How we work
Published on 29 November 2023
CFS operates within a Directorate of NHS National Services Scotland (NSS). NSS supports service-users to deliver their services more efficiently and effectively, offering shared services on a national scale using best-in-class systems and standards. NSS aims to help our service-users save money and free up resources so they can be re-invested into essential services. NSS aims to achieve this through four strategic objectives:
Service Excellence
We will continuously improve the way in which we deliver existing and new services, with a focus on quality, to ensure they are safe, efficient, effective, and meet the needs of our service users, partners, and stakeholders
Financial Sustainability
An organisational financial stewardship culture that will drive effective use of assets, infrastructure, and value for money.
Workforce Sustainability
A diverse, knowledgeable, and skilled workforce deployed in an environment where the organisation is adaptable to the changing lifecycle of employees and delivers leadership and behaviours reflecting the values of NHS Scotland.
Climate Sustainability
Embed climate sustainability in everything that we do to ensure that NHS Scotland becomes a net zero greenhouse gas emissions health service by 2040 or earlier.
CFS has a well-established delivery structure directed at three approaches to countering fraud.
The Prevention Team delivers the Fraud Risk Assessment service and prevention interventions that reduce fraud vulnerability and create measurable savings. Communicating the counter fraud message through campaigning, advice notices and through our training and awareness programme is key to reducing the extent of fraud loss to the service.
The Detection Team, gathers, assesses, and disseminates intelligence both to initiate investigations and to alert health boards of their potential to be targeted in ongoing system attacks. The data analysts in this teamwork with large datasets to seek out anomalies’ indicative of fraud, bribery and corruption and refer these for intelligence assessment.
The Investigation Team works both proactively and reactively to deliver a criminal investigation service that holds perpetrators to account and recovers lost monies back to the health service. Where the accused person is a regulated professional, the team seeks to deliver the triple-track approach in partnership with the appropriate health boards and the professional regulator to deliver the appropriate sanctions for fraud.
CFS is also the home of the Patient Claims Team which undertakes an exemption-checking service for dental and ophthalmic claims on behalf of the territorial health boards. This team has two primary aims; to recover debts to the health boards and to provide effective measurement of the extent of fraud and error in this area. This work is delivered in a civil-Regulatory framework within which the team is demonstrating increasing effectiveness in recovering monies and deterring future incorrect claims.
Following the National Intelligence Model, CFS strives to be intelligence-led; a model that encourages the targeting of the risks that present the greatest harm.
Section 4 above, outlines the Strategic Assessment that seeks to determine the key thematic risk areas around which a ‘Control Plan’ is created.
The Control Plan brings focus to the allocation of tasks across CFS and resources to meet its strategic priorities.
Control Strategy and Strategic Tasking Group (CSSTG)
The purpose of strategic tasking is for members of the wider health service to collectively agree priorities areas for counter fraud activity throughout the strategic cycle. This group forms the Control Strategy for the health boards and CFS to deliver in partnership. CFS aims to constitute a CSSTG in late 2023 with a view to it becoming operational in year two of this strategic cycle.