Common use of Counter Fraud Services Clause in Contracts

Counter Fraud Services. 4.3.1 CFS will support Health Boards to manage their fraud risks by finding, measuring, risk- assessing and reducing their fraud loss and promoting a counter-fraud culture. The aim of this work is to ensure that NHS funds intended for patient care are used for patient care. 4.3.2 CFS will provide support and facilitation for the DoFs, FLOs and CFCs in their work. 4.3.3 The role of CFS, in partnership with Health Boards, is to: • engage with experts to assess programmes and processes to identify fraud risks and mitigation; • support the creation of a Fraud Annual Action Plan that summarises key actions to improve capability, activity and resilience in that year; • maintain reporting routes for staff, contractors and members of the public to report suspicions of fraud and record these referrals and allegations; • provide trained investigators that meet the agreed public sector skill standard; • undertake activity to try and detect fraud; • provide a range of channels for all NHS staff to access and undertake high quality fraud awareness and training as appropriate to their role; • investigate alleged cases of fraud by staff, patients, primary care practitioners, contractors or suppliers, third parties and to pursue all cases to an appropriate conclusion; • where necessary, undertake directed surveillance and CHIS management in relation to fraud in accordance with RIP(S)A; • provide specialist advice to assist in the formulation of national and UK wide counter fraud policy, regulations and guidance; and • assist in the recovery of resources fraudulently or corruptly obtained from NHS Scotland. 4.3.4 CFS shall provide reporting in accordance with section 7 of this Agreement. 4.3.5 Although CFS forms part of NSS and is accountable to the Chief Executive NSS for governance, the Head of CFS has responsibility for providing advice, support and guidance to Health Boards in the delivery of its counter fraud services. Information concerning work carried out on behalf of a Health Board may only be disclosed out- with the confines of CFS with the express permission of the relevant Health Board. The only exception is where disclosure is necessary to the SGHSCD, or other relevant UK statutory bodies, where they require such as part of policy, operational or legal requirements. In particular, the Crown Office and Procurator Fiscal Service, police or appointed auditor may require such information. Where appropriate, CFS will inform the relevant Health Board when information has been disclosed. The Head of CFS also has the right of access to the Director of Health Finance and Governance at Scottish Government in exceptional circumstances (e.g. those involving allegations against the most senior staff in a Health Board, or cases directly involving NSS).

Counter Fraud Services. 4.3.1 In partnership with the Health Boards, CFS will support Health Boards to manage their fraud risks by finding, measuring, risk- assessing and reducing their fraud loss and promoting a be integral in embedding an counter-fraud cultureculture into Scotland’s Health Service and to deliver a health and financial impact by reducing losses from fraud. The aim of this work is to ensure reinforce that fraud against NHS funds intended for patient care are used for patient careScotland is unacceptable. 4.3.2 CFS will provide support and facilitation for the DoFs, FLOs and CFCs in their work. 4.3.3 The role of CFS, in partnership with Health Boards, is to: • engage with experts to assess programmes - reduce fraud through proficient education and processes to identify awareness initiatives, deter fraud risks through effective interventions and mitigationprevent fraud through targeted proactive projects; • support the creation of a Fraud Annual Action Plan that summarises key actions to improve capability, activity and resilience in that year; • maintain reporting routes for staff, contractors and members of the public to report suspicions of fraud and record these referrals and allegations; • provide trained investigators that meet the agreed public sector skill standard; • undertake activity to try and - proactively detect fraud; • provide a range of channels for all NHS staff to access and undertake high quality fraud awareness and training as appropriate to their role; • - investigate alleged cases of fraud by staff, patients, primary care practitioners, contractors or suppliers, third parties and to pursue vigorously all cases to an appropriate conclusion; • - where necessary, undertake directed surveillance and CHIS management in relation to fraud in accordance with RIP(S)A; • - provide specialist advice to assist in the formulation of national and UK wide counter fraud policy, regulations and guidance; and • - assist in the recovery of resources fraudulently or corruptly obtained from NHS Scotland. 4.3.4 CFS shall provide reporting in accordance with section 7 of this Agreement. 4.3.5 Although CFS forms part of NSS and is accountable to the Chief Executive NSS for governance, the Head of CFS has responsibility for providing advice, support and guidance to Health Boards in the delivery of its counter fraud services. Information concerning work carried out on behalf of a Health Board may only be disclosed out- with outwith the confines of CFS with the express permission of the relevant Health Board. The only exception is where disclosure is necessary to the SGHSCD, or other relevant relevant, UK statutory bodies, Statutory Bodies where they require such as part of policy, operational operational, or legal requirements. In particular, the Crown Office and Procurator Fiscal Service, police or appointed auditor may require such information. Where appropriate, CFS will inform the relevant Health Board when information has been disclosed. The Head of CFS also has the right of access to the SGHSCD Director of Health Finance and Governance at Scottish Government Infrastructure in exceptional circumstances (e.g. those involving allegations against the most senior staff in a Health Board, or cases directly involving NSS).

Counter Fraud Services. 4.3.1 CFS CFS, in partnership with the Health Boards, will support Health Boards work proactively to manage their fraud risks by finding, measuring, risk- assessing and reducing their fraud loss and promoting a counterbe integral in embedding an anti-fraud cultureculture into Scotland’s Health Service and to deliver a health impact by reducing losses from financial crime. The aim of this work is for NHS Scotland staff, patients, primary care practitioners, contractors or suppliers and the wider public to ensure have a knowledge of financial crime and its impact and to reinforce that financial crime against NHS funds intended for patient care are used for patient careScotland is unacceptable. 4.3.2 CFS will provide support and facilitation for the DoFs, FLOs and CFCs in their work. 4.3.3 The role of CFS, in partnership with Health Boards, is to: • engage with experts to assess programmes - undertake a campaign of financial crime deterrence and processes to identify fraud risks provide training and mitigation; • support the creation education in respect of a Fraud Annual Action Plan that summarises key actions to improve capability, activity and resilience in that year; • maintain reporting routes for staff, contractors and members of the public to report suspicions of fraud and record these referrals and allegations; • provide trained investigators that meet the agreed public sector skill standard; • undertake activity to try and detect countering fraud; • provide a range of channels for all NHS staff - undertake the work necessary to access and undertake high quality fraud awareness and training as appropriate to their roledisable financial crime; • investigate - proactively detect financial crime; - deal with alleged cases of fraud financial crime by staff, patients, primary care practitioners, contractors or suppliers, third parties suppliers and to pursue vigorously all cases to an appropriate a conclusion; • - where necessary, undertake directed surveillance and CHIS covert human intelligence source management in relation to fraud financial crime in accordance with RIP(S)A; • - provide specialist advice to assist in the formulation of national and UK wide counter fraud policy, regulations and guidance; and • - assist in the recovery of resources fraudulently or corruptly obtained from NHS Scotland.; 4.3.4 CFS shall provide reporting in accordance with section 7 of this Partnership Agreement. 4.3.5 Although CFS forms part of NSS and is accountable to the Chief Executive NSS for governance, the Head of CFS has a professional responsibility for providing advice, support and guidance to the Accountable Officer of Health Boards in for the delivery of its counter fraud servicesCFS’ functions on their behalf, and the provision of subsequent advice. Information concerning work carried out on behalf of a Health Board client body may only be disclosed out- with outwith the confines of CFS with the express permission of the relevant Health Board. The only exception is where disclosure is necessary to the SGHSCD, or other relevant relevant, UK statutory bodies, Statutory Bodies where they require such as part of policy, operational operational, or legal requirements. In particular, the Crown Office and Procurator Fiscal Service, police or appointed auditor may require such information. Where appropriate, CFS will inform the relevant Health Board when information has been disclosed. The Head of CFS also has the right of access to the Director of Health Finance Finance, eHealth and Governance at Scottish Government Pharmaceuticals, SGHSCD in exceptional circumstances (e.g. those involving allegations against the most senior staff in a Health Board, or cases directly involving NSS).