORITISATION

The priority for the NHSCFA – and for Local Anti-Fraud Specialists – will be reports that impact on:

• Patient safety; • The NHS’ ability to disrupt the spread and treatment of COVID-19; • Any immediate significant loss to the NHS.

HOW LOCAL ANTI-FRAUD SPECIALISTS HELP THE NHSCFA

Please let your Local Anti-Fraud Specialist know of any fraud issues that you are experiencing which are significantly impacting the ability of your organisation in its efforts to counter COVID-19. They will liaise directly with the NHSCFA’s Central Intelligence Team.

Darrell DaviesAssistant Director (Anti-Fraud)

0151 285 4520 07785 286381

darrell.davies@miaa.nhs.uk

Paul BellSenior Anti-Fraud Manager

0151 285 4500 07552 253068

paul.bell@miaa.nhs.uk paul.bell2@nhs.net

Claire SmallmanSenior Anti-Fraud Manager

0151 285 4770 07769 304145

Claire.smallman@miaa.nhs.uk

The NHSCFA has established a dedicated Covid-19 advice page which can be found here. It provides additional information on mandate and procurement fraud, as well as links to its updated Fraud Reference Guides which cover the 13 most common areas of NHS fraud.

We would draw your attention in particular to a useful NHSCFA quick reference guide on fraud risks when buying goods and services directly from suppliers which can be accessed here; on supplier due diligence checks which can be found here; and, on suppliers’ code of practice which can be located here.

MIAA COVID-19 ADVICE & GUIDANCE

In MIAA’s first Anti-Fraud Covid-19 Client Briefing at the end of March, we also highlighted, amongst other things, the need to keep core anti-procurement fraud measures in place. We reiterate our advice and guidance in that briefing paper which can be found here.

More recently, we’ve also considered the potential fraud risks and compensating anti-fraud measures resulting from the ‘relaxed’ financial control measures proposed by the HFMA briefing entitled, ‘Covid-19 financial governance considerations’ (March 2020), located here. Our advice and guidance to be considered in applying those revised controls can be found here.

We’re also aware of ongoing concerns nationally around paying “upfront fees” to suppliers for essential goods and services during the crisis and that some organisations have stepped outside of HM Treasury’s guidance limit of 25%. Ultimately, this is a matter for individual health bodies, although organisations are reminded to make reference to ‘Procurement Policy Note 02/20: Supplier relief due to COVID-19’ which can be found here; and, in particular, to the most recent NHS England document on PPN, entitled ‘Guidance to NHS Trusts, NHS Foundation Trusts and Clinical Commissioning Groups on the Cabinet Office Procurement Policy Note PPN 02/20’ that can be located here.