Job summary
The NHSBSA plays an important role in tackling fraud and error across the wider NHS such as working with NHS England on Provider Assurance and Loss Recovery Service within Primary Care. The NHSBSA have the potential to do more to reduce opportunities for fraud and error and improve the way that fraud and error risks are addressed.
We are currently recruitinga Fraud Specialist to work within the NHSBSA Loss and Fraud Prevention Team (LFP) Team on a permanent basis.
As a Fraud Specialist you will apply your expertise to ensure loss and fraud prevention and detection methods are embedded across our services. You will be responsible for identifying and tackling system weaknesses across all NHSBSA services.. You will undertake investigations in accordance with Criminal Procedure and Investigation Act (CPIA), Police and Criminal Evidence Act (PACE) 1984 and NHS Counter Fraud Authority (NHSCFA) guidance.
What we offer:
- 27 days leave (increasing with length of service) plus 8 bank holidays
- Flexi time
- Hybrid working model (working remotely at home but also in the office)
- Career development
- Active wellbeing and inclusion networks
- Excellent pension
- NHS Car lease scheme
- Access to a wide range of benefits and high street discounts
Main duties of the job
Main duties of a Fraud Specialist include:
- Assist in delivery the NHSBSA Loss and Fraud Strategy by undertaking proactive and reactive work and contributing to the NHSBSA Control Framework.
- Undertaking Cabinet Office Fraud Risk Assessments to ensure risks are identified, controls implemented and monitored.
- Completing end to end service reviews to ensure fraud, bribery and loss risks are captured, prevention and detection controls are embedded across our services
- Collaborating with colleagues in NHSBSA and across the NHS to deliver national proactive exercises and loss measurement exercises.
- Represent the NHSBSA LFP Team at partnership meetings with the NHS Counter Fraud Authority, NHS England & Improvement, DHSC Anti-Fraud Unit and NHS Fraud Manager meetings to share best practice and discuss emerging fraud types.
- Undertaking investigations into allegations of fraud, bribery and / or corruption by obtaining and presenting evidence to prove or disprove allegations ensuring appropriate sanctions are considered.
- Responsible for supervising staff and providing line management support to enable them to carry out their roles effectively.
The post holder will either hold an Accredited Counter Fraud Specialist (ACFS) certificate or must successfully complete the ACFS training course within 6 months of commencing post.
The post is full time and employment in this post is subject to a satisfactory Disclosure from the Disclosure & Barring Service.
About us
At the NHS Business Services Authority (NHSBSA) we deliver a range of essential national services to NHS organisations and contractors, patients, and the public.
You may already be using some of our services. Do you have a prescription pre-payment certificate? Perhaps you found this vacancy through NHS Jobs? We're behind these, and much more.
Being one of the UK's Best Big Companies to work for, our values are to be Collaborative, Adventurous, Reliable and Energetic. We CARE about what we do and support each other in achieving our objectives.
Our people are the heart of our organisation. We strive to ensure they feel trusted, valued and empowered. We're passionate about nurturing and developing people. When you join us, we want you to grow, and we offer many opportunities for you to do that.
We welcome applications from people of all backgrounds. With wellbeing and inclusion central to our ethos, our BAME, Disability and Neurodiversity, LGBTQ+, Armed Forces and Women's networks help our colleagues to be their authentic selves at work.
At the NHSBSA we value and respect the diversity of our colleagues and are committed to being a flexible employer. We are proud to offer flexible working opportunities. Whether you're interested in hybrid working, working from home, flexible hours or job sharing, apply today and we can discuss available options with you at the interview stage.
We are the NHS delivering for the NHS.
Job description
Job responsibilities
In this role, you are accountable for:
- To deliver a rolling programme of fraud awareness sessions to staff across the NHSBSA.
- Establish and maintain effective liaison with Heads of Service and key staff within the NHSBSA to identify opportunities where fraud and error could occur. Working with the service area to mitigate or eradicate the opportunities for fraud and error.
- Analyse financial, payment and other systems and regulations within the NHSBSA to identify system weaknesses that have allowed fraud to be perpetrated. Use expertise gained to comment on and propose strategies to impact on fraud in own area of work and across the wider NHS. Such strategies may include the redesign and implementation of policy, procedures and legislation.
- Participate in National Proactive Exercises: devising appropriate methodology, planning and executing exercises in accordance withguidance from NHS Counter Fraud Authority.
- Line management responsibility of junior members of the NHSBSA Fraud Team.
- To investigate, within operational and legislative guidelines to the highest standards, all allegations of fraud in the NHSBSA. Ensure thatappropriate disciplinary, civil or criminal remedies are applied by the following means: Analyse possible avenues and methods of investigation to obtain evidence through various relevant means. Use in-depth knowledge and experience of the processes and systems across the NHS to determine where relevant evidence can befound Analyse and understand the financial, accounting, payment and organisational factors in that part of the NHS relevant to the type andlocation of the fraud committed. Convert technical information into plain English, suitable for presentation at Court. Establish contact with, interview and take statements from relevant witnesses including expert witnesses, displaying the knowledge andapplication of effective interviewing techniques to deal with hostile, uncooperative or reluctant witnesses Prepare and present briefings to staff and police in relation to arrests, searches and interviews with suspects Actively assist police and other agencies in arrest and search procedures, providing expert professional advice where required, all in accordance with current legislation. Where evidence has been passed to the Fraud Specialist following such procedures, or otherwise obtained in the course of an investigation, ensure that the integrity of the evidence is maintained in accordance with NHS Counter Fraud Authority (NHS CFA) policy. Plan and conduct taped interviews with suspects either at police stations or NHS premises in accordance with the Police and CriminalEvidence Act (1984). Maintain investigation files and evidence with due regard to the Criminal Procedures Investigation Act 1996, including management anddisclosure of unused material in accordance with the act. Manage and prioritise own caseload, adhering to non-negotiable deadlines imposed by courts and police.
- Prepare cases for criminal, civil and disciplinary consideration in all cases where evidence of fraud is established.
- Attend criminal and civil courts, disciplinary hearings of NHS or other employers and professional and regulatory bodies, as and whenrequired, in the capacity of witness and / or case officer to give evidence competently, including in cross examination. Provide guidance, advice and instructions to Counsel and other legal professionals before and during criminal and civil proceedings.
- Undertake duties with due regard to patient care and safety, particularly in terms of clinical circumstance, sensitivity and confidentiality, in accordance with Data Protection legislation and the NHS Confidentiality Code of Practice.
- Carry out the responsibilities of the post with full and due regard to NHSBSA policies and procedures and negotiated agreements including those on Equal Opportunities and Health and Safety.
- Lead in negotiations for financial recoveries of NHS funds including: Contacting NHS CFA to seek assistance from their Financial Investigators Analysis of evidence and intelligence.
- Maintain an up to date working knowledge of all relevant and appropriate legislation, standards and procedures, including NHS structure, policy, detection and investigative methods.
- Maintain a good knowledge of available Information Technology and how it can best be used in the detection and investigation of fraud and to present data in a clear and appropriate format, often reflecting specific requirements.
- Prepare and present reports, submissions and other documents as required. Provide clear, complete and accurate information to internal andexternal senior management, professionals and professional bodies
- Promote and contribute to the development of policies, practices and procedures for NHSBSA and more widely across the NHS.
- Work outside normal office hours when required, which will occasionally necessitate extended hours and possibly weekends. Travel and overnight absence from home when required.
- Advise on counter fraud measures by preparing and carrying out fraud awareness presentations, tailoring the presentation for managers and staff reflecting specific requirements.
- Appropriate use, maintenance and security of NHSBSA premises, assets, evidence, exhibits and equipment. Ensure the integrity andcontinuity of evidence at all times.
- Responsible for personal development. Undertake relevant training as identified with line management.
- Provide continuous support, advice and guidance, and manage the expectations of, witnesses and victims including NHS staff, patients and healthcare professionals, from the time of initial contact until after the conclusion of an investigation including any court process.
- To work in circumstances that are potentially hazardous and where there is potential to encounter hostile situations.
Job description
Job responsibilities
In this role, you are accountable for:
- To deliver a rolling programme of fraud awareness sessions to staff across the NHSBSA.
- Establish and maintain effective liaison with Heads of Service and key staff within the NHSBSA to identify opportunities where fraud and error could occur. Working with the service area to mitigate or eradicate the opportunities for fraud and error.
- Analyse financial, payment and other systems and regulations within the NHSBSA to identify system weaknesses that have allowed fraud to be perpetrated. Use expertise gained to comment on and propose strategies to impact on fraud in own area of work and across the wider NHS. Such strategies may include the redesign and implementation of policy, procedures and legislation.
- Participate in National Proactive Exercises: devising appropriate methodology, planning and executing exercises in accordance withguidance from NHS Counter Fraud Authority.
- Line management responsibility of junior members of the NHSBSA Fraud Team.
- To investigate, within operational and legislative guidelines to the highest standards, all allegations of fraud in the NHSBSA. Ensure thatappropriate disciplinary, civil or criminal remedies are applied by the following means: Analyse possible avenues and methods of investigation to obtain evidence through various relevant means. Use in-depth knowledge and experience of the processes and systems across the NHS to determine where relevant evidence can befound Analyse and understand the financial, accounting, payment and organisational factors in that part of the NHS relevant to the type andlocation of the fraud committed. Convert technical information into plain English, suitable for presentation at Court. Establish contact with, interview and take statements from relevant witnesses including expert witnesses, displaying the knowledge andapplication of effective interviewing techniques to deal with hostile, uncooperative or reluctant witnesses Prepare and present briefings to staff and police in relation to arrests, searches and interviews with suspects Actively assist police and other agencies in arrest and search procedures, providing expert professional advice where required, all in accordance with current legislation. Where evidence has been passed to the Fraud Specialist following such procedures, or otherwise obtained in the course of an investigation, ensure that the integrity of the evidence is maintained in accordance with NHS Counter Fraud Authority (NHS CFA) policy. Plan and conduct taped interviews with suspects either at police stations or NHS premises in accordance with the Police and CriminalEvidence Act (1984). Maintain investigation files and evidence with due regard to the Criminal Procedures Investigation Act 1996, including management anddisclosure of unused material in accordance with the act. Manage and prioritise own caseload, adhering to non-negotiable deadlines imposed by courts and police.
- Prepare cases for criminal, civil and disciplinary consideration in all cases where evidence of fraud is established.
- Attend criminal and civil courts, disciplinary hearings of NHS or other employers and professional and regulatory bodies, as and whenrequired, in the capacity of witness and / or case officer to give evidence competently, including in cross examination. Provide guidance, advice and instructions to Counsel and other legal professionals before and during criminal and civil proceedings.
- Undertake duties with due regard to patient care and safety, particularly in terms of clinical circumstance, sensitivity and confidentiality, in accordance with Data Protection legislation and the NHS Confidentiality Code of Practice.
- Carry out the responsibilities of the post with full and due regard to NHSBSA policies and procedures and negotiated agreements including those on Equal Opportunities and Health and Safety.
- Lead in negotiations for financial recoveries of NHS funds including: Contacting NHS CFA to seek assistance from their Financial Investigators Analysis of evidence and intelligence.
- Maintain an up to date working knowledge of all relevant and appropriate legislation, standards and procedures, including NHS structure, policy, detection and investigative methods.
- Maintain a good knowledge of available Information Technology and how it can best be used in the detection and investigation of fraud and to present data in a clear and appropriate format, often reflecting specific requirements.
- Prepare and present reports, submissions and other documents as required. Provide clear, complete and accurate information to internal andexternal senior management, professionals and professional bodies
- Promote and contribute to the development of policies, practices and procedures for NHSBSA and more widely across the NHS.
- Work outside normal office hours when required, which will occasionally necessitate extended hours and possibly weekends. Travel and overnight absence from home when required.
- Advise on counter fraud measures by preparing and carrying out fraud awareness presentations, tailoring the presentation for managers and staff reflecting specific requirements.
- Appropriate use, maintenance and security of NHSBSA premises, assets, evidence, exhibits and equipment. Ensure the integrity andcontinuity of evidence at all times.
- Responsible for personal development. Undertake relevant training as identified with line management.
- Provide continuous support, advice and guidance, and manage the expectations of, witnesses and victims including NHS staff, patients and healthcare professionals, from the time of initial contact until after the conclusion of an investigation including any court process.
- To work in circumstances that are potentially hazardous and where there is potential to encounter hostile situations.
Person Specification
Personal Qualities, Knowledge and Skills
Essential
- Committed to continuing personal/professional development
- Considerable personal initiative with the ability to work independently and work as part of a team.
- Demonstrable ability to tackle a number of diverse tasks and be able to prioritise and manage work accordingly whilst working to tight deadlines
Experience
Essential
- Have practical experience of successfully investigating fraud and be able to demonstrate a proven track record of applying criminal and civil sanctions in relation to fraud offences in a multi-agency environment
- Have an understanding of the practical application of all relevant legislation in relation to the investigation and prosecution of suspected fraud and corruption offences
- Experience of liaising closely with outside o Experience of using IT as an investigative tool to counter fraud and corruption. Application Form, Interview agencies within regulatory frameworks to combat fraud and corruption.
- Experience of line managing staff.
- Can demonstrate strong mentoring and coaching skills.
- Be able to demonstrate a comprehensive knowledge of investigative procedures with an up to date knowledge of systems and processes.
- Can demonstrate a clear analytical approach to both investigative work and the development and support of anti-fraud work in the NHS
- Significant experience of managing and analysing large amounts of data, draw sound conclusions and present findings in an easily understood format.
- Demonstrate excellent written and oral communication skills and be able to communicate complex information persuasively, both orally and in writing, with people at all levels and across professions.
- IT literacy with knowledge of generic software packages.
Desirable
- Experience of using IT as an investigative tool to counter fraud and corruption.
Qualifications
Essential
- Hold an NHS Accredited Counter Fraud Specialist qualification or similar qualification or be able to demonstrate equivalent experience
- Educated to Post Graduate Degree level plus experience in a relevant subject.
- A current full driving licence.
Person Specification
Personal Qualities, Knowledge and Skills
Essential
- Committed to continuing personal/professional development
- Considerable personal initiative with the ability to work independently and work as part of a team.
- Demonstrable ability to tackle a number of diverse tasks and be able to prioritise and manage work accordingly whilst working to tight deadlines
Experience
Essential
- Have practical experience of successfully investigating fraud and be able to demonstrate a proven track record of applying criminal and civil sanctions in relation to fraud offences in a multi-agency environment
- Have an understanding of the practical application of all relevant legislation in relation to the investigation and prosecution of suspected fraud and corruption offences
- Experience of liaising closely with outside o Experience of using IT as an investigative tool to counter fraud and corruption. Application Form, Interview agencies within regulatory frameworks to combat fraud and corruption.
- Experience of line managing staff.
- Can demonstrate strong mentoring and coaching skills.
- Be able to demonstrate a comprehensive knowledge of investigative procedures with an up to date knowledge of systems and processes.
- Can demonstrate a clear analytical approach to both investigative work and the development and support of anti-fraud work in the NHS
- Significant experience of managing and analysing large amounts of data, draw sound conclusions and present findings in an easily understood format.
- Demonstrate excellent written and oral communication skills and be able to communicate complex information persuasively, both orally and in writing, with people at all levels and across professions.
- IT literacy with knowledge of generic software packages.
Desirable
- Experience of using IT as an investigative tool to counter fraud and corruption.
Qualifications
Essential
- Hold an NHS Accredited Counter Fraud Specialist qualification or similar qualification or be able to demonstrate equivalent experience
- Educated to Post Graduate Degree level plus experience in a relevant subject.
- A current full driving licence.
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
Additional information
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
