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: reportaloanshark@stoploansharks.gov.uk

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: lorraine.bennett@nhs.net

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