Policies, Procedures, Guidelines and Protocols. Document Details. Anti-Fraud, Bribery and Corruption Strategy

Transcription

1 Policies, Procedures, Guidelines and Protocols Document Details Title Anti-Fraud, Bribery and Corruption Strategy Trust Ref No Local Ref (optional) Main points the document The Strategy intends to reinforce Shropshire Community covers Health NHS Trust s (Trust) commitment to eradicating, wherever possible, instances of fraud, bribery or corruption within the Trust and the wider NHS Who is the document The Trust Board Members aimed at? Author Terry Feltus, Local Counter Fraud Specialist Approval process Approved by Audit Committee (Committee/Director) Approval Date 5 th January 2018 Initial Equality Impact Yes Screening Full Equality Impact No Assessment Lead Director Director of Finance Category General Sub Category Corporate Review date 31 March 2019 Distribution Who the policy will be Distributed to Board Members and senior staff as defined by distributed to Method Required by CQC Required by NHLSA Other Directors Electronically to Board Members and senior staff, and available via the Trust website Document Links No No Yes NHS Counter Fraud Authority Amendments History No Date Amendment 1 October 2014 To reflect on, and include reference to, The Standards for Providers Guidance issued by NHS Protect 2 October 2014 To remove references to a counter fraud department and replace with Local Counter Fraud Specialist 3 July 2015 To update policy with new Trust Director, and Manager titles Page 1

2 Amendments History No Date Amendment 4 July 2015 To expand on the purposes of the Protocol between the LCFS and the Human Resources Department 5 June 2016 To include Director of Finance details 6 November 2017 To amend all references relating to NHS Protect to read NHS Counter Fraud Authority 7 November 2017 To update the Policy to reflect on the new working arrangements and responsibilities of the NHS Counter Fraud Authority Page 2

3 Anti-Fraud, Bribery and Corruption Strategy Page 3

4 1. Introduction 1.1. This strategy document has been produced to complement the NHS Counter Fraud Authority Standards for Providers, other directions and procedures published by the NHS Counter Fraud Authority, and the NHS Counter Fraud Authority NHS Anti-Fraud Manual. It is intended to reinforce s (Trust) commitment to eradicating, wherever possible, instances of fraud, bribery or corruption within the Trust and the wider NHS. The Trust will do all within its power to reduce losses arising from fraud, bribery or corruption and will adopt a zero tolerance approach when fraud, bribery or corruption is discovered. The process of seeking to embed anti-fraud, bribery and corruption arrangements within the Trust requires a significant commitment by all connected with the organisation. To achieve this goal it must be acknowledged that full executive participation and support, combined with the support of all managers and staff is essential. Partial or conditional support will not bring about the objective of ensuring that all funding to the Trust will be spent as intended In line with the Strategic Governance key section of the NHS Counter Fraud Authority Standards for Providers, it is the responsibility of the Director of Finance for the Trust to arrange sufficient resources to ensure that the organisation s NHS anti-fraud, bribery and corruption responsibilities are addressed. This will include the appointment of an accredited Anti-Fraud Specialist (LCFS), whose role is explained in the NHS Anti-Fraud Manual published by the NHS Counter Fraud Authority and other guidance published periodically within the NHS. This will ensure that the Trust has an effective strategy for dealing with fraud, bribery and corruption within the organisation. During periods of absence of the LCFS, for example when annual leave is taken, the Trust have an arrangement with LCFSs from another organisation to be able to provide cover and specialist advice across all areas of the LCFS responsibilities, should the need arise Preventing and investigating fraud, bribery and corruption is a fundamental responsibility of all public sector organisations, it must be a noncompetitive issue and there should be full co-operation to tackle opportunities to commit such crimes. It has to be recognised that fraud, bribery or corruption is a type of crime which comes in many guises and can be difficult to identify, it tends to be invisible until identified. Therefore there needs to be constant vigilance by all to deter or prevent the occurrence of fraud, bribery or corruption and if identified or suspected it must be reported and acted upon immediately The Trust has an Anti-Fraud, Bribery and Corruption Response Policy, which has been approved by the Trust Director of Finance. Although this Page 4

5 Policy is approved and adopted bi-annually, the LCFS will review it each year and, where appropriate, make amendments. This Policy is available to all members of staff via the Anti-Fraud webpage on the Trust website, or via the Policies section in the Staff Zone on the Trust website. It should be used as a guide on appropriate action to be taken when fraud, bribery or corruption related concerns arise. Moreover, the existing anti-fraud, bribery and corruption methods within the NHS, which have been significantly developed since their introduction in 2000, provide an excellent framework around which to build and further develop future anti-fraud, bribery and corruption work. 2. Objectives of the Strategy 2.1 This section explains the Trust s overriding objectives of its anti-fraud, bribery and corruption strategy, namely to ensure that anti-fraud, bribery and corruption measures are embedded within the organisation s culture and activities. To achieve this it is necessary to commit to the following: Under Key Principle 1 of the NHS Counter Fraud Authority Standards for Providers Inform and Involve ; to create an anti-fraud, bribery and corruption culture. This includes staff completing a mandatory fraud, bribery and corruption awareness e-learning module every three years. It may also include other bespoke fraud, bribery and corruption awareness presentations, a series of initiatives to raise awareness, staff surveys, circulating posters or providing staff with fraud, bribery or corruption awareness leaflets, and publishing fraud, bribery or corruption information, articles, investigations or related concerns in line with the guidance included in the Anti-Crime Specialists Communication Framework; Under Key Principle 2 of the NHS Counter Fraud Authority Standards for Providers Prevent and Deter ; to maximise opportunities to deter fraud. This could include liaising with the Trust Communications Manager, providing detailed examples of recent or important successful fraud, bribery or corruption investigation examples or assisting in the publication of articles in the local press, if appropriate. to seek to successfully prevent fraud, bribery or corruption which cannot be deterred. This could include reviewing a series of policies or procedures within the Trust and Page 5

6 evaluating if there are any potential fraud, bribery or corruption weaknesses or asking members of the Trust to report any potential system weaknesses where fraud, bribery or corruption risks may exist, or considering if fraud, bribery or corruption alerts or case learning may apply to the business of the Trust, to agree a protocol between the Trust LCFS and Human Resources Department on aspects of the Trust Disciplinary Process where there is a potential over-lap between the two departments and to enable information to be shared where system weaknesses are discovered during the course of an internal disciplinary, or a fraud, bribery or corruption investigation. to explore the prospect of being able to promptly detect fraud, bribery or corruption which cannot be prevented, this could include participating in a (national or local) proactive exercise, reviewing claims submitted or making comparisons against those made by others performing a similar role, and participation in the bi-annual Cabinet Office National Fraud Initiative Exercise Under Key Principle 3 of the NHS Counter Fraud Authority Standards for Providers Hold to Account ; to professionally investigate detected or suspected fraud, bribery or corruption. to impose effective sanctions, including appropriate legal action (Criminal or Civil) against people committing fraud, bribery or corruption; and to seek effective methods for seeking redress in respect of money defrauded from the Trust. These last two subjects are mentioned later in this strategy document. 2.2 It is important that the Trust identifies the problems of fraud, bribery and corruption, and thereafter maintains or develops policies, procedures and systems with administrative or technical features which make them less vulnerable or exposed to fraud, bribery and corruption. However it is recognised that it is not always possible to deter or prevent fraudsters from succeeding before there is a loss to public funds. In such circumstances, the Trust must ensure that it effectively investigates identified potential fraud, bribery or corruption and where appropriate imposes sanctions and seeks redress from those responsible. 2.3 The need for effective preventative measures is a major factor in an effective anti-fraud, bribery and corruption strategy, but it can only be so Page 6

7 with the full support of the Executive Officers, Managers and Staff within the Trust. 2.4 Following the detection and investigation of fraud, bribery or corruption, the Trust must ensure that effective sanctions are taken against those responsible. This may include supporting legal action in a Criminal or Civil Court and could extend to reporting individuals found to be responsible for misconduct to their Professional Regulatory body for disciplinary action to be considered. 2.5 The Trust may also take action through its internal Disciplinary Procedure in respect of any potential wrongdoing which has been found during the course of an investigation. In such circumstances, the LCFS may be required to take a leading role, particularly so where the issues are complex or the transfer of evidence may be impractical. The Trust has agreed an Anti-Crime Specialists and Human Resources Advisory Team Protocol to facilitate the sharing of information where system weaknesses are identified during the course of an internal disciplinary investigation, or a fraud, bribery or corruption investigation. This Protocol also addresses a wide range of procedural issues, particularly when there are two coexisting investigations reviewing the same or similar facts. In such cases there is a need to come to an agreement on future action so as not to create a difficult situation. It is important that there is a good working relationship between the LCFS and the Human Resources Department to ensure that potential risk areas are considered and any possible investigatory conflict is addressed. 3. Approach to tackling Fraud, Bribery and Corruption 3.1 The NHS Counter Fraud Authority has published Standards for Providers, other directions and procedures, and the NHS Anti-Fraud Manual to assist in the way that fraud, bribery and corruption is tackled in the NHS. In addition, all of the professional bodies represented within the NHS, together with other significant external partners, have signed agreements to support the eradication of fraud, bribery and corruption within the NHS and recognise the valuable role played by the NHS Counter Fraud Authority. This is a significant step to ensure a collective commitment to address what is clearly a collective responsibility. 3.2 The Trust has an Anti-Fraud, Bribery and Corruption Response Policy which is available to all members of staff. It explains the various aspects of the organisations approach to tackling fraud, bribery and corruption and it also provides useful contact details where concerns can be raised. Page 7

8 3.3 The Trust has at its disposal an accredited LCFS, who following accreditation, is required to undergo regular additional development training. The LCFS has the authority to act in the role in accordance with the NHS Counter Fraud Authority NHS Anti-Fraud Manual, and in doing so needs to deliver on a programme of work to ensure the Trust complies with the Standards for Providers published by the NHS Counter Fraud Authority. The LCFS will regularly meet with the Trust Director of Finance and the Trust Audit Committee to discuss the whole range of anti-fraud, bribery and corruption work being undertaken within the Trust. 3.4 To tackle fraud, bribery and corruption effectively, the LCFS will work with other Trust colleagues, other Organisations and Partners for example NHS Counter Fraud Authority colleagues, other LCFS, External Auditors, Internal Auditors and the Police. It is essential to ensure that anti-fraud, bribery and corruption work is not duplicated by those working in preventing, detecting and investigating potential fraud, bribery and corruption. The potential to duplicate anti-fraud, bribery and corruption work exists where there is an overlap with local or national investigations, which are co-existing and in such cases the provision of practical support or assistance may be more appropriate. 3.5 A central feature of the work undertaken by the LCFS will be the production of a risk assessed Work Plan which will detail a full range of integrated action for the coming year. This Work Plan will be agreed with the Trust Director of Finance and it will be reviewed throughout the year for any appropriate amendments to be made arising from additional work that could not be foreseen. 3.6 At the end of each annual cycle, and in accordance with the NHS Counter Fraud Authority Anti-Fraud, Bribery and Corruption Quality Assurance Programme, the Trust will be assessed on its performance and commitment against the NHS Counter Fraud Authority Standards for Providers, to tackling fraud, bribery and corruption. This is following its submission of the NHS Counter Fraud Authority Self-Review Tool, and any subsequent assessment visit conducted by the NHS Counter Fraud Authority Quality and Compliance Team, following their review of the Self- Review Tool. The Trust should also assess its performance against the CIPFA (Chartered Institute of Public Finance and Accountancy) Code of Practice on Managing the Risk of Fraud and Corruption, which was published in October In compliance with the requirements of the Public Interest Disclosure Act 1998, and The Enterprise and Regulatory Reform Act 2013, and following a number of recommendations being made in the Francis Report looking into whistleblowing in the NHS, the Trust has a Freedom to Speak Up: Raising Concerns (Whistleblowing) Policy. Its purpose is to encourage the Page 8

9 reporting of concerns by Trust staff, including suspicions of fraud, bribery and corruption. In any instances where reports are made under this arrangement the identity of the person/s reporting their genuinely held concerns will not be disclosed by the LCFS. This is both a statutory requirement and an obligation to respect the confidentiality of the person raising the concern. The categories of disclosure covered under the Public Interest Disclosure Act 1998 include one or more of the following: that a criminal offence has been committed, is being committed or is likely to be committed, that a person has failed, is failing or is likely to fail to comply with any legal obligation to which he is subject, that a miscarriage of justice has occurred, is occurring or is likely to occur, that the health or safety of any individual has been, is being or is likely to be endangered, that the environment has been, is being or is likely to be damaged, or that information tending to show any matter falling within any one of the preceding paragraphs has been, is being, or is likely to be deliberately concealed. 3.8 The Trust has an effective Risk Register which is sub-divided into local registers for Directorates and Departments. The Trust Audit Committee will review the registers on a regular basis. The LCFS and Trust Corporate Risk Manager work closely together and share information on potential risks, in order that work under their respective responsibilities is actioned appropriately. 3.9 The LCFS also meets as and when required throughout the year with Internal Audit (IA), and a protocol detailing the interaction between the two parties has been agreed. The protocol is a framework for general interaction requirements between the LCFS and IA to aid the prevention, deterrence and detection of any potential fraud, bribery or corruption within the Trust. To reduce the risk of fraud, bribery or corruption entering the Trust there needs to be close and supportive liaison between the LCFS and IA functions. This includes the sharing of information to reduce the risk of the Trust falling victim to such practices from perceived weaknesses in internal system controls. A strong liaison between these two functions is also required to avoid the potential for an investigation to be compromised Throughout the year the LCFS will undertake a series of activities/events/tasks designed to explain the Trust s approach to tackling, Page 9

10 and raising awareness of, fraud, bribery and corruption. Trust staff are also required to complete an online fraud, bribery and corruption awareness e- learning training module every three years as part of the Trust Mandatory Training Matrix. This whole awareness programme is aimed at creating an Anti-Fraud Culture and may include such topics as: The role of the LCFS. Reporting suspicions of fraud, bribery and corruption Internally and via the NHS Counter Fraud Authority confidential Hotline and website. The Trust has a Freedom to Speak Up: Raising Concerns (Whistleblowing) Policy features as an organisational aid to reporting of fraud, bribery and corruption. The offence of fraud as described in the Fraud Act The Bribery Act The Cabinet Office National Fraud Initiative Exercise. Fraud, bribery and corruption cases, both local and national, combined with any lessons learned in the way that these offences occurred. Significant fraud, bribery and corruption prevention policies. Approach to policy or procedural weaknesses. Investigation considerations. Sanctions and Redress. Management responsibilities in preventing and identifying fraud, bribery or corruption emphasising the importance of the manager s role to prevent and detect fraud, bribery or corruption when carrying out their daily tasks. 4. Procedure for Sanctions and Redress Recovery 4.1 In any effective anti-fraud, bribery or corruption strategy it is imperative that an organisation adopts a robust approach towards imposing sanctions and seeking redress against those responsible for any act of fraud, bribery or corruption, whether or not losses have occurred. Guidance on this important course of action is published in the NHS Counter Fraud Authority documents Applying Appropriate Sanctions Consistently, Parallel Criminal and Disciplinary Investigations and Parallel Criminal and Disciplinary Investigations Guidance to Local Counter Fraud Specialists. These are comprehensive documents which address a wide range of topics surrounding this subject. Copies are available from the LCFS. 4.2 As a note of caution, before a decision is taken on the imposition of sanctions, the Trust should give the person thought to be responsible for any inappropriate act, an opportunity to give an explanation to account for Page 10

11 their actions. The test will always be one of did the Trust behave reasonably. Should the person refuse or fail to give an explanation, the Trust will not be seen as contributing to this failure as an explanation was sought before further action was taken. 4.3 When any act of fraud, bribery, corruption or loss to the Trust arising from inappropriate behaviour, has occurred, it is good practice to request the immediate return of the loss. In the event of the person responsible for the loss refusing to repay in full what was wrongfully obtained, the Trust must consider taking a course of action to recover the loss, either by: Recovering the loss through a locally agreed arrangement or contract, or By taking action through the Civil Court, or By engaging the services of a debt collection agency, or In the event that the person responsible is in receipt of regular payments through an NHS contract directly through the body responsible for such payments, or Where a criminal prosecution takes place, to request the criminal prosecutor to make an application at the time of sentence, for confiscation or compensation order to be awarded against a convicted person who was responsible for a loss to the Trust. Upon conviction a Criminal Court can make a confiscation or compensation order which may address the whole or part of the loss arising from specific criminal misconduct. 4.4 The recovery of debts arising from fraud, bribery, corruption or inappropriate behaviour, should not be attempted through a locally generated invoice as no service was provided to justify an invoice being raised. The imposition of a sanction followed by any subsequent redress must reflect the seriousness of the Trust s approach to tackling fraud, bribery and corruption and underline a zero tolerance to such conduct. 4.5 The preceding paragraphs dealing with Sanctions and Redress relate to the recovery of financial losses. In all instances where misconduct has been identified involving a member of staff, the Trust must consider taking internal disciplinary action. The Trust Human Resources Department will advise on this course of action. The Trust Disciplinary Policies and the Protocol agreed between the Trust Anti-Crime Specialists, and Human Resources Department, both outline the steps to be taken and issues to be considered. 4.6 It may be appropriate to seek to impose an operational sanction against someone responsible for misconduct by challenging their opportunity to continue to practise within a professional body. In such cases the Trust Page 11

12 should consider liaising with the professional regulatory body responsible for the registration of that individual, both to inform them of the facts at issue and to seek clarification upon the prospect of any internal disciplinary action which may be desirable in the circumstances. 4.7 All foreseeable costs arising from action to recover losses should be considered, but in straightforward cases it should be possible for the LCFS to represent the Trust in a civil recovery action in the small claims court. Where the losses exceed the ceiling set for a Small Claims application, there may be legal expenses in taking action in the Civil Court and any application for payment of costs will be at the discretion of the Judge hearing the case. For additional information please see: The potential cost and recovery should be closely considered in all circumstances, however the cost of action to recover losses should not by itself determine the action to be taken as there may be a greater deterrent value in seeking to recover a loss. Page 12