In the ever-evolving landscape of crime, one of the biggest challenges to overcome today is combatting economic fraud. With the rise of fraudulent activities, we need innovative approaches to solve this complex issue.
Forming the Serious Economic Organised Crime and International Directorate (CPS SEOCID) has been a critical step in the right direction.
In this blog, find out what Simon Hammond, Director of Claims Management at NHS Resolution, had to say about the importance of case strategy, intelligence and data sharing, challenges related to disclosure and the alternatives to prosecution.
- Fraud Prevention
- Alternatives to Prosecution
- The Importance of an Effective Case Strategy
- Effective Tools and a Change in Culture
Fraud Prevention
After a brief introduction and highlighting the work he and his team are responsible for, Hammond kicked off his talk by stating that data sharing is, in his view, “the only solution to addressing an exponential growth in fraud across all aspects of the economy.”
Hammond quickly moved on to fraud prevention as a subject, saying it can be prevented but only through proper compliance checks on payment services, well-managed procurement processes and regular employment checks.
A recent example is the prosecution of a lady called Zholia Alemi, where everything mentioned above didn’t happen and the risks patients faced due to the lack of due diligence from those responsible.
Alemi was sentenced to seven years in prison in early 2023 for various fraud and forgery offences relating to fake psychiatric medical qualifications. She practised in the UK for 20 years based on New Zealand qualifications, costing the taxpayer over £1 million and, more importantly, putting patients at risk.
Hammond stated on this topic: “Simple employment checks with New Zealand could have prevented that fraud happening in the first place.”
Alternatives to Prosecution
He added that it’s also vital for us to assess and exercise proportionality when determining cases that require criminal prosecution, as an individual’s actions might be dishonest, but it doesn’t need criminal law to intervene.
For instance, lying on a job application or low-level fraud from NHS staff, such as false timesheets, doesn’t need to end in criminal intervention. However, Hammond highlighted some examples where the outcome would result in criminal intervention.
“If CPS staff were found to have submitted inaccurate timesheets, for instance, I would expect them to face internal disciplinary, possibly leading to job dismissal. On the other hand, a member of the CPS staff was prosecuted in 2013 for a five-year, £1 million fraud involving fake taxi invoices.
“It’s all about exercising proportionality around the facts and circumstances of particular cases. We really need to use and develop intelligence to inform our selection of cases that merits investigation and criminal prosecution and use it to influence the point of intervention,” he explained.
The Importance of an Effective Case Strategy
Also in the session, Hammond wanted to discuss his ‘mantra’ of having an important case strategy, especially in complex cases. He explained that investigators should have an idea of the outcomes they hope to achieve, linking back to the point on proportionality and being influenced by the context and background of each case.
Sharing desired objectives enables teams like Hammond’s to shape a case to make any investigation manageable and concluded within a reasonable timescale. For instance, there have been occasions where cases have taken 10 years as they’ve been allowed to develop to such a scale that they’re unprosecutable.
The objectives Hammon talked about include:
- Is there a risk of asset dissipation? This may justify involving financial investigation and confiscation to strip defendants of their ill-gotten gains.
- Consider any special measures needed for victims or witnesses to support them in giving evidence, such as using technology.
- Asset recovery measures prevent defendants from operating in a specific sector again to avoid future criminality.
These operational objectives allow prosecutors to help shape the outcomes of cases with appropriate charges.
For instance, Ian Paterson — the former breast surgeon who charged patients for operations they didn’t need — benefitted financially. However, most of his patients were NHS patients, so they had no financial loss. Instead, the focus of the case strategy turned to the victims and the physical harm they suffered, landing him a 20-year prison sentence.
Effective Tools and a Change in Culture
To conclude his talk, Hammond discussed an investigative tool that can be a game-changer in economic crime cases — using cooperating offenders with strong evidence against them and flipping them to give evidence against others.
He mentioned it’s popular in the US but underutilised in the UK.
Hammond also delved into disclosure and its vulnerability in complex cases. Significant cases are collapsing due to a failure in disclosure and it’s commonplace in crime cases where substantial digital data sets are seized and need to be examined, which is a colossal amount.
He then discussed the importance of provoking a culture change, where the responsibility doesn’t just fall to the prosecutors alone. He mentioned that it isn’t possible to investigate and prosecute every single aspect of fraudulent activity.
According to Hammond, 41% of reported criminality involves fraud, but only 1% of criminal prosecutions involve fraud cases. He admitted they can’t make a dent in the overall numbers but can improve what everybody does and work together to imprison fraudsters to send an important message.
Overall, Hammond underscored the starting point for improvement lies in consistently striving to enhance investigative practices and foster more transparent and efficient processes to deliver the right outcomes.
Don’t Miss Out on Future Insights at Counter Fraud 2024
Counter Fraud is returning on 22nd February 2024 at the QEII Centre in London. Designed to help you stay at the forefront of counter fraud, the topics up for discussion at the event will range from prevention tactics and risk assessment to emerging threats and local strategy — plus a lot more.
The event is bringing Central Government, Local Authorities and NHS together under one roof to address the challenges of public sector fraud collaboratively. Don’t miss out and secure your spot today using the button below.
Jessica Kimbell, GovNet
