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How to prevent fraud in general practice

From a practice manager overpaying herself by almost £100,000 over six years to a receptionist creating fake prescriptions, fraud in general practice comes in many guises. In my experience it is rare, but it does happen. The Financial Cost of Healthcare Fraud Report 2015, published recently, suggests that of the £5.7bn a year the NHS could be losing to fraud, £348m (6%) is attributable to general practice. But this is only the losses suffered by the NHS, not those suffered by GP partners.

When it does happen, it is unsettling for partners and staff, and concerning to patients if it is made public. Be aware of the risks and don’t assume it could never happen in your practice. Here is some advice to prevent fraud occurring.

1. Keep track of cash

Prevent the theft of cash, as many larger frauds have arisen because small-scale frauds were not noticed, and the perpetrator got sucked into a cycle of theft. You should require receipts for all petty cash purchases, and count the cash balance at least monthly to ensure it matches records. In dispensing practices, cash received from patients for prescriptions must be recorded separately from other cash receipts, so that it can be matched against the amount deducted by the NHS. As more patients value the option of paying by card, introducing a card machine will have the added benefit of reducing the amount of cash in circulation.

2. Monitor the payroll

Payroll is a large cost so an easy place to hide fraudulent payments. Would you notice if your practice manager added a dummy staff member and arranged for payment to an account to which they had access? Is there a division of duties so that one person cannot authorise payments to a new employee? Is the monthly list of payments reviewed by a partner?

3. Be aware of the possibility of fraud

Be very conscious of what is happening in your practice. Is a staff member having financial problems, or spending beyond their means? It’s more difficult to spot a partner who is overstepping the mark, but there are things to look out for. Can an individual GP create ghost patients, falsely claim for enhanced services or personally administered drugs? If your agreement allows for partners to keep enhanced service income instead of sharing it, the temptation to make fraudulent claims will be greater.

Luke Bennett is a partner at Francis Clark LLP and a committee member of the Association of Independent Specialist Medical Accountants