The NHS Counter Fraud Service (NHS CFS) will use a new fraud detection system that uses neural networks – artificial systems capable of sophisticated, almost ‘intelligent’, calculations – to predict where fraud is most likely to occur.
Jim Gee, director of the NHS CFS, said: ‘We’re looking to work with SAS to develop more advanced software than has been traditionally available.’
Since it was set up in 1998, the NHS CFS has already recovered almost £200m – the equivalent of three new hospitals, more than 12,000 heart transplants or 46,000 hip replacements.
Since 1999, pharmaceutical patient fraud has reduced from £117m to £69m, dental patient fraud is down 25% to £30m and optical patient fraud has been cut from £13m to £10m, according to NHS CFS estimates.
Fraud by NHS professionals has fallen by up to 30%, and the amount of money recovered has increased seven-fold over the last three years.
Recent cases include the chief executive of one NHS trust who was prosecuted for £50,000 over mileage claims, and a GP in the West Country prosecuted for £800,000. But despite these achievements, Gee said there was still work to be done. ‘We want to target our fraud detection work more effectively. Our first objective is to get something to protect NHS resources.’
Gee said fraud detection systems could be of enormous benefit to other public sector bodies, as well as organisations in the private sector.
‘But at the moment there’s enough work to be done in the NHS,’ he said.
In a statement, the health minister, Lord Hunt, said: ‘We aim to learn from every example of fraud so that we continuously improve our capacity to detect and stop it. We shall be using the most sophisticated technology to target those who would deprive the NHS of the resources it needs for patient care.’
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