Types of Fraud

The types of fraud encountered can generally be classified into four main groups:

Patient Fraud

Examples of patient fraud can include claiming for free or reduced cost dental/ophthalmic treatment when not entitled; fraudulently attempting to obtain prescription medication either for personal use or resale; foreign nationals coming to Northern Ireland in order to gain access to non emergency treatment which they should have to pay for.

Staff Fraud

Fraud by HSC staff can include submitting false claims for hours worked, travel or subsistence; falsifying qualifications to obtain employment; theft of cash or equipment and flexi/sick leave abuse.

Contractor Fraud

Examples of contractor fraud can include altering prescriptions - substituting expensive drugs for a cheaper alternative and claiming for the expensive one; claiming for services or treatments that were not provided; creating 'ghost' patients; charging patients privately while also claiming reimbursement under health service regulations.

Supplier Fraud

Supplier fraud can include submitting false invoices for goods or services not received or offering a personal incentive to secure a contract or price fixing.

For information on reporting fraud please click here.