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TRANSCRIPT
Siblings who stole £558k jailed 3
Mr and Mrs Money face jail again 4
Temp worker jailed for charity fraud 5
Nurse used false qualifications 5
Help Stop Loan Sharks 6
Is your identity safe? 7
Manager jailed for £3.5million fraud 8
Support worker deceived employer 8
Physiotherapist sentenced for timesheet fraud 9
Doctor sentenced for working whilst sick 9
National Fraud Initiative 10
Reporting your concerns Q&A 11
Your Counter Fraud Specialist 11
Jailed for lying about qualifications 12
fraudstop!Helping to protect your NHS
Inside this Issue:
Issue 2 - 2016
2 TIAA
Welcome
Why do we need counter fraud measures?
All organisations providing NHS services are required to put
in place appropriate counter fraud arrangements.
What does a Counter Fraud Specialist (CFS) cover?
Helping to deter fraud and fostering an anti-fraud culture
through a ‘risk based’ work plan to raise awareness and help
identify and manage fraud risks:
• Investigating allegations of fraud, corruption and bribery;
• Assisting the organisation with local disciplinary action
and providing professional bodies, Civil or Criminal
Courts with appropriate evidence where required;
• Where possible, assisting the organisation with the
recovery of any losses.
Who regulates Counter Fraud work?
• NHS Protect is the organisation which leads on work to
identify and tackle crime across the health service;
• Locally your CFS reports to the Director of Finance /
Chief Finance Offi cer.
What are the risks associated with fraud, corruption and
bribery?
• Financial resources diverted away from patient care;
• Quality and safety being compromised;
• Damage to staff morale;
• Reputational risk;
• Breaking regulatory standards or the law e.g. Bribery
Act;
• Financial penalties.
What does the Counter Fraud Specialist do?
• Provides professional expertise to tackle fraud,
corruption and bribery.
• Operates within a national legal framework for tackling
fraud, corruption and bribery, with all work completed in
accordance with legal standards and in compliance with
guidance provided by NHS Protect;
• Delivers a value adding service that provides advice on
fraud and related matters, such as making procedures
‘fraud resistant’;
• Works closely with a range of other agencies, including
the Police and UK Visas and Immigration, to provide an
holistic counter fraud service.
TIAA has provided business assurance services throughout the UK since 1995. We are one of the largest providers of
Counter Fraud Services to the NHS in England with a team of 46 accredited counter fraud specialists. Our staff are experts
in fraud prevention, detection and investigation helping to protect your NHS.
NHS Counter Fraud Service
Fraud Stop Newsletter 3
Concerned about a fraud taking place in the NHS?
0800 028 40 60
Information can be given to your Counter Fraud Specialist or a confi dential
NHS Fraud and Corruption Reporting Line
All calls are dealt with by trained staff and professionally investigated
Freephone Monday - Friday 8am - 6pm
Online reporting at www.reportnhsfraud.nhs.uk
Jailed – the ‘siblings’ who stole £558K in
benefits and NHS bursaries Two women who posed as sisters
and lied about their identity in order
to defraud the NHS and Department
for Work & Pensions (DWP) of over
half a million pounds have been
jailed for 33 months each at
Croydon Crown Court, London,
following a joint investigation by the
NHS Protect and the DWP.
“Antoinette Kaidi”, of Enfi eld,
London, and “Louise Kaidi” of East
Ham, London, between them pleaded
guilty to 23 offences of conspiracy to
assist unlawful immigration, fraud by
false representation, and dishonestly
making false statements.
It was established that the women
are not related and are of different
nationalities, though both women
claimed, falsely, to be from Togo.
“Antoinette” consistently used the
name Chikodi Ijezie. She was
convicted of stealing £83,986 from the
DWP in false Tax Credit and Income
Support payments alongside a further
£205,631 from the NHS in training
and bursary costs, as well as earnings
from the NHS and other employment
agencies. “Louise”, has not yet
revealed her true identity but was found
to have consistently used the name
“Shadia” in text messages. She stole
£204,167 from the DWP in false Tax
Credits, Income Support and
Housing Benefi t payments, plus a
further £64,335 from the NHS in
training and bursary payments.
The fake families were created by
Ruth Nabaguzi and her partner Tyson
Nsoa (both now convicted) when they
submitted multiple false immigration
claims to the Home Offi ce between
1991 and 2011. Nabaguzi and Nsoa
subsequently used over 100 identities
to falsely claim benefi ts for themselves
but also gave away or sold many
identities to others for cash. ‘Louise’
and ‘Antoinette’ were two such
identities, making it possible for them to
work, study or claim benefi ts as any UK
citizen was able to do.
The women assuming the identities
of the Kaidi sisters both enrolled in
courses to study nursing – “Antoinette”
at Greenwich University and the
University of Hertfordshire, and
“Louise” at London South Bank
University, though she was still
studying at the time of her arrest and
consequently could not complete the
course. “Antoinette” had previously
completed her studies, qualifying as a
nurse and registering with the Nursing
& Midwifery Council.
At the time of her arrest she was
working at The Whittington Hospital in
London but had previously worked at
the Royal Free hospital in Hampstead
and the Queen Elizabeth II hospital in
Welwyn Garden City, Hertfordshire. In
March 2015, the women posing as the
Kaidi sisters were both arrested in
London and later charged. They
changed their plea to guilty on 6th day
of their trial at Croydon Crown Court in
March 2016.
Sentencing them each to 33 months in
prison, the judge told them their crimes
were of a serious nature. He said:
“These are not victimless offences.
They are offences the community feels
very strongly about.” He said the
convictions were part of a wider probe ,
adding: “I was told all of this is part of a
very large investigation involving some
£4million.”
Sue Frith, Managing Director, NHS
Protect said: “These were serious
offences committed over a long
period of time, with the intent of
diverting public money away from the
NHS and other government agencies.
The sentences refl ect this and should
send out a warning to those intending
to defraud the NHS”.
Dave Horsley, Anti-Fraud Specialist at
NHS Protect said: “Through effective
joint working with the DWP, NHS
Protect was able to uncover the full
extent of the Kaidi sisters’ deception.
As a result of adopting these false
identities, they were able to deceive
the NHS and several other government
departments. By taking up university
places, they denied genuine applicants
the chance to start their studies and
embark upon careers in nursing”.
Defendants known as Antoinette Kaidi (right)
and Louise Kaidi (left)
4 TIAA
Mr and Mrs Money face jail again if they don’t
hand over assets to NHSA couple who were jailed last year for (respectively)
defrauding and laundering hundreds of thousands of
pounds from the NHS have been ordered by a judge to
hand over their remaining assets to the NHS.
Brenda Money defrauded the NHS, and David Money
helped launder the proceeds.
David Money appeared at the Proceeds of Crime Act
hearing, but Brenda Money did not attend court.
The total to be recovered is £142,352. Judge Shorrock
made the following determination:
Brenda Money
Realisable assets £68,490
Confi scation order £68,490
David Money
Realisable assets £73,861
Confi scation order £73,861
This means that if they don’t hand over the money within
three months, and don’t give a good enough reason for not
doing so, the Moneys can both be sent to jail again.
Brenda Money had worked at the Memorial Hospital in
Shooters Hill, Woolwich. By diverting petty cash to their
joint account, she stole a total of £293,000 and together they
spent the money on lavish meals, shopping and expensive
holidays.
Their personal bank statements revealed a lifestyle way
beyond their offi cial income. Between January 2010 and
October 2011 they spent nearly £12,000 on grocery
deliveries from Ocado, over £11,000 at Marks and
Spencer, and £3,000 at John Lewis. They treated them-
selves to holidays and cruises worth over £15,000, including
fi ve trips to Turkey in just 22 months, as well as to Hawaii
and the Caribbean, and dined at the Oxo Tower in
London. The couple meanwhile made mortgage
repayments of £46,000, and paid off credit cards and loans
of £36,000.
Brenda and David Money diverted money received from
an inheritance. A court order was in place restraining this
money and requiring it be placed in a specifi c bank account.
But when they received this inheritance, the Moneys
bypassed the order, transferred it to their daughter’s account
and used the money to pay off debts from credit cards and
loans, when it could have been used to repay their debt
to the NHS. For this offence Brenda and David Money
received an additional custodial sentence of eight months
each.
Susan Frith, Managing Director of NHS Protect, said “This
result shows that NHS Protect will vigorously pursue those
who defraud the NHS. This confi scation order is for all of the
available assets they have”.
It includes the equity released from a pension David
Money has, and the equity in the family home, which has
been repossessed. The NHS is also in the process of
recovering money from Brenda Money’s NHS Pension.
Protecting your NHS from fraudIt is important to remember that it is only a minority of staff, patients and contractors that defraud the NHS.
However, the NHS employs over 1.4 million staff and provides healthcare to a population of 65 million. As a
result, the minority who seek to deprive the NHS of its valuable resources can have a signifi cant impact and
that is why specialist offi cers are there to help protect your NHS.
Fraud Stop Newsletter 5
NHS temp jailed for patient charity fraud
A temporary worker who abused his position at Kent
and Medway NHS and Social Care Partnership Trust
to steal nearly £7,000 from a charity for patients was
sentenced to a 12 month jail sentence.
Ash Aariyaan, 30, of Rochester, was employed by the Trust
as a temporary ‘bank’ employee. He began working in the
trust’s voluntary services team in March 2015, when the
manager was retiring and no replacement had yet been
appointed.
Aariyaan was solely responsible for handling requests for
grants made by staff to the charity on behalf of patients.
These were presented at a monthly committee meeting of
the charity ‘Friends of Mental Health’ and, if approved, would
be paid in cash.
A new team manager started working with the Trust in July
2015 and quickly raised concerns which were reported to the
Local Counter Fraud Specialist.
It was quickly established that Aariyaan had made false
representations in a bid to defraud the Friends of Mental
Health (West Kent and Medway) of £5,825 with a further
£1,050 attempted – a total amount of £6,875.
Between March 2015 and July 2015 there were at least
22 occasions when he either submitted a false request for
charitable funds, altered a genuine request, or failed to pay
the applicant their grant.
Aariyan was arrested in September 2015 and pleaded guilty
at Chatham Magistrates Court in February 2016.
Aariyaan was sentenced at Maidstone Crown Court in May
2016. The Recorder said: “You had a duty to act
responsibly and safeguard the hard-earned funds of that
charity. Charitable donations are generated in modest
amounts by people up and down the country. They are
hardworking and generous, spirited people. This charity, like
other charities, needs to be reassured that people who help
themselves to hard-earned funds generated by members of
the public will be punished severely.”
Andrew Ede, TIAA Local Counter Fraud Specialist for Kent
and Medway NHS and Social Care Partnership Trust, said:
“The Trust actively publicises cases of proven fraud, to
maximise the deterrent effect on others who might try to
target Kent and Medway NHS for their own gain. These
crimes by a small minority tarnish the efforts of all the honest
and hardworking people working in and for the NHS.”
A trainee nurse defrauded the NHS
out of nearly £12,000 in grants while
studying for a qualifi cation at a
Cambridge university.
Maria Domingos, 48, of London,
sububmitted false GCSE certifi cates
in order to obtain NHS grants to help
with her studies at Cambridge’s Anglia
Ruskin University.
Starting in 2009, Domingos, who
had been working at Addenbrooke’s
Hospital, applied for grants to help her
study to become a full-time nurse. The
course required foundation-level GCSE
qualifi cations.
When she wasn’t able to produce
certifi cates for these, she submitted
documents she knew to be false in
order to obtain the grants.
Domingos, appeared at Cambridge
Crown Court and pleaded guilty to fi ve
counts of fraud and another of forgery.
She was sentenced to a two-year
community order that will require her to
undertake 200 hours of unpaid work.
She was also ordered to pay £1,000 on
top of the remaining repayment of the
funds.
The Prosecutor told the court
Domingos had left the course after
a single year for personal reasons.
She had already claimed £11,815 in
grants. Had she continued for the full
three years, Mr Kellett said she could
have racked up £30,000 in fraudulently
acquired grants.
The Defence told the court that
Domingos had held equivalent
qualifi cations in Angola, where she
used to live. Due to “a great deal of
trouble” in the country, she was unable
to obtain the correct certifi cates to
participate in the nursing course and
apply for the NHS funding. This was
when the false certifi cates were said to
have emerged.
Sentencing Domingos, the Judge told
the court he had considered a
custodial sentence for the fraud, but
had drawn back because of her early
guilty plea and genuine remorse. He
said: “You wanted to take a diploma
course at Anglia Ruskin University
which required foundation
qualifi cations. Because of events in
your country, you were unable to
provide them and, instead, gave what
you knew to be a false statement. It
was a deliberate and repeated lie.”
Trainee Nurse provided false qualification documents
6 TIAA
Patient case study The borrower suffers from mental health problems and lived
opposite the loan shark’s associate. The loan shark visited
this property on six days of the week, often up to three times
a day. The witness’s son, also a borrower, suffers from
Bi-polar Disorder.
The loan shark and associates would enter the witness’s
property causing disruption in the house with verbal
outbursts. The witness’s mental health deteriorated to the
point of losing control of bodily functions, not sleeping or
eating and spending their days in their dressing gown.
The Crisis Care Team were called and subsequently carried
out a visit. They admitted the witness to hospital, due to the
witness having suicidal thoughts. When the witness’s son
suffered from serious psychotic episodes involving self-harm
and threats to his own life and others, he also ended up in
hospital.
There’s always a chance to ask people why their mental
health has worsened. It may be because they are involved
with an illegal lender.
Stop Loan Sharks
With an estimated 310,000 households in the UK
borrowing from unauthorised lenders, or loan sharks as
they are more commonly known, illegal money lending
is a problem across the country.
Anyone who operates a money lending business without
permission from the Financial Conduct Authority is acting
illegally. The England Illegal Money Lending Team (IMLT)
are cracking down on unauthorised lenders who...
• Rarely offer paperwork so those who borrow from them
are kept in the dark about how much they still owe.
• Can charge extortionate rates of interest - rates of
131,000% APR have been seen.
• Add additional amounts to the debt so the borrowers
struggle to repay.
• Take items as security. These items could even include
passports and bank cards.
• Resort to extreme methods to reclaim their debts. This
could mean threats, intimidation, violence or worse.
NHS staff are urged to be alert to the dangers, and look
out for any patients or staff who may have fallen into a loan
sharks trap, in order to point them in the direction of support.
Illegal money lending is a crime which can have a hugely
detrimental impact on the emotional and mental
wellbeing of victims. A study by the IMLT revealed several
loan shark victims were suffering from high levels of
depression, averaging at 24.1 on the PHQ9 scale.
There have been cases where loan shark victims have
attempted suicide or self-harm whilst in debt to an illegal
money lender, and cases where victims have gone into
hospital or sought medical attention following an assault
from the lender.
If a patient is concerned about a debt which must be paid or
money owed to “a friend”, it is possible they have borrowed
from an illegal money lender.
Loan sharks usually appear friendly at fi rst, but will quickly
trap their victims into spiralling debt, resorting to the most
extreme methods. Often people are afraid to speak out, but
help is available.
Nationally the Stop Loan Sharks Project has helped over
27,000 victims.
Loan sharks could be lending to patients and staff
Call the 24/7 confi dential hotline 0300 555 2222
E-mail: [email protected]
The following information has been provided by
The England Illegal Money Lending Team
SuicideUp to 2014, the IMLT had worked with 27 families where
someone has attempted or completed suicide because
of an illegal money lender. This is out of 24,500 victims
helped.
Therefore we can extrapolate that out of the 310,000
households who are believed to be victims of illegal money
lenders, 342 will attempt/complete suicide. In the general
population out of this many households, the number
expected would be 22.
The cost of an individual suicide is £1.45 million in
support services, investigation, court time etc (2010 fi gures
quoted by Cheshire and the Wirral NHS Partnership Trust).
Therefore Loan sharks have the potential to cost the NHS
£464million (320x1.45).
Of the 27 families where someone has attempted suicide,
only one was completed. Since working with the team none
of the other 26 individuals have re-attempted suicide. This
alone could save £37.7 million plus a lot of heartache and
devastation.
Fraud Stop Newsletter 7
Is your Identity Safe?Identity theft is one of the UK’s
fasting growing crimes. Are you at
risk?
• 97% of household waste contains
at least one or more items which
could assist fraudsters in stealing
an identity.
• A quarter of the UK population
has been, or believe they know,
somebody who has been a victim
of identity fraud; and over two
thirds are concerned that they may
be at risk, according to a recent
survey.
• According to a “Which?”
report, a friend, ex-partner or old
fl atmate is just as likely to steal an
identity as a stranger. Over a
quarter of victims of identity fraud
say that they knew the person who
perpetrated the fraud.
• Personal information such as your
date of birth, address, mother’s
maiden name and passwords are
now as valuable as money. This is
enough information for a fraudster
to open bank accounts, apply for
credit cards, loans and much more.
• Many people fear identity fraud
more than burglary, mugging or
pick-pocketing.
It takes 467 days on average to
discover that you are a victim of identity
fraud according to Experian.
By managing your personal
information carefully, you can
substantially reduce the likelihood of
becoming a victim of identity fraud.
Here are some tips to show you how:
Pay Attention To Billing Cycles:
Contact creditors immediately if your
bills arrive late. A missing bill could
mean a fraudster has taken over your
credit card account and changed your
billing address.
Check Your Credit Report at Credit
Reference Agencies:
It is a good idea to check your credit
report regularly to ensure no accounts
or credit have been illegally set up in
your name. Regular monitoring of your
credit report will alert you if someone
has been using your identity to
obtain credit, ensuring you can not only
rectify your credit report as soon as
possible but also stop the fraudster in
their tracks. You can obtain a copy
of your credit report from one of the
UK’s three credit reference agencies,
Experian, Equifax and Call Credit.
Be Vigilant:
Beware of anybody who contacts you
unexpectedly and asks for personal
information or account details even if
they claim to be from your bank, the
police or another offi cial organisation
like your local council. Ask for their
name and a contact number, and then
check with the organisation in question
before calling back.
Shred All Documents:
Shredding documents is the best way
to ensure that criminals cannot build
up a profi le based on the information
you discard in your rubbish. Invest in a
shredder and make it standard
practice, whether at home or at work,
to shred all documents containing
personal or fi nancial information
Protect Your Post:
If you plan to go away, contact
Royal Mail about its Keepsafe service
which helps you avoid that tell-tale pile
of unopened mail on your doormat.
Keepsafe will hold your mail for up
to two months, and deliver it on your
return.
Stay Safe Online:
If you use the internet make sure you
have the latest security patches and
up-to-date anti-virus software installed.
8 TIAA
NHS manager and accomplices jailed for £3.5m NHS fraudA senior NHS manager and three accomplices, who
were found guilty of money laundering and fraud
offences after a £3.5m NHS fraud, have been sentenced
at Leeds Crown Court for a total of 9 years, 8 months.
This follows a lengthy investigation led by police and
supported by NHS Protect and HMRC.
Sentenced:
• Neil Wood, 41, of Leeds: pleaded guilty to two counts
of conspiracy to commit fraud by abuse of position,
one count of conspiracy to commit fraud by false
representation. Sentenced to 4 years and 8 months
imprisonment.
• Lisa Wood, 40, of Leeds: pleaded guilty to one count
of money laundering. Sentenced to 16 months’
imprisonment, suspended for 2 years.
• Huw Grove, 43, of Bristol: found guilty of two counts
of conspiracy to commit fraud by abuse of position.
Sentenced to 4 years’ imprisonment.
• Terry Dixon, 46, of Monmouth: found guilty of one count
of conspiracy to commit fraud by abuse of position.
Sentenced to 1 year imprisonment.
The investigation was launched into the £3.5m loss to
Leeds and York Partnership NHS Foundation Trust, Leeds
Community Healthcare NHS Trust and NHS England in
March 2014. Neil Wood was a senior manager at Leeds and
York Partnership NHS Trust until March 2013, and he also
worked with Leeds Community Healthcare NHS Trust before
moving to NHS England.
Wood was responsible for the awarding of training
contracts and awarded the vast majority of these to a
company called The Learning Grove, which was run by his
friend Huw Grove, totaling more than £3m over a seven year
period. During this time, a total of £1.8million was
transferred from The Learning Grove to LW Learning Ltd,
a company registered in his wife, Lisa Wood’s, name. The
investigation revealed brazen messages between Neil Wood
and Huw Grove in which they discussed transferring money
between accounts and what they could charge the NHS for,
including sporting events, trips to London and dinners in
expensive restaurants.
After taking up his position with NHS England, further
monies authorised by Neil Wood were paid to The Learning
Grove. During this time, Neil Wood was able to award a
contract worth £231,495 to a company called Multi Health
Systems in Canada. This work was subcontracted back to
the UK, to be undertaken by a close relative of Terry Dixon.
Dixon was a contact of Neil Wood, and messages between
the two revealed how Dixon would keep £18,000 as an
‘agent fee’ before the rest of the money was transferred by
him to LW Learning Ltd.
The Police North East Regional Asset Recovery Team
began the investigation after a referral was made to them
by Her Majesty’s Revenue and Customs. In conjunction with
the police, NHS Protect anti-fraud specialists interviewed
Neil & Lisa Wood after they were arrested in June 2014.
NHS Protect’s Forensic Computing Unit undertook extensive
analysis of the computer equipment seized, to help prove
the fraud.
Sue Frith, Managing Director of NHS Protect, said today:
“This successful result of a joint operation involving the
Police (Regional Asset Recovery Team), HMRC and NHS
Protect shows how well a multi-agency approach can work
in tackling fraud”.
Neil Wood
A support worker who undertook
additional shifts as a domestic has
been found ‘guilty’ of fraud by false
representation at Staines
Magistrates Court.
Cristina Maria Aleixo Sousa Dos
Santos, worked as a support
worker at Kingscroft, Staines, a
Respite Service for adults with a
learning disability.
An investigation carried out by TIAA
Counter Fraud Specialist, Mary Ellaby,
found that Dos Santos was working
‘bank’ shifts as a domestic at Cedar
Unit, Ashford and St Peters Hospital
whilst reporting sick from duty at
Kingscroft.
Analysis of timesheets also identifi ed
Dos Santos had over-claimed for hours
worked totalling £1,297.
Dos Santos had earlier pleaded ‘not
guilty’ to charges of fraud by false
representation. The Magistrates
determined there was no doubt that
she had made a false declaration, and
had worked less than she had been
paid for.
Dos Santos was later sentenced
at Redhill magistrates to 150 hours
unpaid work, and ordered to repay
£600 towards costs, and
compensation of £1,297.
TIAA Counter Fraud Specialist, Mary
Ellaby, said: “Dos Santos worked as
a domestic after hours when the offi ce
was not manned. She would
frequently leave early and claim for
hours not worked. This was a breach
of trust in which Dos Santos deceived
and stole from her employers”.
Support worker worked shifts as domestic whilst on sick leave
Fraud Stop Newsletter 9
A doctor who claimed sick pay from
the NHS while working for a private
company has been sentenced at
Warwick Crown Court.
Dr. Nawshad Suleman, 65, of Solihull,
West Midlands, pleaded guilty to Fraud
by False Representation and Fraud by
Abuse of Position, and was sentenced
to 12 months imprisonment on each
count, suspended for two years. He
must also carry out 150 hours of
community service and pay back
£2,800 in prosecution costs, having
already paid back the £16,074 he
defrauded from the NHS.
Dr. Suleman began working as a
doctor at Coventry and Warwickshire
Partnership Trust in April 2000 until his
retirement in December 2014.
Following an allegation that Dr.
Suleman was working for employers
other than the NHS, an investigation
was launched by the trust. It revealed
that Suleman had worked for a
company called Premex Limited on
three instances where he was signed
off sick from his NHS role and was
receiving sick pay. Further evidence
showed that Dr Suleman had under-
taken 16 consultations on behalf of
Premex Ltd between January 2012
and April 2013 during the time he was
employed by the trust. These
consultations were undertaken at St
Michaels Hospital without the
permission of his employers and
while he was being paid to treat NHS
patients.
Reg Madden-Waite, Anti-Fraud
Specialist at NHS Protect said: “Dr.
Suleman deceived his employers and
let down the NHS with his actions.
The NHS expects the highest levels of
probity and integrity from its employees
and Dr. Suleman fell well short of those
high standards”.
Sentenced – doctor who stole £16K by working while sick
Whilst there may be some variations between policies
the general principle behind this advice is that you
should not be undertaking any work if you are on sick
leave. If you do, then you may be committing fraud and we
will investigate the matter. Below is our advice:
• Do not work for another employer while sick from any
NHS employment.
• Do not work hours that are outside your contracted
hours or shift pattern if you are sick, i.e. if you have gone
sick on an early shift don’t do a night shift for another
employer.
• Remember that you remain recorded as sick until you
next report fi t for duty by either calling in or attending
work.
• A doctor’s medical note states that you are “not fi t for
work”, this generally means all work not just your main
employment unless stated otherwise.
• If your doctor advises that another type of work or
environment may aid your recovery, you must obtain
agreement from HR and your Line Manger, in writing,
before you embark on alternative employment.
If you have any doubts or queries regarding the rules at your
Trust/CCG, contact your Line Manager or HR.
Fake sickness absence in the NHS puts your colleagues
under unfair pressures, and takes away valuable resources
from patient care.
Agency worker sentenced for timesheet fraudA Locum Physiotherapist has been sentenced at
Worthing Magistrates Court to a suspended sentenced
and will have to complete 150 hours of unpaid work.
Stephanie Howes, 31, of Hove, was employed by Sussex
Community NHS Trust as a Locum Physiotherapist through
Piers Meadows Recruitment Agency.
Howes was required to complete timesheets and submit
these to her line manager for authorisation. Concerns were
raised that Howes had claimed for hours whilst she was off
sick and had forged the authorising signature on timesheets.
TIAA Counter Fraud Specialist, Clive Leadley, conducted
an investigation and evidence was uncovered to show that
between 2nd February 2015 and 14th May 2015 Howes
submitted fi ve weekly timesheets that included seven days
she had not worked. Furthermore, 14 timesheets were
found to contain forged authorising signatures. The value of
these shifts was £1,945.
Following the sentencing, Clive Leadley, said: “This
conviction shows that fraud against the NHS will not be
tolerated. Howes will now have to give something back to
the community by completing 150 hours of unpaid work”.
Can I work somewhere
else if I am sick?
10 TIAA
TIAA Counter Fraud Specialists have been providing
assurance to NHS organisations using specialist
equipment.
Making use of ‘Identity Scan’ software, TIAA’s experts can
authenticate in seconds more than 3000+ documents
including passports, visas, ID cards, driving licences and
work permits.
All organisations have a legal duty to check employees
documentation. Failure to conduct appropriate checks can
result in a fi ne of up to £20,000 for each illegal worker.
If an employer knowingly employs an illegal worker, they will
commit a criminal offence and may face a jail sentence of up
to two years and an unlimited fi ne.
TIAA can carry out checks on existing staff as well as new
starters. In addition to providing assurance on existing staff
it will also deter identity fraudsters from seeking
employment with your organisation. Fraudsters may soon
start to target organisations where technology is not in use.
Will your organisation be a target?
For further information, and to arrange Identity Scan at
your organisation, please contact your TIAA Counter Fraud
Specialist or Debbie Crawford on 01732 752022
Fake? Forged? - Do you know?
Your Data - National Fraud Initiative 2016/17
DO report your concerns to the Counter Fraud
Specialist (CFS)
DO report your concerns as soon as possible
DO keep any documentary evidence for use by the CFS
DO remember that fraud and corruption affects us all
DON’T contact the police - contact your CFS in the fi rst
instance
DON’T be afraid to ring the CFS for advice
DON’T confront an individual with your suspicions
DON’T investigate the matter yourself
Reporting Fraud & Bribery in your NHS
• Working somewhere else whilst on sick leave
• Providing false qualifi cations / references/ employment
history
• Identity fraud
• Undertaking private work during NHS time
• False timesheet / travel / overtime claims
• Failing to declare a salary overpayment
• Failure to work contracted hours
• Failure to disclose criminal convictions
• Purchasing fraud (Procurement)
• Fake sickness / abuse of sick leave
• Invoice fraud
• Prescription fraud
• Health Tourism
• Internet and telephone misuse
• Acceptance of bribes by staff / staff offering bribes to
obtain goods, services or contracts
• Failure to declare gifts / hospitality
If you have any concerns about a suspected fraud in the NHS
Examples of fraud found in the NHS
The National Fraud Initiative
(NFI), is an exercise that matches
electronic data within and between
a wide range of public bodies to
prevent and detect fraud. Since
1996, an estimated £1.17 billion of
fraud and overpayments have been
identifi ed from this work.
The NFI works by matching data
provided by participating organisations
against data from other public bodies,
such as payrolls, pensions, and
housing benefi ts. Once the data
matching processes are complete the
participating bodies are provided with
relevant matches for consideration. It
is vital to note that matches are not
necessarily fraudulent or erroneous,
but they are potentially worthy of
further investigation.
All data extracted for NFI purposes is
strictly controlled to ensure compliance
with data protection and human rights
legislation.
Previous exercises have revealed a
number of NHS employees claiming
public funds to which they were not
entitled. In addition, participating NHS
bodies received listings showing
individuals employed by them but who
also had employment elsewhere. The
exercise has revealed individuals who
were receiving sick pay from one
organisation whilst working for another.
Alternatively, two employments may
have overlapping shifts so that it is not
possible to cover both jobs.
Further details about the data used can
be can be found at https://www.gov.uk/
government/publications/fair-process-
ing-national-fraud-initiative/fair-pro-
cessing-level-3-full-text
Fraud Stop Newsletter 11
Lorraine Bennett - Counter Fraud Manager
Tel: 07779 030925
E-mail: [email protected]
Your Counter Fraud Specialist(s)
Often people have concerns about reporting suspicions
of fraud and corruption, below are some questions and
answers to help alleviate any concerns you may have:
“I don’t know who to report it to.”
In the fi rst instance contact your Counter Fraud Specialist
(CFS). Details of how to contact your CFS are below.
Alternatively you can telephone the NHS Fraud and
Corruption Reporting Line on 0800 028 40 60. All calls are
confi dential and can be reported anonymously. You can also
report fraud online at www.reportnhsfraud.nhs.uk
“I am uncertain if fraud is being committed.”
Don’t worry, this is what the role of the CFS is all about. It
is for the CFS to investigate and decide if there is enough
evidence to indicate fraud. You should contact your CFS
if you have any concerns or even if you just need some
advice. Lots of investigations do not uncover fraud.
Sometimes genuine mistakes are being made, a system is
not working properly, or there has been a simple
misunderstanding.
“I wouldn’t want to get anyone into trouble.”
The person reporting a fraudster doesn’t get them into
trouble. The fraudster gets himself or herself into trouble by
committing fraud in the fi rst place. If you don’t report it they
might get away more money - or even put patient care at
risk. Remember it’s your NHS, we all pay for it and need to
protect its valuable resources. Don’t rely on someone else
to report your concerns.
“Nothing will be done so why bother?”
Rest assured that every single referral of fraud is assessed
and appropriate action is always taken. There can
sometimes be an impression that reports of suspected fraud
are not taken seriously, but it must be remembered that all
information relating to fraud investigations and subsequent
action is strictly confi dential. It is only when cases reach a
criminal court that specifi c detail can be made known to staff
and the public.
“If it’s only a minor issue I probably wouldn’t bother.”
Every instance of suspected fraud, no matter how small,
should be reported and investigated. Most cases start in
respect of something minor, but can uncover fraud to the
value of tens, sometimes hundreds of thousands, of pounds.
“Suppose it was my manager whom I suspected?”
It doesn’t matter. You should always report your suspicions
directly to your CFS. Your report is in confi dence; your
manager will not be told who made the referral.
“I’m concerned about repercussions and reprisals.”
Don’t be concerned. All reports of suspected fraud are
made in confi dence. The identity of the person reporting
their suspicions is protected, even if a case were to reach
court. Providing your concerns are genuine there should
be no repercussions to you reporting them. If you wish, you
can make the report anonymously, but the CFS would much
prefer it if you told us who you are in case we need to speak
to you to get further information.
Hopefully most concerns have been covered here. In
summary, no one should be worried about reporting a
genuine suspicion. If anyone has worries not mentioned
here, or would like advice on any other matter, please don’t
hesitate to contact your CFS.
Reporting Your
Concerns Q&A
The content of this publication is intended to give general information only. Its contents should not, therefore, be regarded as constituting specifi c advice,
and should not be relied upon as such. No specifi c action should be taken without seeking appropriate professional advice.
12 TIAA
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Help protect your NHS
from fraud Fraud against the NHS means that taxpayer money intended for patient care ends
up in the pockets of criminals, so fewer resources are available to pay for things like
doctors, nurses and healthcare facilities.
If you have any concerns or suspicions about fraud or corruption in the NHS, please
report them to your Counter Fraud Specialist or to the confidential NHS Fraud and
Corruption Reporting Line
0800 028 40 60All calls are dealt with by trained staff and professionally investigated
Freephone Monday to Friday 8am – 5pm
Online reporting at www.reportnhsfraud.nhs.uk
NHS Fraud in the News
A man who lied about crucial medical qualifi cations to
work as a cardiac physiologist has been jailed, after an
investigation supported by NHS Protect.
Mitchell Morris, 36, of Yardley, Birmingham, pleaded guilty to
two counts of Fraud by False Representation at
Birmingham Crown Court. He was sentenced to three years’
imprisonment for each charge – to run concurrently - and
must serve at least 18 months in jail before being considered
for release on license. The judge remarked that Morris had
betrayed the trust of his colleagues and employers.
He was employed as a Senior Cardiac Physiologist at the
Heart of England NHS Foundation Trust in Birmingham
from 2008, and was promoted in 2011 to Deputy Head of
the Cardiac Physiology Department. Both roles required a
Higher National Diploma (HND) and membership of the
Registration Council for Clinical Physiologists – Morris
fulfi lled neither of these crucial requirements. These matters
came to light after an anonymous letter was received by the
Trust, and a fraud investigation was quickly launched.
Morris claimed that he had been tricked by a lecturer at a
Further Education College, a ‘Mr Richards’, who had offered
to supervise him on a long-distance HND course. But the
certifi cates he had provided to the Trust as proof of his
qualifi cations were false, as was his explanation that they
were duplicates issued to him by the examining board
Edexcel. In a statement, Edexcel noted that as Morris had
no qualifi cations, he would not have been issued with any
certifi cates at all.
A Trust spokesperson said, “We are pleased to see that this
has been taken seriously by the courts”.
Reg Madden-Waite, Area Anti-Fraud Specialist, NHS Protect
said: “Mitchell Morris lied in order to deceive his employers
and obtain a salary to which he was not entitled. The
seriousness of his offence is refl ected in the sentence
handed down today, which should send out a message to
those intending to defraud the NHS. All suspicions of fraud
reported to NHS Protect will be followed up, and
investigated wherever appropriate. The NHS is not a soft
touch and those intending to steal from it will be caught”.
Birmingham NHS worker jailed for
£287K qualification fraud