Prevention of Fraud

Appendix 3

 

 

             PREVENTION OF FRAUD

             INTRODUCTION

 

One of the most fundamental principles governing any organisation, whether in the private or public sector, is the proper use of funds – however these are derived.   This document sets out the procedures that apply with regard to reporting of any detected or suspected fraud or other illegal act determined within or outside of Portsmouth Primary Care Alliance Ltd.

 

          PRINCIPLES

 

There are seven fundamental principles that govern everyone working within the Alliance:

1.Selflessness – Those involved with the work of PPCA shall act solely in terms of the interest of the membership.

2.Integrity – Those involved with the work of PPCA must avoid placing themselves under any obligation to individuals or organisations that might try inappropriately to influence them in the work of the Alliance. Actions will not be taken or decisions made in order to gain financial or other material benefit for themselves or others. They must declare and resolve any interests and / or relationships that may in anyway cause conflict.

3.Objectivity – Those involved in the work of PPCA must act and take decisions impartially, fairly and on merit using the best evidence and without discrimination or bias.

4.Accountability – Those involved in the work of PPCA are accountable for their decisions and actions and must be prepared to submit themselves to the scrutiny necessary to ensure this.

5.Openness – Those involved in the work of PPCA should act and take decisions in an open and transparent manner. Information should not be withheld unless there are clear and lawful reasons for this.

6.Honesty – Those involved in the work of PPCA should be truthful.

7.Leadership – Those involved in the work of PPCA will exhibit these principles in their own behaviour. They will actively promote and robustly support these principles and be willing to challenge poor behaviour wherever it occurs.

It is therefore important that all those who work within PPCA are aware of our commitment to the elimination of fraud and other illegal acts involving dishonesty or damage to property.   For simplicity, all such offences are referred to as “fraud”, except where the context indicates otherwise.

 

 

          THE POLICY

 

Portsmouth Primary Care Alliance is committed to the elimination of any fraud within the activities it undertakes. To this end:

 

  1. Every case of suspected fraud will be rigorously investigated by the employing organisation of the staff member concerned.
  2. The Police will be called in whenever it appears that a criminal offence may have been committed.
  3. Disciplinary procedures of the employing organisation will be rigorously followed.
  4. Action will be taken to recover any loss to Portsmouth Primary Care Alliance Ltd.
  5. All suspected cases of fraud will be reported to NHS Protect. Telephone: 020 7895 4500. On line reporting: http://www.reportnhsfraud.nhs.uk

          INTERNAL REPORTING

 

If a member of staff has reason to suspect a colleague, provider or other person of committing a fraudulent offence, or other offence involving a serious infringement of rules of the employing organisation, for example:

  • theft of PPCA property
  • abuse of PPCA property
  • deception or falsification of records
  • fraudulent claims

The member of staff should, in the first instance, report their concerns to their line manager. If it is suspected that the line manager may be involved in the fraud, the report should be made to a more senior person. If concerns are reported, the Clinical Chairperson of Portsmouth Primary Care Alliance Ltd will be made aware.

The person receiving the report will make a written record of the discussion and immediately inform the Alliance before taking any action.

The member of staff reporting the fraud will be kept informed as to the outcome of the investigation.

 

            “NO DETRIMENT” POLICY

All members of staff have a responsibility to protect the assets of Portsmouth Primary Care Alliance Ltd.

The Alliance wishes to encourage anyone having reasonable suspicions of fraud to report them. Therefore Portsmouth Primary Care Alliance Ltd will rigorously enforce the principle that no employee will suffer in any way as a result of reporting reasonably held suspicions.

Any member of staff who raises suspicions that they are unable to justify as being “reasonably held” or with malicious intent will be dealt with through the relevant employing organisation disciplinary procedures.