FRAUD AND CORRUPTION · 13 March 2019 To include reference to the role of the Trust Associate Director of Finance in overseeing fraud, bribery and corruption related work and include

Anti-Fraud, Bribery and Corruption Response Policy Shropshire Community Health NHS Trust

Anti-Fraud, Bribery and Corruption Response Policy 2019 version 1 SCH NHS T.doc March 2019 Page 1

Policies, Procedures, Guidelines and Protocols

Document Details

Title Anti-Fraud, Bribery and Corruption Response Policy

Trust Ref No 1963-52866

Local Ref (optional)

Main points the document covers

The Policy lays down procedures which reinforce Shropshire Community Health NHS Trust’s (Trust) commitment to eradicating, wherever possible, instances of fraud, bribery and corruption within the Trust and wider NHS

Who is the document aimed at?

All Trust Members of staff

Author Terry Feltus, Local Counter Fraud Specialist

Approval process

Approved by (Committee/Director)

Audit Committee/Sarah Lloyd, Associate Director of Finance

Approval Date 01 March 2019

Initial Equality Impact Screening

Yes

Full Equality Impact Assessment

No

Lead Director Ros Preen, Director of Finance and Strategy

Category General

Sub Category Corporate

Review date 01 March 2021

Distribution

Who the policy will be distributed to

Distributed to all Trust staff

Method Electronically to Board Members and senior staff, and available via the Trust website to all other staff

Document Links

Required by CQC No

Required by NHLSA No

Other Yes – NHS Counter Fraud Authority

Amendments History

No Date Amendment

1 April 2014 To remove “counter fraud department” and replace with “Local Counter Fraud Specialist”

2 April 2014 To include the new Statutory Fraud Legislation for NHS Providers

3 July 2015 To update policy with new Trust Director titles

4 July 2015 To include Interim Director of Finance details

5 July 2015 To include reference to the newly produced NHS Protect NHS Anti-Fraud Manual

6 July 2015 To include reference to the new Statutory Fraud Legislation for NHS Providers (Service Condition 24 of NHS Standard Contract 2015/2016)

7 July 2015 Minor amendments to Anti-Bribery Procedures (Paragraph 8)

8 July 2015 Remove requirement to send LCFS Annual Report with Self Review Tool submission to NHS Protect (Appendix A)


Anti-Fraud, Bribery and Corruption Response Datix Ref: 1963-52866 Policy 2019 version 1 SCH NHS T.doc March 2019 Page 2

Amendments History

No Date Amendment

9 June 2016 To include Director of Finance details

10 November 2017

To amend all references relating to NHS Protect to read NHS Counter Fraud Authority

11 November 2017

To update the Policy to reflect on the new working arrangements and responsibilities of the NHS Counter Fraud Authority

12 March 2019 To update policy with Lead Director’s new title (Director of Finance and Strategy) and to amend their contact details

13 March 2019 To include reference to the role of the Trust Associate Director of Finance in overseeing fraud, bribery and corruption related work and include their contact details

14 March 2019 To amend all references relating to data protection to the Data Protection Act 2018

15 March 2019 To update the Local Counter Fraud Specialist contact details



Anti-Fraud, Bribery and

Corruption

Response Policy



Index 1. Introduction 2. Scope 3. Policy Statement

4. NHS Counter Fraud Authority

5. Standard for Providers Document – Fraud, Bribery and Corruption

6. Local Counter Fraud Specialist

7. Definitions

7.1 Fraud 7.2 Fraud Act 2006 offences 7.3 Bribery 7.4 Corruption 7.5 Bribery Act 2010 offences

8. Anti-Bribery Procedures

9. Public Service Values

10. Roles and Responsibilities 10.1 Chief Executive 10.2 Director of Finance and Strategy 10.3 Associate Director of Finance 10.4 All Employees 10.5 Managers 10.6 Local Counter Fraud Specialist 10.7 Internal and External Audit 10.8 Human Resources 10.9 Information Management and Technology

11. Prevention Arrangements

12. Investigating Fraud, Bribery and Corruption

12.1 Reporting Fraud, Bribery and Corruption 12.2 The Process 12.3 Investigative Procedures and Methods

13. Disciplinary Sanctions



14. Criminal Sanctions

15. Recovery

16. Conclusion

17. Appendices

Appendix A: NHS Fraud, Bribery and Corruption Referral Flowchart Appendix B: Referral Form (CFS 1) Appendix C: NHS Fraud, Bribery and Corruption: Do’s and Don’ts Guide Appendix D: Investigation of Fraud, Bribery and Corruption Flowchart



1. Introduction

1.1 Shropshire Community Health NHS Trust (Trust) is committed to the anti-fraud, bribery and corruption procedures as laid down in this policy.

1.2 This document sets out the Trust’s policy for dealing with detected or suspected fraud, bribery or corruption, and the avoidance of such activity as directed by the NHS Counter Fraud Authority.

1.3 The policy contains the procedure to be followed when employees or

members of the public wish to raise concerns in connection with actual or suspected fraud, bribery or corruption.

1.4 The Trust Board wishes to encourage anyone having reasonable

suspicions of fraud, bribery or corruption to report them. 1.5 The Trust Board will ensure that no employee will suffer in any way as a

result of reporting reasonably held suspicions of fraud, bribery or corruption. For these purposes “a reasonably held suspicion” shall mean any suspicion other than those which are raised maliciously.

1.6 All suspicions of fraud, bribery or corruption against the Trust will be

investigated regardless of whether perpetrated by a member of the public, a member of staff or a NHS contractor.

1.7 The ultimate aim of the policy is to protect the property and finances of the

Trust. 2. Scope

2.1 This policy applies to all employees of the Trust and should also be used by interim or agency staff, contractors or suppliers to report any concerns they may have.

2.2 The Trust will adhere to the NHS Counter Fraud Authority Standards for

Providers, other directions and procedures published by the NHS Counter Fraud Authority, and the NHS Counter Fraud Authority NHS Anti-Fraud Manual when investigating cases and imposing sanctions.

2.3 The Trust will make every effort to investigate fully any suspicion of fraud,

bribery or corruption. It is the policy of the Trust to seek to recover all losses arising from all identified fraud, bribery or corruption related activities and to take such sanctions as are appropriate.

2.4 All investigations into fraud, bribery or corruption against the Trust will be

reported to the Trust Associate Director of Finance, and the NHS Counter Fraud Authority.



2.5 The Trust shall nominate a suitable person to act as its Local Counter Fraud Specialist, whose role and responsibilities are determined by the NHS Counter Fraud Authority, and the NHS Counter Fraud Authority NHS Anti-Fraud Manual.

3. Policy Statement

3.1 All employees have a personal responsibility to protect the assets of the Trust, including buildings, equipment and monies, against the loss from theft, fraud, bribery, corruption or any other irregularity.

3.2 The Trust is absolutely committed to maintaining an honest, open culture within the Trust, so as to best fulfil the objectives of the Trust and of the NHS.

3.3 The Trust is, therefore, also committed to the elimination of any form of

fraud, bribery or corruption within the Trust, to the rigorous investigation of any such allegations and to taking appropriate sanctions against those individuals when fraud, bribery or corruption is identified, including possible criminal prosecution, as well as undertaking steps to recover any assets lost as a result fraud, bribery or corruption.

3.4 It is the responsibility of each member of staff to report any reasonable

suspicions to the nominated Local Counter Fraud Specialist for the Trust. No individual will suffer any detrimental treatment as a result of reporting reasonably held non malicious suspicions.

4. NHS Counter Fraud Authority

4.1 The NHS Counter Fraud Authority is responsible for the prevention of crime within the NHS, and sets the standards that NHS organisations have to follow when tackling crime across NHS-funded services.

4.2 The NHS Counter Fraud Authority also assesses NHS organisations against these standards and uses an evaluation model to assess the effectiveness of the crime prevention activity undertaken by the organisation to safeguard its resources from crime and the risk of crime.

4.3 To achieve their vision, which is for an NHS which can protect its valuable

resources from fraud, bribery and corruption, the NHS Counter Fraud Authority have identified five initial main objectives to tackle during the period 01 November 2017 to 31 October 2020. These are:-

to deliver the Department of Health strategy, vision and strategic plan, and be the principal lead for counter fraud, bribery and corruption activity in the NHS in England.



to be the single expert intelligence led organisation providing a centralised investigation capacity for complex economic crime matters in the NHS.

to lead, guide and influence the improvement of standards in counter fraud, bribery and corruption work, in line with HM Government Counter Fraud Professional Standards, across the NHS and wider health group, through review, assessment and benchmark reporting of counter fraud, bribery and corruption provision across the system.

to take the lead and encourage fraud, bribery and corruption reporting across the NHS and wider health group, by raising the profile of fraud, bribery and corruption and its effect on the health care system.

to invest in and develop NHS Counter Fraud Authority staff; recognise their expertise and passion to deliver high quality counter fraud, bribery and corruption work for the NHS; and ensure and demonstrate that our professionals are respected for their contribution and that they feel proud to work for the NHS Counter Fraud Authority.

4.4 In line with legislative requirements, the NHS Counter Fraud Authority will

be subject to review every three years. This will enable them to demonstrate how they are delivering against their strategic and operational objectives and will allow them to:

adapt to emerging threats and issues and address current and future fraud, bribery and corruption risks in the NHS.

ensure, through evaluation of operational performance, that they remain fit for purpose to deliver counter fraud, bribery and corruption functions beyond 2020.

assess, analyse and report on existing and future fraud, bribery and corruption risks affecting the NHS and wider health group.

identify requirements for future counter fraud, bribery and corruption work in the NHS and wider health group.

4.5 As well as setting organisational standards, the NHS Counter Fraud

Authority also sets the standards by which investigators must operate when combating crime within the NHS.

4.6 Only trained and accredited Local Counter Fraud Specialists can be

nominated by a NHS organisation to undertake their anti-fraud, bribery and corruption activities. Such nomination processes are overseen by the NHS Counter Fraud Authority.



4.7 The NHS Counter Fraud Authority also has a National Investigations Team. This team is responsible for investigating serious, complex or cross boundary (across NHS organisations) fraud, bribery or corruption.

4.8 The nominated Local Counter Fraud Specialist for the Trust, will refer any

investigation that meets the criteria to the National Investigations Team, and liaise and support this team in any investigations affecting the Trust.

5. Standards for Providers Document – Fraud, Bribery and Corruption 5.1 This document aims to provide information to providers of NHS services

on the anti-fraud, bribery and corruption clauses in the NHS Standard Contract, and explain what providers need to do to comply with them.

5.2 Topics covered in the document include:

• NHS Standard Contract • Standards for Providers for fraud, bribery and corruption • Quality Assurance Programme

5.3 The document for the current year can be accessed via the following link:

https://cfa.nhs.uk/counter-fraud-standards/current-nhs-standards 6. Local Counter Fraud Specialist

6.1 The Trust shall nominate a suitable person to act as its Local Counter

Fraud Specialist, whose role and responsibilities are determined by the NHS Counter Fraud Authority, the NHS Counter Fraud Authority NHS Anti-Fraud Manual, and Service Condition 24 of the Standard NHS Contract.

6.2 The Local Counter Fraud Specialist will actively promote an anti-fraud, bribery and corruption culture throughout the Trust.

6.3 The Local Counter Fraud Specialist will investigate all cases of fraud,

bribery and corruption committed against the Trust, as per NHS Counter Fraud Authority policy, the NHS Counter Fraud Authority NHS Anti-Fraud Manual, the Data Protection Act 2018 and criminal legislation.

6.4 The Local Counter Fraud Specialist will report to the Trust Director of

Finance and Strategy, Associate Director of Finance, Audit Committee and the NHS Counter Fraud Authority.

6.5 The Local Counter Fraud Specialist will produce an anti-fraud, bribery and

corruption work plan with the Trust Associate Director of Finance, which will be ratified by the Audit Committee.

https://cfa.nhs.uk/counter-fraud-standards/current-nhs-standards



6.6 The Local Counter Fraud Specialist will attend Audit Committee meetings of the Trust, to report progress on the annual work plan and raise matters of concern.

6.7 The Local Counter Fraud Specialist will also produce an annual report

outlining the activities and achievements in the field of anti-fraud, bribery and corruption work during the period, and present the report to the Audit Committee.

6.8 The Local Counter Fraud Specialist will regularly meet with the Trust

Associate Director of Finance, to discuss matters and any investigations. Note; the Local Counter Fraud Specialist has direct access to Audit Committee Chair.

7. Definitions

7.1 Fraud is defined as “wrongful or criminal deception intended to result in financial or personal gain, causing the loss or risk of loss to another.”

7.2 On the 15th January 2007, the Fraud Act 2006, became law and

introduced a number of offences relating to fraudulent and dishonest actions. The main offences are listed in the following sections of the Fraud Act 2006:-

• “(1) A person is guilty of fraud if he is in breach of any of the

sections listed in subsection (2) (which provide for different ways of committing the offence).”

• “(2) The sections are;

(a) section 2 (fraud by false representation),

A person is in breach of this section if he:-

(i) dishonestly make a false representation and, (ii) intends, by making the representation –

(a) to make a gain for himself or another or, (b) to cause loss to another or to expose another to a

risk of loss.

(b) section 3 (fraud by failing to disclose information), A person is in breach of this section if he:-

(i) dishonestly fails to disclose to another person information which he is under a legal duty to disclose, and

(ii) intends, by making the representation – (a) to make a gain for himself or another or, (b) to cause loss to another or to expose another to a

risk of loss.



(c) section 4 (fraud by abuse of position), A person is in breach of this section if he:-

(i) occupies a position in which he is expected to safeguard, or not to act against, the financial interests of

another person. (ii) dishonestly abuses that position, and (iii) intends, by making the representation –

(a) to make a gain for himself or another or, (b) to cause loss to another or to expose another to a

risk of loss.”

• “(3) A person who is guilty of fraud is liable; (a) on summary conviction, to imprisonment for a term not

exceeding 12 months and/or to a fine not exceeding the statutory maximum.

(b) on conviction on indictment, to imprisonment for a term not exceeding 10 years and/or to a fine.”

7.3 Bribery is defined as “The offering, giving, receiving, or soliciting of something of value for the purpose of influencing the action of an official in the discharge of his or her public or legal duties”.

7.4 Corruption is defined as “where someone is influenced by bribery,

payment or benefit in kind to unreasonably use their position to give some advantage to themselves or to another.”

7.5 On the 1st July 2011, the Bribery Act 2010, became law and introduced

new offences in relation to bribery and corruption. The generic term “corruption” is accommodated into this act. The main offences are listed in the following sections of the Bribery Act 2010:- • “(1) A person is guilty of an offence if either of the following

applies:-“

“Section 1 Offences of bribing another person –

(a) Offers, promises or gives a financial or other advantage to another person, and

(b) Intends the advantage- (i) To induce a person to perform improperly a relevant

function or activity, or (ii) To reward a person for the improper performance of

such a function or activity (c) Knows or believes that the acceptance of the advantage

would itself constitute the improper performance of a relevant function or activity.”



“Section 2 Offences relating to being bribed –

(a) Requests, agrees to receive or accepts a financial or other advantage and intending that, in consequence, a relevant function or activity should be performed improperly (whether by the recipient or another person)”

A simple example would include a candidate for a job offering the interviewer tickets to an event in order to secure the position. Under the Bribery Act 2010, two offences would be committed; one by the person offering the bribe and one by the person receiving the bribe.

“Section 7 Failure of commercial organisations to prevent bribery – (The Corporate Offence)

(1) A relevant commercial organisation (a commercial

organisation includes all NHS bodies), is guilty of an offence under this section if a person associated with it bribes another person intending –

(a) To obtain or retain business for the organisation or (b) To obtain or retain an advantage in the conduct of

business for the organisation.”

Two simple examples of this would be: i) Where an act of bribery has occurred, for a director,

manager or officer of an organisation to ignore the act or acts of bribery within the organisation. Under the Bribery Act 2010, the corporate offence would have been committed.

ii) Where an act of bribery has occurred, it was subsequently established that the organisation employing the individual failed to have adequate procedures in place to identify and prevent the act of bribery by its employee. Again, under the Bribery Act 2010, the corporate offence would have been committed.

8. Anti-Bribery Procedures

8.1 An organisation will have a defence against prosecution if it can show that

they have the following adequate procedures in place to prevent bribery. 8.2 The Secretary of State has outlined six principles that are expected from

commercial organisations to address the risk of bribery occurring within its business activities. These six principles if adopted amount to a defence from prosecution. The six principles are:



8.2.1 Proportionality

The Trust must have procedures in place to prevent bribery by persons associated with it. These are proportionate to the bribery risks faced by the organisation and to the nature, scale and complexity of the organisation’s activities. They are also clear, practical, accessible, effectively implemented and enforced.

8.2.2 Top Level Commitment

The Trust Chief Executive and Directors should demonstrate that they are committed to preventing bribery by persons associated with the Trust. They will foster a culture within the organisation in which bribery is never acceptable.

8.2.3 Risk Assessment

The Trust assesses the nature and extent of its exposure to potential external and internal risks of bribery on its behalf by persons associated with it. The assessments are periodic, informed and documented. This includes financial risks but also other risks such as reputational damage.

8.2.4 Due Diligence

The Trust takes a proportionate and risk based approach, in respect of persons who perform or will perform services for or on its behalf, in order to mitigate identified bribery risks.

8.2.5 Communication (including training) The Trust seeks to ensure that its bribery prevention policies and procedures are embedded and understood throughout the organisation through internal and external communication, including training that is proportionate to the risks it faces.

8.2.6 Monitoring and Review The Trust will monitor and review its procedures, designed to prevent bribery by persons associated with the Trust, and make improvements to minimise the risk where necessary.

8.3 For more comprehensive detail on anti-bribery procedures, please see the Trust Anti-Bribery Policy and Procedure on the Trust Website in the “Staff Zone” under “Policies”.



9. Public Service Values 9.1 The Nolan Committee was set up in 1994 to examine concerns about

standards of conduct of all holders of public office. The committee published the seven principles of public life, which are:

9.1.1 Selflessness

The Trust should take decisions solely in terms of the public interest. Decisions are not to be made in order to gain financial or other material benefits for the members of the Trust, their family, or their friends.

9.1.2 Accountability

Everything done by those who work at the Trust must be able to stand the tests of parliamentary scrutiny, public judgements on property, and professional codes of conduct.

9.1.3 Probity

Absolute honesty and integrity should be exercised in dealing with NHS patients, assets, employees, suppliers and customers.

9.1.4 Openness

The Trust’s actions should be sufficiently public and transparent to promote confidence between the Trust and its stakeholders.

9.1.5 Objectivity

In carrying out business, including making appointments, awarding contracts, or recommending individuals for rewards and benefits, the Trust should make choices on merit.

9.1.6 Honesty

Members of the Trust have a duty to declare any private interests relating to their duties and take steps to resolve any conflicts arising in a way that protects the public interest.

9.1.7 Leadership

Members of the Trust should promote and support these principles by leadership and example.

9.2 It is expected that Non-Executive/Executive Directors and staff at all levels

will lead by example in acting with the utmost integrity and ensuring adherence to all relevant regulations, policies and procedures.



10. Roles and Responsibilities

10.1 Chief Executive

10.1.1 The Trust Chief Executive has the overall responsibility for funds entrusted to the Trust as the accountable officer. This includes instances of fraud, bribery and corruption. The Chief Executive must ensure adequate policies and procedures are in place to protect the Trust and the public funds entrusted to it.

10.2 Director of Finance and Strategy

10.2.1 The Director of Finance and Strategy is provided with powers to

approve financial transactions initiated by directorates across the Trust.

10.2.2 The Director of Finance and Strategy prepares, documents and maintains detailed financial procedures and systems and ensures that they incorporate the principles of separation of duties and internal checks to supplement those procedures and systems.

10.2.3 The Director of Finance and Strategy will report to the Board on the

adequacy of the internal financial control as part of Board’s overall responsibility to prepare a statement of internal control for inclusion in the Trust’s annual report.

10.2.4 The Director of Finance and Strategy has overall responsibility for overseeing the work of the nominated Local Counter Fraud Specialist for the Trust, and will liaise and discuss with the nominated Local Counter Fraud Specialist, where appropriate, the anti-fraud, bribery and corruption arrangements and any investigations undertaken. It should however be noted that day to day management of the Local Counter Fraud Specialist has been reassigned to the Trust Associate Director of Finance.

10.2.5 The Director of Finance and Strategy will liaise, as required, with

the NHS Counter Fraud Authority with regard to anti-fraud, bribery and corruption arrangements and investigations relating to the Trust.

10.2.6 The Director of Finance and Strategy will authorise any

prosecution, following discussion with the nominated Local Counter Fraud Specialist and, if appropriate, the NHS Counter Fraud Authority. When investigations have been referred to the Police or the investigation is in conjunction with the Police, the Crown Prosecution Service will make the decision concerning any prosecution.



10.2.7 The Director of Finance and Strategy will, depending on the outcome of investigations (whether on an interim/on-going or a concluding basis) and/or the potential significance of suspicions that have been raised, inform the Trust Chief Executive and the Chair of the Audit Committee of cases, as may be deemed appropriate or necessary especially where the loss may be above an agreed level or where the incident may lead to adverse publicity.

10.3 Associate Director of Finance

10.3.1 The Associate Director of Finance will oversee the work of the

nominated Local Counter Fraud Specialist for the Trust on a daily basis, and will liaise and discuss with the nominated Local Counter Fraud Specialist the anti-fraud, bribery and corruption arrangements and any investigations undertaken.

10.4 All Employees

10.4.1 Employees of the Trust are expected to adhere to the policies and

procedures of the Trust and to the Public Service Values (Nolan Principles). All employees should also be aware of their own responsibilities in protecting the Trust from crimes, and in doing so have a duty to protect the assets of the Trust, including information and goodwill, in addition to property.

10.4.2 Employees are expected to act in accordance with the standards laid down by their Professional Institutes, where applicable.

10.4.3 The Trust’s Standing Orders and Prime Financial Policies place an

obligation on all staff, to act in accordance with best practice. In addition, all Trust non-executive Directors, and employees must declare and register any interests that might potentially conflict with those of the Trust or the wider NHS.

10.4.4 When an employee suspects that there has been an incident of

fraud, bribery or corruption, they must report the matter to the nominated Local Counter Fraud Specialist, or the Director of Finance and Strategy, or the Associate Director of Finance, or to the NHS Counter Fraud Authority via the Fraud and Corruption Reporting Line or via the online facility. (See Section 12 below)

10.4.5 Under no circumstances should staff attempt to investigate

any instance of actual or suspected fraud, bribery or corruption; nor subject any individual(s) to surveillance of any kind.



10.5 Managers

10.5.1 Managers should ensure that policies, procedures and processes within their local area are adhered to and kept under constant review

10.5.2 Managers must also be vigilant and ensure that policies and

procedures to guard against fraud, bribery and corruption are followed. They should be alert to the possibility that unusual events or transactions could be symptoms of fraud, bribery or corruption. Where they have any doubt they must seek advice from their nominated Local Counter Fraud Specialist.

10.5.3 They also have a responsibility to ensure that their staff are aware

of fraud, bribery and corruption and understand the importance of protecting the Trust from it.

10.5.4 Managers should also be responsible for the enforcement of

disciplinary action for staff who do not comply with policies and procedures.

10.5.5 Any instances of actual or suspected fraud, bribery or corruption

brought to the attention of the manager should be reported to the nominated Local Counter Fraud Specialist, or the Director of Finance and Strategy, or the Associate Director of Finance, or to the NHS Counter Fraud Authority via the Fraud and Corruption Reporting Line or via the online facility. (See Section 12 below)

10.5.6 Managers should be aware that failure to gather evidence in an

appropriate legal manner may undermine any potential criminal investigation and subsequent prosecution. Therefore not under any circumstances should managers attempt to investigate any instance of actual or suspected fraud, bribery or corruption; nor subject any individual(s) to surveillance of any kind.

10.5.7 Managers should make all members of staff aware of this policy and its contents.

10.6 Local Counter Fraud Specialist

10.6.1 The nominated Local Counter Fraud Specialist is responsible for

taking forward all anti-fraud, bribery and corruption arrangements at the Trust in accordance with national standards as set by the NHS Counter Fraud Authority and the NHS Counter Fraud Authority NHS Anti-Fraud Manual, and reports directly to the Director of Finance and Strategy, and to the Associate Director of Finance on a daily basis.



10.6.2 Adhering to the NHS Counter Fraud Authority Standards is important in ensuring that the Trust has appropriate anti-fraud, bribery and corruption arrangements in place, and that the nominated Local Counter Fraud Specialist will look to achieve the highest standards possible in their work.

10.6.3 The nominated Local Counter Fraud Specialist will work with key

colleagues and stakeholders to promote anti-fraud, bribery and corruption work, apply effective preventative measures, and investigate allegations of fraud, bribery and corruption.

10.6.4 The nominated Local Counter Fraud Specialist will conduct risk

assessments in relation to their work to prevent fraud, bribery and corruption.

10.6.5 The nominated Local Counter Fraud Specialist will take the lead in

investigating any allegations of fraud, bribery or corruption in accordance with the procedures detailed in this policy. (See Section 12 below)

10.7 Internal and External Audit

10.7.1 The role of internal and external audit includes reviewing controls

and systems and ensuring compliance with financial instructions. 10.7.2 The Trust nominated Internal and External Auditors have a duty to

pass on any incident or suspicion of fraud, bribery or corruption that they identify as part of an audit, to the nominated Local Counter Fraud Specialist for the Trust.

10.8 Human Resources

10.8.1 Human Resources will liaise closely with the nominated Local

Counter Fraud Specialist, from the outset where an employee is suspected of being involved in fraud, bribery or corruption.

10.8.2 Close liaison between the nominated Local Counter Fraud

Specialist and Human Resources is essential to ensure that any parallel sanctions (i.e. criminal and disciplinary) are applied effectively and in a coordinated manner. A Trust Anti-Crime Specialists and Human Resources Advisory Team Protocol has been produced and put into place, which fully explains this process.

10.9 Information Management and Technology

10.9.1 The Computer Misuse Act 1990 protects and secures computer material against unauthorised access and any harmful type of modification.



10.9.2 Its main purpose is to prevent copyright infringements, hacking,

using computer data for fraud or blackmail, the creation of viruses, and the illegal deleting or altering of computer data.

10.9.3 The act makes the offences, which can be made on computers,

clear making sure the ever growing amount of people using them; both victims and criminals, are aware of the offences they could be subject to, in both committing and being a part of them.

10.9.4 Any suspected fraudulent use of information technology will be

reported by the Trust Head of Informatics to the nominated Local Counter Fraud Specialist to investigate in accordance with the procedures detailed in this policy. (See Section 12 below)

11. Prevention Arrangements

11.1 Prevention arrangements are a key part of an organisation’s defence

against fraud, bribery or corruption. Therefore deterring and preventing dishonesty is a key component in combating internal or external fraud, bribery and corruption.

11.2 Through measuring the problem of fraud, bribery or corruption and

learning from where it is detected and how it is perpetrated, knowledge can be gained of where it is necessary to build strong preventative systems.

11.3 Prevention arrangements include revising and strengthening procedures,

administrative processes, and providing input for review of policies. 11.4 The Trust needs to be aware of what system weaknesses have become

apparent during an investigation. The nominated Local Counter Fraud Specialist and Internal Auditors will advise on the development and procedures to prevent fraud, bribery and corruption when organisational weaknesses have been identified.

12. Investigating Fraud, Bribery and Corruption

12.1 Reporting fraud, bribery or corruption

12.1.1 The Trust works within a structure for reporting fraud, bribery and corruption in the NHS. See Appendix A for the referral flowchart.

12.1.2 A key aspect of an effective anti-fraud, bribery and corruption

strategy is the ability to undertake professional and objective investigation into allegations of fraud, bribery or corruption. Early



detection both helps an investigation and will minimise the potential for further loss to the organisation.

12.1.3 The purpose of an investigation is not to prove that fraud, bribery or

corruption is present but rather to objectively assess the truth or otherwise of the allegation that has arisen.

12.1.4 Anyone who encounters behaviour, or finds documents that they

think may constitute fraud, bribery or corruption should take the following action:

• You should report your suspicions to the Trust’s nominated

Local Counter Fraud Specialist; contact details of which are given below: • Name: Terry Feltus • Telephone: 01743 277635, or internal extension

number 2274 • Mobile: 07818 421404 • Email: [email protected] • Address: William Farr House, Mytton Oak Road,

Shrewsbury, SY3 8XL

• Alternatively you can complete an online referral form which is located on the Trust website, in the Staff Zone, and on the Anti-Fraud webpage. The form can also be accessed via: www.shropscommunityhealth.nhs.uk/fraud-reporting-form

• Another option is for you to complete the referral form (CFS

1), which is attached to this Policy as Appendix B, and send it to the address detailed on the form.

• You can also report your concerns to the Trust Director of Finance and Strategy; contact details of which are given below:

• Name: Ros Preen • Telephone: 01743 277583, or internal extension

number 2179 • Email: [email protected]

• You can also report your concerns to the Trust Associate

Director of Finance and Strategy; contact details of which are given below:

• Name: Sarah Lloyd • Telephone: 01743 277634, or internal extension

number 4017 • Email: [email protected]

mailto:[email protected]

http://www.shropscommunityhealth.nhs.uk/fraud-reporting-form





• Alternatively you can report your suspicions in accordance with the guidance issued in the Trust Freedom to Speak Up: Raising Concerns (Whistleblowing) Policy.

• Another option is to report your suspicions directly to the NHS Counter Fraud Authority via the NHS Fraud and Corruption Reporting Line on telephone number 0800 028 4060, which is operated by Crimestoppers.

• You can also report your suspicions directly to the NHS

Counter Fraud Authority online via https://cfa.nhs.uk/reportfraud

12.1.5 All referrals received will be treated in confidence. The Public

Interest Disclosure Act 1998 came into force in July 1999; this act provides statutory protection, within defined parameters, to staff that make disclosures about a range of concerns, including fraud, bribery or corruption, which they believe to be happening within the organisation employing them.

12.1.6 On no account should anyone seek to investigate suspicions of

fraud, bribery or corruption, as this may cause difficulties later. You should: • retain any potential evidence and make notes of any issues

and concerns immediately. • take no further action once suspicions have been raised in

accordance with the policy.

12.1.7 Please see Appendix C for a full list of Do’s and Don’ts when suspecting fraud, bribery or corruption.

12.2 The Process

12.2.1 The process for fraud, bribery and corruption investigations is

documented in Appendix D. It is important that this process is followed in order to substantiate any subsequent sanction and redress actions/methods e.g. prosecution, disciplinary.

12.2.2 Process is briefly summarised as:

• Suspicion of fraud, bribery or corruption is reported to the nominated Local Counter Fraud Specialist, or the Trust Director of Finance and Strategy, or the Trust Associate Director of Finance, or documented on an NHS Fraud, Bribery and Corruption Referral Form (manual or online), or via the NHS Fraud and Corruption Reporting Line, or via the NHS Counter Fraud Authority website online reporting facility.

https://cfa.nhs.uk/reportfraud



• The nominated Local Counter Fraud Specialist will log the suspicion onto the NHS Counter Fraud Authority Case Management System known as FIRST (Fraud Information Reporting System and Toolkit) within ten working days of receiving the referral.

• The nominated Local Counter Fraud Specialist will

investigate the suspicion or refer it to another colleague for investigation, as appropriate.

• Once the alleged fraud, bribery or corruption has been

established, the nominated Local Counter Fraud Specialist will also discuss the situation with the Trust Director of Finance and Strategy/Associate Director of Finance and agree a course of action (note, in exceptional circumstances the nominated Local Counter Fraud Specialist has direct access to the Audit Committee Chair).

• If fraud, bribery or corruption exists, appropriate action is

taken in accordance with law and procedure, NHS Counter Fraud Authority policy, and the NHS Counter Fraud Authority NHS Anti-Fraud Manual.

12.3 Investigative Procedures and Methods

12.3.1 All investigations will be undertaken in accordance with the criminal

legislation and procedure, NHS Counter Fraud Authority policy, and the NHS Counter Fraud Authority NHS Anti-Fraud Manual.

12.3.2 The nominated Local Counter Fraud Specialist for the Trust, under this policy will be allowed access to all Trust Non-Executive Directors, employees, and contractors, as well as to systems, processes, records, data and information, as is necessary, in order to progress any investigation. All information requests will be made in accordance with the relevant sections of the Data Protection Act 2018.

12.3.3 During the course of an investigation all other legal consideration will have to be taken into account, for example:

• Theft Act (England and Wales) 1968 and 1978 • Police and Criminal Evidence Act 1984 • Criminal Procedures and Investigations Act (CPIA) 1996 • Regulation of Investigatory Powers Act 2000 • Forgery and Counterfeiting Act 1981 • Computer Misuse Act 1990 • Misuse of Drugs Act 1971 • Data Protection Act 2018 • Codes of Confidentiality



• Criminal Law • Civil Law

13. Disciplinary Sanctions

13.1 The Trust will decide on the appropriate disciplinary action, in accordance with the Trust Policy and Procedure – Disciplinary (Non-Medical and Dental Staff), and Maintaining High Standards of Performance – Medical and Dental, in instances when fraud, bribery or corruption has taken place involving an employee.

13.2 There will be instances when it is appropriate to pursue more than one course of action at the same time e.g. a criminal investigation and a disciplinary investigation taking place at the same time. In such instances close liaison must exist between those investigating criminal and disciplinary matters.

13.3 Criminal action should take precedence over disciplinary action. However,

care must be exercised as criminal investigations and prosecutions can take much longer to complete and the Trust should avoid being in a position where they are paying for a member of staff to be suspended whilst awaiting a criminal trial.

13.4 Close liaison must exist between those investigating criminal and

disciplinary matters. In situations where an investigation impacts on another the matter should be referred to the Trust Director of Finance and Strategy/Associate Director of Finance, and Director of People to consider the advice from each investigator and agree which investigation take priority.

14. Criminal Sanctions

14.1 The Trust’s Director of Finance and Strategy/Associate Director of Finance, and nominated Local Counter Fraud Specialist, will discuss the issues under consideration before a criminal prosecution is undertaken. This may not however be possible as a suspect may have been arrested by the Police and in that case full co-operation should be provided to secure evidence that may be required.

15. Recovery

15.1 The Trust will seek to recover any monies, property or assets lost as a result of any fraud, bribery or corruption committed against the Trust.



15.2 The Trust will consider all forms of recovery available under both criminal and civil law, when seeking to obtain recovery; e.g. Proceeds of Crime Act 2002 or debt collection agencies.

15.3 The Trust Director of Finance and Strategy/Associate Director of Finance

will consider the recovery options available and authorise the appropriate recovery action dependant on the circumstances.

16. Conclusion 16.1 All employees of the Trust have a duty to follow the Public Service Values

and ensure in particular that they maintain the standards of honesty and accountability.

16.2 All employees should at all times comply with the Trust’s internal control systems and procedures and report any reasonable, non-malicious suspicions of fraud, bribery, corruption or serious criminal misconduct.



Appendix A

NHS Fraud, Bribery and Corruption Referral Flowchart

Referral

(Allegation)

Trust Director of Finance and Strategy / Associate Director of

Finance

NHS Fraud, Bribery and Corruption Reporting Line

NHS Counter Fraud Authority Online Referral Form

Nominated Local Counter Fraud Specialist

NHS Counter Fraud Authority

NHS Counter Fraud Authority National

Investigations Team

Trust

Chief Executive

Trust Director of Finance and Strategy / Associate Director of

Finance

Trust Freedom to Speak Up: Raising Concerns (Whistleblowing) Policy

Trust Manual or Online Referral Form



Fraud, Bribery and Corruption Reporting Referral Form

If you wish to report a potential fraud, bribery or corruption please print out and complete this form, and post it to the Local Counter Fraud Specialist, Shropshire Community Health NHS Trust, William Farr House, Mytton Oak Road, Shrewsbury, SY3 8XL

YOUR DETAILS

It is not necessary to provide your contact details; however it is possible that more information may be required in order for any investigation to take place. All reported incidents will be investigated, and where appropriate the offenders prosecuted. As a result the Police may also be contacted. All concerns will be treated sensitively and in the strictest confidence. You will not suffer any recriminations as a result of raising a reasonable and justified suspicion.

Your Name:

Address: Telephone:

E-mail:

SUSPECT DETAILS

Name:

Description:

FRAUD, BRIBERY OR CORRUPTION DETAILS

Location:

Details: (Please attach any available information)

Signed: Dated:

The Trust Local Counter Fraud Specialist will undertake to acknowledge receipt of this referral within 5 working days unless otherwise requested.

Form CFS 1

(Please continue on a separate piece of paper and attach if necessary)

Appendix B


Anti-Fraud, Bribery and Corruption Response Policy 2019 version 1 SCH NHS T.doc March 2019

Page 27

NHS Fraud, Bribery and Corruption: Do’s and Don’ts – A guide for Shropshire Community Health NHS Trust

FRAUD is the intent to obtain a financial gain from, or cause a financial loss to, a person or party through false representation, failing to disclose information or

abuse of position. BRIBERY and CORRUPTION is the deliberate use of payment or benefit-in-kind to influence an individual to use their position in an unreasonable way to help

gain advantage for another.

DO NOT

Confront the suspect or convey concerns to anyone other than those authorised, as listed below

Never attempt to question a suspect yourself; this could alert a fraudster or lead to an innocent person being unjustly accused.

Try to investigate, or contact the Police directly Never attempt to gather evidence yourself unless it is about to be destroyed; gathering evidence must be done in line with legal procedures in order for it to be useful. Your Local Counter Fraud Specialist can conduct an investigation in accordance with legislation.

Be afraid of raising your concerns The Public Interest Disclosure Act 1998 protects employees who have reasonable concerns. You will not suffer discrimination or victimisation by following the correct procedures.

Do nothing!

DO

Note your concerns Record details such as your concerns, names, dates, times, details of conversations and possible witnesses. Time, date and sign your notes.

Retain evidence Retain any evidence that may be destroyed, or make a note and advise your Local Counter Fraud Specialist.

Report your suspicion Confidentiality will be respected – delays may lead to further financial loss.

If you suspect that fraud against the NHS has taken place, you must report it immediately, by:

directly contacting the Local Counter Fraud Specialist, or

by completing a fraud referral form manually or online, or

telephoning the freephone NHS Fraud and Corruption Reporting Line (see details on the right), or

via the online facility (see details on the right), or

by contacting the Director of Finance.

Do you have concerns about a fraud taking place in the NHS?

If so, any information can be passed to the

NHS Fraud and Corruption Reporting Line: 0800 028 40 60

All calls will be treated in confidence and investigated by professionally trained staff

Or via the online facility: https://cfa.nhs.uk/reportfraud Your nominated Local Counter Fraud Specialist is Terry Feltus, who can be contacted by telephoning 01743 277635 or 07818 421404, or emailing

[email protected] If you would like further information about the NHS Counter Fraud Authority, please visit https://cfa.nhs.uk/home

Tackling Fraud, Bribery and Corruption

Appendix C



https://cfa.nhs.uk/home


Anti-Fraud, Bribery and Corruption Response Policy 2019 version 1 SCH NHS T.doc March 2019

Page 28

Appendix D

Investigation of Fraud, Bribery or Corruption - The Process

Suspicions aroused by behaviour / documents

Convey information directly to Local Counter Fraud Specialist (LCFS), or

Director of Finance and Strategy/Associate Director

of Finance

Referral is passed to LCFS by

telephone / letter

Complete Referral Form

(Manual (CFS 1) or online), and pass to LCFS

NHS Fraud and Corruption Line: 0800 028 40 60

or website: https://cfa.nhs.uk/reportfraud

LCFS acknowledges referral within 5 days

Information passed by NHS Counter Fraud Authority to

LCFS for action in accordance with guidance

LCFS logs referral onto Case Management System (FIRST) within 10 working days of receipt; allocated to category; referral number is generated; investigation

file commenced

LCFS decides if the referral relates to a fraud, bribery or corruption matter

LCFS proceeds lawfully and collates all relevant information

LCFS presents information to Director of Finance and Strategy/Associate Director of Finance to decide if fraud, bribery or

corruption has taken place

If the decision is no, details of the reasons to be documented in the file concluding report

and case closed down

If the decision is yes, need to determine sanctions to be sought

LCFS prepares appropriate documentation and submits to relevant

body for action as appropriate

If no; no further action taken by LCFS. (If appropriate, the

referral may however be passed to another area of the Trust to look into) Referrer notified of decision

If yes


Documents

FRAUD AND CORRUPTION · 13 March 2019 To include reference to the role of the Trust Associate Director of Finance in overseeing fraud, bribery and corruption related work and include