Fraud Redress Policy

Fraud Redress Policy Who Should Read This Policy Target Audience All Trust Staff All consultants, vendors, contractors, and/or any other parties who have a business relationship with the Trust Version 2.0. October 2015

Ref. Contents Page 1.0 Introduction 4 2.0 Purpose 4 3.0 Objectives 4 4.0 Possible outcomes from an investigation 4 5.0 Sanctions 7 5.0 Procedures connected to this policy 11 6.0 Links to Relevant Legislation 11 6.1 Links to Relevant National Standards 11 6.2 Links to Other Key Policies 12 6.3 References 13 7.0 Roles and Responsibilities for this policy 14 8.0 Training 15 9.0 Equality Impact Assessment 15 10.0 Data Protection Act and Freedom of Information Act 15 11.0 Monitoring this Policy is Working in Practice 16 Version 2.0. October 2015 2

Explanation of terms used in this policy Redress - To set right, to remedy the fraudulent action taken by an individual(s) against the Trust to counteract the effects of fraudulent activity Please note the term redress is used in several other contexts within the NHS e.g. financial redress following maladministration or poor service in dealing with a compliant or concern; for determining the appropriate interest rate to be applied to NHS Continuing Healthcare redress, a package of care to meet physical or mental health needs which have arisen as a result of disability, accident or illness; a redress package where there has been clinical negligence in hospital under The NHS Redress Act 2006 none of which have any relevance to this policy. Sanctions - Penalties attached to an offence e.g. disciplinary, criminal prosecution, regulatory, civil action (a more detailed explanation is provided in the main policy) Fraud - The dishonest intent to obtain a financial gain from, or cause a financial loss to, a person or party through false representation, failing to disclose information or abuse of position (a more detailed explanation is provided in the main policy) Bribery - An inducement to undertake an action which is illegal, unethical or a breach of trust, such as gifts, loans, fees, rewards or other advantages (a more detailed explanation is provided in the main policy) Corruption - The deliberate use of bribery or payment of benefit-in-kind to influence an individual to use their position in an unreasonable way to help gain advantage for another (a more detailed explanation is provided in the main policy) Economic Crime - The collective term used to cover all fraud, bribery and corruption NHS Protect - Established in April 2011 is an independent division of the NHS Business Services Authority; it has responsibility for all policy and operational matters relating to the prevention, detection and investigation of fraud and corruption and the management of security in the National Health Service Local Counter Fraud Specialist (LCFS) - A specialist position within all NHS trusts directly accountable to the Director of Finance for the day-to-day implementation of counter fraud, bribery and corruption activity and, in particular, the investigation of all suspicions of fraud Crown Prosecution Service (CPS) - The principal prosecuting authority for criminal cases in England and Wales, they work closely with the police and other investigators to advise on lines of inquiry and decide on appropriate charges or other outcomes Her Majesty's Revenue and Customs (HMRC) - Was formed by the merger of the Inland Revenue and Her Majesty's Customs and Excise in 2005; it is a non-ministerial department of the UK Government responsible for the collection of taxes Policy - Sets out the aims and principles under which services, divisions, or units will operate. A policy outlines roles and responsibilities, defines the scope of the subject covered, and provides a high level description of the controls that must be in place to ensure compliance Version 2.0. October 2015 3

1.0 Introduction Black Country Partnership NHS Foundation Trust is committed to ensuring that all instances of fraud, bribery or corruption are fully investigated and that appropriate action is taken against those responsible. This form of wrongdoing is costly to the Trust both in terms of reputation and financial loss and deprives the NHS of valuable resources that should be used for providing and improving patient care. Where fraud, bribery or corruption is proven or believed to be present, it is the responsibility of the Trust to recover the monies lost. Those responsible for executing fraud, bribery or corruption should also be aware that appropriate sanctions will follow, to ensure they do not benefit from their wrongdoing and to act as a strong deterrent to anyone else who might consider misappropriating valuable NHS funds. This policy sets out the options available to the Trust to recover money lost to fraud, bribery and corruption and the range of sanctions that may be applied to those responsible for carrying out these activities. 2.0 Purpose The aim of this policy is to make all Trust staff, contractors and those who undertake work on behalf of the Trust, aware of the arrangements in place following a fraud investigation to apply appropriate sanctions and wherever possible to recover any financial losses. 3.0 Objectives Improve the knowledge and understanding of everyone in the Trust, irrespective of their position, about the consequences of fraud, bribery and corruption within the organisation and its unacceptability Explain the Trust s approach in respect of sanctions to be applied against those persons and/or organisations who have committed fraud or wrongdoing against the Trust, which may include any or all of the following, and which can be concurrent:- - criminal prosecution; - civil prosecution; and/or - internal/external disciplinary action (including professional/regulatory bodies) Explain the steps the Trust will take to recover any money, which has been lost as a result of fraud or wrongdoing Assist in promoting a climate of openness and a culture and environment where staff members feel able to raise concerns sensibly and responsibly 4.0 Possible outcomes from an investigation Depending on the findings of the investigation, the possible outcomes may result in:- No case to answer or evidence of fraud found No evidence of fraud found but system controls need to be strengthened No evidence of fraud found but wrong doing identified and the matter needs to be referred back to Human Resources for potential disciplinary sanction to be considered No evidence of fraud found but wrong doing identified which relates to a breach of professional conduct by an NHS contractor Version 2.0. October 2015 4

Sufficient evidence of suspected fraud to warrant criminal investigation and other sanctions The actions of the individual have resulted in a financial loss to the Trust 4.1 No case to answer or no evidence of fraud found The Local Counter Fraud Specialist will inform the Director of Finance and where the investigation relates to staff, the Human Resources Manager, that no fraudulent action has been identified. A concluding report will be produced by the Local Counter Fraud Specialist and issued to the relevant manager, the Director of Finance, internal audit and NHS Protect via the FIRST case management system, with a copy forwarded to the Trust s Audit Committee. 4.2 No evidence of fraud found but system controls need to be strengthened The Local Counter Fraud Specialist will inform the Director of Finance and where the investigation relates to staff, the Human Resources Manager, as soon as the outcome is known. A draft concluding report containing recommendations to strengthen controls in identified areas of weakness will be issued to relevant officers who are responsible for implementing recommendations. The LCFS will meet with relevant managers to seek agreement on action required to strengthen system weaknesses. Once actions are agreed, a final concluding report will be distributed to the relevant managers, the Director of Finance, internal audit and NHS Protect via the FIRST case management system, with a copy forwarded to the Trust s Audit Committee. The recommendations will be followed up by internal audit as part of the protocol between the Trust s counter fraud services and the Internal Audit function. 4.3 No evidence of fraud found but the referral is notified to Human Resources for potential disciplinary sanction to be considered The Local Counter Fraud Specialist will inform the Director of Finance of the outcome of the investigation. Where there is no evidence of fraud but a breach of policy or procedures may have occurred, the LCFS will meet with the Human Resources Manager to discuss the findings and pass on relevant information from the case file containing evidence gathered to date. The LCFS will take no further part in gathering evidence for a Human Resources investigation but may be called as a witness in a disciplinary case due to their role in gathering evidence. A concluding report will be produced by the LCFS and distributed to the relevant manager, the Director of Finance, internal audit and NHS Protect via the FIRST case management system, with a copy forwarded to the Trust s Audit Committee. 4.4 No evidence of fraud found but wrong doing identified which relates to a breach of professional conduct by an NHS contractor Where the matter has affected the Trust s resources and the investigation identifies a professional misconduct issue which has been perpetrated by an NHS contractor who is not directly employed by the trust, the Local Counter Fraud Specialist will inform the Director of Finance of the outcome of the investigation. Version 2.0. October 2015 5

The LCFS will provide relevant documentation collected to date during the course of their investigation so the Director of Finance may inform the relevant professional body. The LCFS will continue gathering evidence until a concluding report is ready to be produced and distributed to the relevant manager, the Director of Finance, internal audit and NHS Protect via the FIRST case management system, with a copy forwarded to the Trust s Audit Committee. The LCFS may be called as a witness in a case relating to the professional misconduct of an NHS contractor due to their role in gathering evidence. Any information gathered and passed to the relevant professional body will be in accordance with the Data Protection Act. 4.5 Sufficient evidence of suspected fraud to warrant criminal investigation and other sanctions Where evidence indicates that a fraud act has been committed, the Local Counter Fraud Specialist will liaise with the Director of Finance and conduct an investigation in line with the NHS Counter Fraud and Corruption Manual and in accordance with current legislation. The investigation will be undertaken in a timely and professional manner so that the pursuit of other potential sanctions are not compromised. Updates on the progress will be regularly provided to the Director of Finance, the Audit Committee and if staff related, the Human Resources Manager. This may be undertaken jointly or as separate meetings with the purpose to update parties on the investigation and to discuss any potential sanctions that may be pursued. Where parallel sanctions are to be pursued, the LCFS will meet regularly with the Human Resources Manager to share information and avoid any duplication of effort or either case being compromised. If there is evidence to show that monies or other assets have been fraudulently misappropriated by an employee, in order to preserve the proceeds of the fraud it may be necessary to apply to the civil courts for injunction relief without notice to the suspected fraudster. This decision will be made jointly between the Director of Finance and the LCFS following advice from NHS Protect and where necessary, the Trust s Solicitors. If during the course of an investigation it is identified that the Trust has suffered a significant financial loss, the Director of Finance will seek advice from the Trust s Solicitors regarding recovery at the earliest opportunity. This may result in recovery action commencing whilst the investigation continues 4.6 Fairness and Potential Abuse of Process It may be argued that disciplinary and civil proceedings should be delayed pending criminal proceedings, on the grounds that to do otherwise may prejudice them in some way. Arguments may be raised about breach of human rights, particularly the right to a fair trial and potential for abuse of process. However, there is nothing to prevent the disciplinary proceedings being invoked in circumstances where criminal charges are pending following the conclusion of the investigation by the LCFS, or the Police, or where the criminal investigation is in progress so long as the process is conducted fairly and the approach to collating the evidence does not undermine the criminal investigation. Where an employee has been subject to disciplinary and/or civil proceedings, it does not exclude them from criminal prosecution and visa-versa. Version 2.0. October 2015 6

5.0 Sanctions Following an investigation by the Local Counter Fraud Specialist where fraud, bribery or corruption is identified, there are three main sanctions, which can be applied by the Trust. Each sanction will play an equally important role in creating and maintaining an anti-fraud culture across the organisation. 1. Criminal proceedings to be brought against alleged offenders and the case heard in Court, with a view to obtaining a criminal conviction, and an appropriate fine, imprisonment, confiscation, compensation order and award of costs. 2. Civil proceedings to recover money or assets fraudulently obtained including interest and costs. 3. Disciplinary proceedings brought against any employee involved in fraud, bribery and corruption and will be managed internally by the Director of Human Resources. Where an employee is a professional it may also be necessary to notify their professional body for the matter to be dealt with externally. In addition, the Trust may exercise its powers to co-ordinate with the National Commissioning Board on the potential suspension or other relevant sanctions which may be brought against a doctor, dentist, or pharmacist, where it is necessary for the protection of a member of the public or is otherwise in the public interest. The application of a criminal, civil or disciplinary proceeding will not be a stand-alone sanction. Dependent on the outcome of an investigation, each sanction is capable of being applied and it is not unusual for each of the sanctions to overlap. It is however, important that when running parallel sanctions, that one proceeding does not undermine the other and although there is no set rule, it is usual that a criminal proceeding will take precedence over the other two types of sanction. Where an employee or a practitioner is being investigated with a view to pursuing criminal proceedings, they may also be simultaneously the subject of disciplinary sanctions provided the collection of the evidence for disciplinary sanctions does not affect the integrity of the criminal case and provided both are conducted fairly. During a fraud investigation the Local Counter Fraud Specialist will work in conjunction with Human Resources, Payroll and the relevant departments or organisations, to calculate the amount of monies lost due to the alleged fraud. The LCFS will report the total of the loss to the Director of Finance advising of the possible actions available to recover any monies lost. The LCFS will advise the Director of Finance on the most cost effective method of recovery. If an offer to repay is received it must only be accepted on the condition that it is without prejudice of any other criminal, civil or disciplinary action that may still be undertaken. If voluntary repayment is to occur, then a single payment in full will be the preferred method. Payment should be made payable to the Trust. If payment is to be made by instalments, details of the arrangement will be passed to the Trust s Finance Department who will manage recovery of the debt. 5.1 Disciplinary Action In cases where there is evidence that an employee has committed an act of fraud, corruption or bribery, the Trust will follow its disciplinary procedure The appropriate senior manager, in conjunction with the HR department, will be responsible for Version 2.0. October 2015 7

initiating any necessary disciplinary action. All employees have a right to be represented at internal disciplinary interviews by a trade union representative or accompanied by a friend, colleague or any other person of their choice, not acting in a legal capacity in connection with the case. During a disciplinary investigation, an employee can choose not to answer questions but in the interests of acting fairly and reasonably, they should be informed that the matter may be referred for criminal investigation or prosecution. Under no circumstances should the impression be given to an employee that prosecution can be avoided if an employee elects to answer questions and co-operate during the disciplinary process. Where, during a disciplinary process, it becomes apparent that a fraudulent matter may be emerging, the situation should be reported to the LCFS immediately, and it may be necessary to suspend the disciplinary proceedings. After the conclusion of any disciplinary investigation, the Human Resources Manager will provide the LCFS with documentary information confirming the outcome. It may also be that the matter has identified a matter concerning professional misconduct and in this instance the Human Resources Manager will be responsible for reporting the matter to the employee s professional body. 5.2 Payment from Earnings Following disciplinary action, if the employee is still employed by the Trust, recovery can be affected through payroll until the debt is met. The employee should be written to confirming the debt and a reasonable proposal will be made for recovery. An agreement will be sought with the employee to ensure that recovery is made in the shortest possible time Where an employee is in the process of leaving, they should be advised that the recovery can be actioned through the final salary payment. Where the available funds are insufficient, they should be written to advising them of the debt and inviting a proposal to pay. 5.3 Attachment of Earnings Where an individual is employed elsewhere, an arrangement can be made through the Courts to recover losses via payroll. An attachment of earnings order is a method by which money will be stopped from the employee s wages to pay back the debt. The amount to be paid each month is determined by the Courts, who work out the minimum amount of money the person needs to live on, referred to as the protected earnings rate. If the person earns more than the protected earnings rate, an order will be made; if the person is on a low wage, it may not be possible to make an attachment of earnings order. 5.4 Criminal Prosecution During the course of an investigation, the Local Counter Fraud Specialist will keep in regular contact with NHS Protect who will provide advice in relation to the level of evidence and potential sanctions. The decision regarding the application of criminal prosecution will rest with the Director of Finance but will be decided following advice from NHS Protect and the Crown Prosecution Service. Depending on the extent of the loss and the circumstances of the case, a criminal prosecution may prove the most judicious route for the recovery of losses to be obtained under the Proceeds of Crime Act 2002. Version 2.0. October 2015 8

The responsibility for identifying costs and compensation associated with a criminal prosecution will rest with the LCFS. Compensation will be determined through the investigation process and based on the evidence. The LCFS will keep a record of the time spent on the investigation and this will be converted to a cost based on an hourly rate. This information will be passed to the Crown Prosecutor at the earliest opportunity and prior to the commencement of a court case 5.5 Confiscation of Assets In cases of serious fraud (generally 5000 or more), NHS Protect can apply to the courts to make orders concerning the restraint and confiscation of the proceeds of criminal activity. Restraint orders are generally obtained when a suspect is charged with a relevant criminal offence. Confiscation and compensation orders can only be made if an offender is found guilty of an offence from which he has benefited. It is therefore important to identify assets at an early stage of the investigation in order to prevent a defendant from moving assets beyond reach. In such cases the Local Counter Fraud Specialist will work closely with NHS Protect and the Director of Finance. 5.6 Civil Recovery The civil recovery route is available to the Trust and this could include a number of options including the Small Claims Court and Debt Collection Agencies. When weighing up the cost effectiveness of such action, as well as considering the amount of the outstanding debt and the likelihood of success, the Trust should also consider the likely deterrent effect a successful civil court action would achieve. In order to pursue a claim through the Court, the Trust must demonstrate that attempts have been made to recover the money, and all reasonable avenues of redress have been sought. Civil recovery should not be considered as a first option. For external bodies or NHS contractor, recovery should be affected by formal contact. They should be written to advising them of the debt and inviting a proposal to pay. Should they not respond, or the proposal is deemed to be unacceptable, they should be written to making a formal demand for the money. This letter should be sent by Recorded Delivery. Should this demand be ignored, the external body or contractor should be sent a third and final letter again by Recorded Delivery advising them that the Trust will be considering legal action through the Civil Court process in order to secure the recovery. In this instance the Director of Finance should seek the advice from the Solicitors concerning recovery. Costs associated with the recovery should be included in the claim submitted to the Court. For employees, ex-employees, external bodies or NHS contractors, if following a conviction, the court awards compensation and/or costs the action will be awarded from the court and collected from the individual by the court. The LCFS will notify the Finance Department of the award and the expected periodical payment. Where the payment from the court does not materialise after a period not exceeding three months, the LCFS should be notified by the Finance Department. The LCFS will be responsible for following the matter up with the relevant court. 5.7 Debtor Invoice A debtor invoice and notification letter may be issued by the Finance Department as a form of seeking redress. The letter should contain a Without prejudice clause to Version 2.0. October 2015 9

inform the subject that any repayment of an overpaid amount will not prejudice any other criminal or civil action being taken by the Trust in respect of the subject. 5.8 Penalty Charges The penalty charge is a civil fine payable by someone who wrongly obtains help with NHS health charges for themselves or someone else. The penalty payable is five times the amount of the NHS charge owed, up to a maximum of 100, plus the unpaid charge itself. Patients found to have made a false claim are sent a penalty notice telling them how much they need to pay and that they must pay within 28 days of the notice. If the fine is not paid on time a further surcharge of 50% of the original charge (up to a maximum of 50) will be imposed. If payment is still not made, civil court action can be taken to recover the debt. Administrative procedures are in place to ensure that a penalty charge is not imposed inappropriately. For example, if a patient has a serious learning disability or severe mental illness and may have difficulty understanding the arrangement, or if imposing a penalty may affect a person s mental stability, then a penalty charge may not be appropriate. The Health Act 1999 introduced a new criminal offence designed to complement the penalty charge by providing a sanction for serious cases of repeated or persistent fraud. The maximum penalty on conviction is a fine of up to 2,500. 5.9 Recovery of contributions from Her Majesty s Revenue and Customs (HMRC) Certain types of proven fraud cases such as false references used to gain employment from the outset may enable the Trust to recover contributions made to HMRC and the Trust will liaise with HMRC to ensure this is used wherever possible. 5.10 NHS Pension Scheme If an employee commits fraud and is a member of the NHS Pension Scheme, redress can be sought through the scheme. The NHS Pensions Agency is responsible for administering the scheme, and the provision for redress was introduced in the Pension Act 1995. The Pensions Agency operates according to the code of practice set out in the NHS Pension Scheme Regulations, Statutory Instrument 1995/300. Part T5 of the regulations covers the recovery of money, which states that, If a loss of public funds occurs as a result of a member s criminal, negligent or fraudulent act or omission, the Secretary of State may reduce any benefits or other amounts payable to, or in respect of, the member by an amount equal to the loss. There can be a delay using this form of redress as the Pensions Agency is only able to make recovery from benefits in payment at normal pension age, or earlier in the case of retirement on health grounds. Certain types of proven fraud cases such as false references used to gain employment from the outset may enable the Trust to recover pension contributions and the Trust will liaise with the NHS Pensions Agency to ensure this is used wherever possible. Version 2.0. October 2015 10

5.11 Publicity In addition, the Trust will aim to publicise all local cases of fraud, and will stress that recovery is vigorously sought. This will act as a strong deterrent to those thinking of committing fraud and will further reinforce the message that an anti-fraud culture is embedded within the organisation. 6.0 Procedures connected to this Policy Standing Financial Instructions 7.0 Links to Relevant Legislation The Fraud Act 2006 The Act sets out provisions for a general offence of fraud, defining it in three classes, fraud by false representation; fraud by failing to disclose information; fraud by abuse of position. In all three classes of fraud, it requires that for an offence to have occurred, the person must have acted dishonestly, and in law a person acts dishonestly if:- Their fraudulent act is deemed to be dishonest by the ordinary standards of reasonable and honest people The fraudster realised that what he was doing was, by the standards of reasonable and honest people, dishonest Secondly, a person must act either with intent to gain for himself or another, or with intent to cause loss to another or expose another to a risk of loss. It does not matter whether any gain, loss, or exposure to risk of loss occurs all that matters is that the fraudster acts with the requisite intent. A gain or a loss is defined to consist only of a gain or a loss in money or property (including intangible property), but could be temporary or permanent. The Proceeds of Crime Act 2002 (POCA) The Act sets out the legislative scheme for the recovery of criminal assets with criminal confiscation being the most commonly used power. Confiscation occurs after a conviction has taken place. Other means of recovering the proceeds of crime which do not require a conviction are provided for in the Act, namely civil recovery, cash seizure and taxation powers. The aim of the asset recovery schemes is to deny criminals the use of their assets, recover the proceeds of crime and disrupt and deter criminality. The Act also provides for a number of investigative powers, such as search and seizure powers, and powers to apply for production orders and disclosure orders, and allows for the restraint or freezing of assets to prevent dissipation of assets prior to a confiscation order being made. The NHS Redress Act 2006 has no relevance to this policy 7.1 Links to Relevant National Standards NHS Standards of Business Conduct [HSG (93)5] This circular gives guidance to NHS employers and staff in maintaining strict ethical standards in the conduct of NHS business Version 2.0. October 2015 11

NHS Protect Standards for Providers 2015-16: Fraud Bribery and Corruption NHS Protect has developed a set of standards for all NHS organisations. All providers of NHS services in England (except small providers as defined in the NHS Standard Contract) must complete an organisation crime profile. Following completion of the profile, the provider is assigned a category and then has to meet the standards set by NHS Protect in relation to its identified level of risk. 7.2 Links to other Key Policies Anti-Fraud, Bribery and Corruption Policy Most people who work in and use the NHS are honest, and find that fraud, bribery and corruption committed by a minority is wholly unacceptable, as it ultimately leads to a reduction in the resources available for patient care. It is therefore important that all staff working in the Trust are aware of the risk of fraud, corruption, theft, and other illegal acts involving dishonesty. The policy sets out the Trust s approach to all forms of fraud or suspected fraud, which and to improve the knowledge and understanding of all staff, irrespective of their position, about the risk of fraud and bribery within the organisation and its unacceptability Standing Financial Instructions (SFIs), describe the way that the transactions of the Trust should be carried out, including the role and responsibilities of the Trust Board, Chief Executive, Director of Finance and all members of staff. The SFIs identify the role of audit and regulations regarding the production of the Trust s annual financial accounts and the management of cash and bank accounts. In addition, the SFIs record, in detail, the way that contracting in general; and tendering for goods and services, in particular, is required to be managed. Disciplinary Policy and Procedure The aim of the policy is to correct inappropriate conduct to maintain a working environment where the highest standards possible may operate. The rights of the individual employee are protected by affording them balanced consideration in any disciplinary proceeding, ensuring the right to representation by a Trade Union Representative or workplace colleague and making available the right to appeal against disciplinary decisions made. Equally, it recognises the rights of managers to exercise the authority delegated to them by the Trust to organise and supervise work, setting and maintaining standards of behaviour and efficiency. The policy is to be applied equitably and fairly to ensure that no employee receives less favourable treatment on the grounds of grounds of age, gender, gender reassignment, ethnicity, religion or belief, disability, marriage or civil partnership, pregnancy or maternity, or sexual orientation. Version 2.0. October 2015 12

7.3 References NHS Counter Fraud and Corruption Manual Fraud Act 2006: www.legislation.gov.uk/ukpga/2006/35/contents The Bribery Act 2010: www.legislation.gov.uk/ukpga/2010/23/data.pdf Proceeds from Crime Act 20012: www.legislation.gov.uk/ukpga/2002/29/contents Version 2.0. October 2015 13

8.0 Roles and Responsibilities for this Policy Title Role Key Responsibilities Director of Finance Audit Committee Local Counter Fraud Specialist (LCFS) Human Resources Payroll Manager - lead responsibility for the implementation of this policy Executive Lead - monitors and ensures compliance with NHS Standards for Providers regarding fraud and bribery - meets with the LCFS, NHS Protect and Trust s Solicitors to seek appropriate advice and guidance before deciding on a course of action for recovery - agrees the most appropriate course of action for recovery for the benefit of the Trust - ensure that the organisation is effective in recovering any losses incurred to fraud and corruption - civil redress is progressed effectively through the Trust s Finance department - any serious concerns regarding the implementation of this policy are brought to the attention of the Board of Directors - reviews the establishment and maintenance of an effective system of integrated governance, risk management and internal Assurance control, across the whole of the Trust s activities that supports the achievements of the Trust s objectives - all members of the Committee are independent non-executive directors at least one of whom will have recent and relevant financial experience Operational Lead - advise the Director of Finance on the evidence available and whether it is feasible to seek recovery of funds - identify the amount of money due to be recovered - ensure that all records are of sufficient quality to be able to support the recovery process - liaise with NHS Protect to obtain guidance and advice as appropriate and inform the Director of Finance - seek agreement with the Director of Finance on the most appropriate course of action - liaise with HR, the relevant line manager and Payroll Manager to facilitate any deductions from salaries - liaise with the Financial Accountancy Assistant (Debtors) to ensure that debtors account is raised - liaise with outside agencies as appropriate e.g. Insurance Companies, NHS Pensions Agency. - monitor and record the progress of recoveries and report progress to the Director of Finance and the Audit Committee - day to day application of this policy Specialist advice for all workforce related issues Recovery from Earnings - liaise closely with managers and the local counter fraud specialist from the outset if an employee is suspected of being involved in fraud and/or corruption - ensuring the appropriate use of the trust s disciplinary procedures - liaise closely with the local counter fraud specialist to ensure that any parallel sanctions (i.e. criminal, civil and disciplinary sanctions) are applied effectively and in a co-ordinated manner - liaise with HR, the relevant line manager and LCFS to facilitate any deductions from salaries - implement agreements reached on the amount and timescale of any repayments Financial Accountancy Assistant (Debtors) All Staff Debtor Invoicing Adherence - agree with the individual the amount and timescale of any repayments - Ensure that invoices are raised and followed up on a timely basis - have a duty to protect the assets of the Trust, including all buildings, equipment and monies from fraud, theft, or bribery - if they have reasonable suspicions of fraud or wrongdoing are expected to report them - understand the consequences arising from fraud, theft, or bribery set out in this policy Version 2.0. October 2015 14

Title Role Key Responsibilities All Staff 9.0 Training Adherence Fraud Redress Policy - compliance with all Trust policies is a condition of employment and a breach of this policy may result in disciplinary action - if a member of staff has concerns about the way this policy is being implemented or about this area of practice in general, they should raise this with their line manager. If they feel unable to raise the matter with them, he/she may write to an Executive Director. If they feel unable to raise the matter with an Executive Director, he/she may write to the Chairman or a Non-Executive Director. If he/she is unsure about raising a concern or requires independent advice or support, they can contact:- - their Trade Union representative - the relevant professional body - the NHS Whistleblowing Helpline - 08000 724 725 What aspect(s) of this policy will require staff training? General awareness and understanding of what Fraud, Bribery and Corruption is, how to report it and the consequences for anyone involved Which staff groups require this training? Is this training covered in the Trust s Mandatory and Risk Management Training Needs Analysis document? How will the training be delivered? All Trust Staff Yes At Induction on commencement of employment Who will deliver the training? Learning and Development How often will staff require training Please refer to Trust s Mandatory and Risk Management Training Needs Analysis document for details on training requirements, and update frequencies Who will ensure and monitor that staff have this training? Learning and Development produce monthly reports for MH, LD and CYPF Groups to monitor and take action as necessary 10.0 Equality Impact Assessment Black Country Partnership NHS Foundation Trust is committed to ensuring that the way we provide services and the way we recruit and treat staff reflects individual needs, promotes equality and does not discriminate unfairly against any particular individual or group. The Equality Impact Assessment for this policy has been completed and is readily available on the Intranet. If you require this in a different format e.g. larger print, Braille, different languages or audio tape, please contact the Equality & Diversity Team on Ext. 8067 or email EqualityImpact.assessment@bcpft.nhs.uk 11.0 Data Protection and Freedom of Information This statement reflects legal requirements incorporated within the Data Protection Act and Freedom of Information Act that apply to staff who work within the public sector. All staff have a responsibility to ensure that they do not disclose information about the Trust s activities in respect of service users in its care to unauthorised individuals. This responsibility applies whether you are currently employed or after your employment ends and in certain aspects of your personal life e.g. use of social networking sites etc. The Trust seeks to ensure a high level of transparency in all its business activities but reserves the right not to disclose information where relevant legislation applies. Version 2.0. October 2015 15

12.0 Monitoring this Policy is working in practice What key elements will be monitored? (measurable policy objectives) Where described in policy? How will they be monitored? (method + sample size) Who will undertake this monitoring? How Frequently? Group/Committee that will receive and review results Group/Committee to ensure actions are completed Evidence this has happened Staff and contractors understand the arrangements for, and the consequences of, any involvement in fraud, bribery or corruption 4.0 5.0 Training as described in Section 9.0 above Communications and Promotions through surveys, awareness campaigns and newsletters to create an anti-fraud and corruption culture Learning and Development Local Counter Fraud Specialist See Section 9.0 above As part of the Local Counter Fraud Specialist s work programme See Section 9.0 above Audit Committee See Section 9.0 above Audit Committee See Section 9.0 above Reports and Minutes of Meetings Fraud Outcomes and Monies Recovered 5.0 7.0 Professionally trained local specialist in place to detect and investigate offences. The Trust will seek to apply full range of sanctions to those found to have committed fraud, bribery or corruption including criminal, civil and disciplinary sanctions Local Counter Fraud Specialist As part of the Local Counter Fraud Specialist s work programme Audit Committee Audit Committee Reports and Minutes of Meetings Standards and measuring success NHS Protect Standards for Providers 2015-16: Fraud Bribery and Corruption 7.1 NHS Protect undertakes a quality assurance programme that assesses NHS organisations compliance with the standards NHS Protect Annually Audit Committee Audit Committee Reports and Minutes of Meetings Version 2.0. October 2015 16

Policy Details Title of Policy Unique Identifier for this policy State if policy is New or Revised Fraud Redress Policy BCPFT-FIN-POL-05 Revised Previous Policy Title where applicable Policy Category Clinical, HR, H&S, Infection Control etc. Executive Director whose portfolio this policy comes under Policy Lead/Author Job titles only Committee/Group responsible for the approval of this policy Month/year consultation process completed * N/A Finance Director of Finance Local Counter Fraud Specialist Manager Audit Committee August 2015 Month/year policy approved August 2015 Month/year policy ratified and issued October 2015 Next review date October 2018 Implementation Plan completed * Equality Impact Assessment completed * Previous version(s) archived * Disclosure status Key Words for this policy Yes Yes Yes B can be disclosed to patients and the public fraud, bribery, corruption, NHS Protect, local counter fraud specialist, finance, sanctions * For more information on the consultation process, implementation plan, equality impact assessment, or archiving arrangements, please contact Corporate Governance Review and Amendment History Version Date Details of Change V.2.0 Oct 2015 Complete review and update of policy and new format following an external review of the Trust s process for the development and management of procedural documents V.1.0 April 2011 Policy for the new organisation BCPFT Version 2.0. October 2015 17