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Fraud in the NHS, as in all walks of life, is under-reported, according to the NHS Counter Fraud Authority.

Its leaders are keen to stress that trusts and other local NHS organisations need to proactively seek out and identify instances of fraud, or instances where their processes are vulnerable to fraud.

Not only will this help bolster the policies and procedures in that one trust, improving preventative measures against future loss, it will also enhance other trusts’ knowledge and understanding, and improve their prevention, too.

NHSCFA recently completed a national proactive exercise, working with trusts to identify potential vulnerabilities to fraud in their procurement systems.

It identified multiple instances that could amount to hundreds of millions in lost pounds. A national campaign and work by local trusts has started closing these possible gaps.

It is vital trusts keep on with this work but their capacity to do so will be hampered if the back-office staff who guard against fraud keep getting cut.

Finance and procurement administrators, and counter-fraud specialists, are crucial but also often among the first in line when cuts are made.

Continuing the depletion of their ranks is surely a false economy.

An acute problem

All is not well in Devon, where all of the county’s acute NHS trusts are now in special measures.

With the integrated care board also in the highest tier of central oversight, NHS England will be taking a much closer interest in the county.

Asked by HSJ why Royal Devon and South Devon and Torbay had been downgraded to segment four of the oversight framework, formerly known as special measures, the ICB said waiting times and finances were among their “greatest challenges”.

The two trusts join Plymouth University Hospitals, which was already in segment four.

Both still have two-year waiters several months on from the national deadline to treat all of them. They also struggle on accident and emergency performance, with Torbay and South Devon treating just 34 per cent of patients within the four-hour standard.

Money is also a worry, as the ICB was one of a handful to say at the start of the year it would not be able to break even.

NHSE said it made sense to promote “joint solutions” given the “common themes” across Devon.

Whether closer central oversight can fix what many regard as a structural problem of long-term underfunding remains to be seen.

Also on hsj.co.uk today

In our new expert briefing ImPatient, David Gilbert says communities, groups, carers and patients should not be seen as the cheap option, picking up the pieces of a broken system. And in the first in a series of articles commissioned by HSJ from the National Care Forum to explore the most pressing issues in the care sector, Professor Vic Rayner shares her thoughts on why social care should be for people, not for profit.