Building Capability Across the NHS: Government Counter Fraud Profession

Jessica Kimbell, GovNet
January 29, 2024

Fraud costs the NHS a staggering 1.198 billion annually, according to a recent estimate by the NHS Counter Fraud Authority (NHSCFA).

Tackling NHS Fraud requires a robust strategy, and central to this is ensuring you, as a counter fraud professional, are equipped with the tools and skills you need to respond to fraudulent activity effectively.

The NHSCFA has pioneered the development of career pathways. Still, a consistent overarching framework for career progression and professional development in counter fraud across the public sector hasn’t emerged until recently. Now, the government has set objectives to build and grow the profession and bring the counter fraud community together under a common set of standards.

The skills-focused strategy is set out in the government’s policy paper, Counter Fraud Profession Strategy 2023-2025; it aims to increase the capability of government staff who protect public services from fraud.

The strategy will be overseen by the Public Sector Fraud Authority (PSFA), which was set up in August 2022. The Government Counter Fraud Profession (GCFP), launched in October 2018, is now within the Authority’s Practice, Standards and Capability Function.

Laura Eshelby, Deputy Director of Practice, Standards and Capability at the PSFA, explained more about future objectives and the importance of investing in people in her keynote speech at the recent NHS Fraud 2023 conference. 

This blog shares the key messages from Eshelby’s conference address.


 

Firstly, here’s a quick overview of the key bodies involved.

The NHSCFA

The NHSCFA is a special health authority tasked with leading the fight against fraud, corruption and bribery in the NHS and broader health services. Its staff include specialists in intelligence, fraud prevention, computer forensics, fraud investigation, financial investigation, data analysis and communications.

The PSFA

The Public Sector Fraud Authority (PSFA) is the UK government’s Centre of Expertise for managing fraud against the public sector. It leads the Government’s Counter Fraud Function.

The GCFP

The Government Counter Fraud Profession (GCFP) pulls together individual and organisational learning from across the public sector, and beyond, into one place. It was established to recognise the importance of counter fraud work and the specialist skills and experience it takes to deliver it. The GCFP’s primary remit is to provide pathways for individual capability building and career development through access to professional standards and competencies. 

Today, there are more than 7,000 members of the Government Counter Fraud Profession.


 

The importance of career development in counter fraud

In 2015, a group of passionate senior leaders in the counter fraud sector met to share their frustrations, and three years later, the GCFP was created.

Laura Eshelby recalls that among the frustrations was the lack of recognition and career development.

This lack of recognition, she argues, could be detrimental to achieving the objectives of counter fraud professionals. Eshelby cites the example of an investigator presenting a case in court, who could lose their perceived authority when a judge asks, ‘What qualifications do you have?’ Now they can say: “I’m a recognised member of the Government Counter Fraud Profession”.

The GFCP has members from 67 organisations, including HMRC and the SFO. It is the first profession in the world dedicated to those working to fight fraud. It provides a structure with common professional standards and competencies for those in counter fraud roles.

For Eshelby, the broad reach of the GCFP is its strength: “It gives members access to a wider community. I know from decades ago when I was an investigator that what gets you through an investigation to a successful outcome is not working in your own silos. It’s by reaching out to other networks, other organisations and having a modern approach to how we counter fraud.”

Growing confidence is essential for tackling fraud

Membership of the GCFP allows people to gain confidence in the profession. This is an essential attribute, as Eshelby explains: “We are really focused on how we can all make a difference and act as advocates. We want our members to challenge and be proactive.

“Our members can be the person in the procurement meeting that says, 'Wait a minute. Can I ask the question? There’s a red flag.' That’s the behaviour we want from people who work in counter fraud. It’s what sets us apart from just ticking boxes.

“A counter fraud professional should ask questions and challenge, which means being brave and courageous. That isn’t easy.”

They may not always win a popularity contest, but that is not what they are there for. Laura Eshelby recalls on many occasions when she was an investigator that, she would find instances of fraud, which could be rather inconvenient. The temptation could be to overlook such instances. It is here where people must abide by a code of ethics and be the person that challenges.

The GCFP helps to build confidence in its members and to clarify the importance of ethics and standards.

“It’s in everyone’s interest who works in counter fraud to raise the profession’s profile

The future of the GCFP and its objectives for the next three years

The GCFP recently published a three-year strategy for the profession. Eshelby urged all public sector counter fraud professionals (even non-members) to read and implement the strategy.  

Eshelby outlined the five key areas for members as follows:

1. Support continual development 

“One thing that really helps practically day-to-day is to have regular technical updates with your cadre of other members. It’s really important we bring that community together.

Every month, we will provide CPD technical events for free to our members on topics such as disclosure and risk assessment. If you have a membership, you can access these, and if you’re a manager, it saves you from having to organise that monthly CPD for your team.”

2. Apprenticeships

An apprenticeship programme is in place, but Eshelby acknowledged it needs improvement. It is an investigation apprenticeship. “The good news is we’re building another apprenticeship focusing on risk, prevention and measurement. We’ll be opening a trailblazer to develop the programme and welcome people to get involved.”

3. Increase diversity and inclusion

Diversity and inclusion must be improved in everything that we do from now on, said Eshelby. “The profession needs to be opened up and barriers removed. This will help us build talent in the profession.”

4. Investment in leadership

Eshelby is confident that the recent launch of a new leadership programme will put senior leaders through their paces. “We will be testing their counter fraud knowledge, including their understanding of risk assessment. These people will be looking at ministers in the eye and asking for more investment, so we need them to be really strong, knowledgeable advocates.”

5. Raising the profile 

As a profession, Eshelby is acutely aware of the need to raise its profile. “I always try my best to raise the profile on LinkedIn and other platforms”, she says. She stresses the importance of everyone in the profession (members and non-members) getting involved. “It’s in everyone’s interest who works in counter fraud to raise the profession’s profile. It can only enhance your value as a counter fraud officer and your future career value.”

 

Listening to GCFP members

Eshelby was keen to impress the importance of listening to members and recognises the importance of transparency. A recent members’ survey found that 66% were proud to be a member of the GCFP. Eshelby said, “That might seem pretty good, but that’s not my view. 

I’ve set my team a goal to raise that by at least 10% this year. I want at least 70-80% of members to be proud.”

Another key finding from the survey was that only 59% of members said that the profession helps them in their role. “We’ve already taken steps and introduced a monthly CPD and are working on more training. We need to do more and provide the right tools and support. We take this very seriously”, said Eshelby.

And only 51% of members say they were satisfied with the member benefits. Eshelby added, “Again, my team have personal targets to improve these this year.”

How future PSFA objectives support career development in the NHSCFA

A three-year strategy to support career development includes:

  • Upgrading the Civil Service Learning (CSL) Programme
  • Building on the current Leadership Programme to offer a ‘future leaders’ course 
  • Doubling the number of people trained and increasing the cohort of people able to perform fraud risk assessments
  • Offering more practical guidance to help fraud professionals in their day-to-day role, including disclosure and initial fraud impact assessments
  • Expanding the apprenticeship scheme
  • The development of a ‘Fraud Measurement’ online training course

 

How can you join the profession?

There are two current routes to join:

Through the evaluation of your organisation’s learning environment

Your organisation can join if you work in a very mature learning organisation, like the NHSCFA as an investigator. This process is based on an evaluation of training and CPD, assessed by a panel. 

Or, through individual training groups

This can be either via the pathway for leadership or through the investigation apprenticeship. A counter fraud apprenticeship will be launched later this year, adding a third individual training group pathway to join the profession.

In addition, Eshelby said the PFSA will look at how to introduce individual assessments and portfolios as an alternative route over the next couple of years.

The benefits of GCFP membership

  • Access to monthly CPD technical events
  • Engage with other members of the profession via a digital networking tool

 

Laura Eshelby was speaking at the annual NHS Fraud 2023 conference organised by GovNet. To learn more about next year’s event, visit the website here.