Sept FT 1 redraft by nyut545e2


									                                                                      EAST MIDLANDS
                                                                      Local Counter Fraud Services

                                         T T I ME S
                               F RAUDULEN
                                                                                           Volume 4, Issue 2

                                                                                           September 2010

            EXPENSES FRAUD
A hospital Doctor has been                     with inventories and invoices from
struck-off by the General Medical              a company called ‘Remove to
Council (GMC) after falsely                    Move Ltd’ and in an initial meeting
claiming £2,450 for relocation                 with the Local Counter Fraud                Inside this issue:
and removal expenses from                      Specialist and the Trust’s
Derby Hospitals NHS Foundation                 Resource Team Manager, insisted
                                               that the money she was claiming          Message from the Head
Trust.                                                                                  of Local Counter Fraud
Dr.Basma Bashir Rghebi submitted               had been paid out to this company.
                                               An investigation by the LCFS found
                                                                                        Fraud Awareness Month
                                               that the removal company did not         report
                                               actually exist.
                                               At a later date, during a formal         National Fraud Initiative
                                               interview carried out by the LCFS,       -What is it?
                                               Dr. Rghebi admitted that she
                                               (together with her husband) had          Travel expenses              4
                                               invented ‘Remove to Move Ltd’ and
                                               had produced her own inventory
  Guilty Dr. Rghebi submitted expenses for a   and invoice for this fictitious          Beware of Scammers!          5
  fictitious removal company                   company on her home computer. It
                                               transpired that Dr. Rghebi and her
an expenses claim relating to her              husband had hired a van and              Local & National cases       6-7
move from London after starting                carried out the removal
work in Derby in 2007. After being             themselves, at a much lower cost
unable to verify the claim, staff at           than that claimed.                       LCFS News                    7
the Trust refused to pay the £2450             In mitigation, Dr. Rghebi explained
and informed their Local Counter               that she did not want to lose any        Who you gonna call?
Fraud Specialist (LCFS) Penny                  money when moving jobs and was           - Latest LCFS contact list
Gee.                                           planning to use the cash claimed
Dr. Rghebi had supplied the Trust                               (continued on Page 2)

Quarterly newsletter from your local counter fraud team
Fraudulent Times: Volume 4, Issue 2.                                                                                       1
                                                                   EAST MIDLANDS             Local Counter Fraud Services

        Welcome from your Local Counter
        Fraud Team for the East Midlands!
    Hello! My name is Richard Holmes and I’m the
    Head of the Local Counter Fraud Service in the                        What is Fraud?
    East Midlands NHS. Every quarter, my team                   In simple terms, fraud involves the
    produce this newsletter and distribute it to all of
                                                                following 3 elements:
    our East Midlands health body clients.
                                                                • A false representation (by any
    Fraudulent Times gives an opportunity for staff to
    read about topical counter fraud matters & cases.
    It is an alternative way of raising fraud                   • An intention to cause a loss or
    awareness for staff who may not have access                    make a gain
    to the fraud pages on their health body’s intranet or       • Dishonesty
    may not have had the opportunity to attend a fraud
                      presentation.                             The legislation used most widely to
                                                                prosecute fraudsters is The Fraud
                       Our newsletter also highlights
                                                                Act 2006
                       current scams and frauds
                       affecting the NHS and
                       demonstrates that referrals of
                       potential frauds to my team are
                       taken seriously and that action is
                       taken wherever appropriate.
                    If you wish to contact me, or any
    of my team, our contacts details can be found at
    page 8.

                 Expenses Fraud Doctor Struck-Off
(continued from front page)              in this country. The panel           that the public are entitled to
from her new employer to buy             described her actions as, "a         place in the medical profession."
furniture. She apologised,               pre-planned act of deception for     Penny Gee, the Local Counter
accepted that her actions were           her own financial gain" and          Fraud Specialist for Derby
wrong and claimed it was out of          found that the receipt of a police
                                                                              Hospitals NHS Foundation Trust
character.                               caution was, "a serious breach
                                                                              at the time of the investigation,
On receipt of the LCFS’s                 of the standards expected of a
findings, Derby Hospitals NHS            doctor".                             had this to say about the
Foundation Trust dismissed Dr.                                                decision:
                                         In reaching its decision, the
Rghebi and referred the matter                                                “Dr. Rghebi compounded her
                                         GMC stated that Dr. Rghebi’s
to the GMC.                                                                   dishonest actions by failing to
The evidence gathered by the                                                  admit, at the earliest opportunity,
LCFS was passed to Derbyshire                                                 that she had manufactured her
Police, who subsequently issued                                               removal expenses claim. Her
both Dr. Rghebi and her                                                       claim was never paid by the
husband with a formal police                                                  Trust and she has lost both her
caution for fraud by false                                                    employment and her career as a
representation.                                                               result of her actions. This case
The GMC carried out their own                                                 should serve as a warning to
independent investigation and at         fitness to practice was impaired.    others that fraud does not pay
the subsequent hearing, decided          The panel concluded that, "Such      and that offences committed by
to erase Dr. Rghebi from the             a blatantly engineered act of        NHS employees at all levels will
Medical Register, meaning she            dishonesty represents a serious      be professionally investigated
can no longer work as a doctor           risk to the confidence and trust     and dealt with appropriately.”

Fraudulent Times: Volume 4, Issue 2.                                                                                   2
                                                                       EAST MIDLANDS                                    Local Counter Fraud Services

                                       Fraud Awareness Month
        June was Fraud Awareness Month and during that time, your local counter fraud team held a number
        of dedicated events to promote the service they provide and to raise awareness of fraud in the NHS.
        As we all know, the NHS is here to keep the country healthy, so the loss of
        funds due to the dishonesty of a few has a knock-on effect for us all.
        Activities that took place at various NHS sites in the region included:
        •    ‘Meet and Greet’ events, where your LCFS’s were able to take
             questions from staff and tell them more about the ways in which they
             can help
        •    Display of our latest counter fraud video at key locations
        •    Promotion of the Counter Fraud e-Learning module                             Contact your Local Counter Fraud

                                                                                          Specialist in confidence:
        •    Promotional material (information booklets and leaflets) distributed
        •    Posters displayed incorporating a topical ‘World Cup’ theme                  EAST MIDLANDS

        For those who couldn’t attend one of these events, there is an interactive presentation on how NHS
        fraud is being tackled at:

                     Patients from abroad
                Can they get free treatment?
                                                                                    Keep your eyes peeled for our
    The question has been raised about treatment of patients                      Counter Fraud leaflets and posters
    from abroad- specifically whether they qualify for free                       displayed in both staff and public
    primary or secondary healthcare.                                               areas at sites across the region.
    Advice on dealing with patients from abroad can be                       If your stocks are low and you require
    obtained by visiting the Department of Health website:                    more, please contact your LCFS who                      will be more than happy to help.
    You can also contact the Department of Health Overseas
    Healthcare Team on 020 7210 4850.

                                              Don’t forget to complete our
                                              Counter Fraud e-Learning Module.
                                              Our Counter Fraud e-Learning module is
                                              designed to give you information about what
                                              fraud is, what actions your Local Counter Fraud
                                              Specialists take to combat it and how you can get
                                              in touch with them to share your concerns.
                                              The module only takes around 15 minutes and
                                              we’ll send a certificate to you to prove you’ve
                                              completed it. The module can be found on the
                                              Counter Fraud pages of your local intranet.

Fraudulent Times: Volume 4, Issue 2.                                                                                                              3
                                                                    EAST MIDLANDS             Local Counter Fraud Services

               National Fraud Initiative
Since 1996 the Audit                       were subsequently dismissed or      creditor payments systems. The
Commission has run the                     resigned.                           NFI also now includes a suite of
National Fraud Initiative (NFI), a         Traditional matches also            tests developed to deal with a
bi-annual exercise that matches            continue to identify individuals    range of risks, from duplicate
electronic data within and                 fraudulently working at more        payments and incorrect VAT
between around 1300                        than one organisation, for          payments to potential corruption.
organisations, to prevent and                                                  In addition, bringing trade
detect fraud. Bodies involved                                                  creditors’ payments history
include the NHS; police                                                        together provides information to
authorities; local probation                                                   enable       inter-authority
boards; fire and rescue                                                        comparisons relating to payment
authorities; and local councils.                                               processes and a database to
To date, an estimated £664                                                     check on illegal activity by
million      of   fraud      and                                               suppliers such as price-fixing
o ver p a ym ent s has been                                                    and cartels.
identified from this work, with                                                The aim of these arrangements
the      initiative     gaining                                                is to ensure that, whist
international recognition. The             example with overlapping shift      upholding and protecting
2008/9 exercise alone identified           patterns or working for one         citizens’ rights in relation to their
£215 million in fraud, error and           organisation whilst on paid sick    personal data at all times, the
overpayments.                              leave from another. In total, the   NFI continues to serve the
Recently, the introduction of UK           2008/09 NFI resulted in 181         public interest by:
visa data has added a new                  people being dismissed or           ∗ safeguarding     public money
dimension to fraud detection in            resigning and 269 people being         against losses from fraud or
the NFI, enabling the                      prosecuted.                            corruption; and
identification of a significant            Each year audit ed and
number of employees not                                                        ∗ making        an effective
                                           inspected bodies pay over £200         contribution to the wider fight
entitled to work in the UK who             billion through their trade            against fraud.

  IT’S time for the 2010/11 exercise. More information can be
        found at

                                       Vehicle Usage and Mileage Claims
                         A recent case has highlighted the need to remind staff, authorised
                         signatories and managers of guidance relating to the completion of
                         mileage claims.
                         Staff should pay particular attention when entering their vehicle’s engine
                         size, as this will have an effect on the amount they are reimbursed.
                     Any changes in circumstances regarding vehicle usage
     should be reported to the relevant manager and staff should be aware
     that they are responsible for providing adequate documentary
     evidence, such as insurance certificates demonstrating cover for
     business use to allow the use of their vehicle for business purposes.

Fraudulent Times: Volume 4, Issue 2.                                                                                    4
                                                                EAST MIDLANDS            Local Counter Fraud Services

      Scammers continue to target unsuspecting members
      of the public. During times of economic uncertainty
      and organisational change, incidents of fraud are
      likely to increase. Consequently, a rise in the number
      and variety of scams is expected and staff are
      reminded to be extra vigilant.
      Here are the latest incidents to be aware of:

      Keep Taking the Medicine!
      The Counter Fraud Team has received three separate reports of inappropriate communications
      between a private company and patients regarding their medication.
      Calls have been made to patients, usually elderly, to offer advice on their medications, with the
      patient believing the caller to be either from their health body or local Health Centre.
      In the reported cases, the caller has advised the patient to stop taking essential medication and
      to change to their own ‘much better’ herbal remedy. The patient has then been subject to a
      hard sell and bank details have been repeatedly requested.
      The company has been reported to the Counter Fraud and Security Management Service. If
      staff should hear of further patient contacts of this type please call your Local Counter Fraud
      Specialist- details on page 8.
      Patients are advised to speak to their local community pharmacist or GP before they stop
      taking any prescribed medication, or start taking alternative medications.

      Is Paypal your Pal?
      Yet another PayPal scam is doing the rounds. A notification is being sent out stating that the
      recipient’s PayPal account has been frozen and a security link needs to be selected to restore
      PayPal do not use this method of security check. If recipients respond, the scammers are
      notified that they have reached a live e-mail address and obtain the access they require to link
      into any personal e-bay account (if one is held).
      Readers are strongly advised to delete any such contact and delete it from their e-mail boxes,
      as soon as possible.

      Happy Birthday Microsoft ®
      A new MICROSOFT ® scam is doing the rounds in the format of a competition celebrating
      their 35th Anniversary. An email notifies the recipient that they have won £850,000.00 and to
      receive it they must supply a comprehensive ID list– including name, address, etc. (giving the
      potential for identity theft). They are also asked for bank details to transfer the funds. Readers
      are warned never to give any financial details to an unknown source.
      Microsoft ® would not contact anybody in this way. This is a typical phising scam and any reply
      would confirm that the scammers have hit a live e-mail address.
      Readers are warned to ignore and delete any such contact and delete it from their e-mail
      boxes, as soon as possible.

Fraudulent Times: Volume 4, Issue 2.                                                                               5
                                                                     EAST MIDLANDS              Local Counter Fraud Services

                                Local and national cases
       Fraudster ‘Neighmed’ & Shamed                        specialist CCTV system at her stables was claimed to be
A senior NHS manager, who bought thoroughbred horses        for a hospital CCTV system. Many bills were for stabling
and numerous other goods and services for her private       fees (typically £150 per week per horse) and rent for
stud business with NHS funds, was recently jailed for two   fields and farm buildings. These and other invoices (from
years and nine months at Southwark Crown Court for          innocent suppliers to her horse business) were
defrauding the NHS of over £200,000. The sentence           transformed into invoices for everything from “paediatric
followed an extensive joint investigation by the NHS        services” and “psychological support for breast cancer
Counter Fraud Service (NHS CFS) and the Metropolitan        patients” to payment for “locums” and “administrative
Police.                                                     support” and sundry hospital hardware such as “two
Louise Tomkins, 47, of Faygate, Horsham, West Sussex,       portable washing aid units” (£8,000).
earlier pleaded guilty to one charge of making a false      Her role at the Hammersmith Hospital included acting as
representation, contrary to The Fraud Act 2006, covering    a Fund Advisor for hospital charitable funds, which she
the period July 2007 to September 2008. Sentencing was      also misused, again through falsified invoices, to benefit
adjourned to allow her to achieve the best prices for       her own business.
some of her horses in the Spring horse                                      Tomkins was suspended by Imperial
sales, with a view to the NHS being repaid.                                 College NHS Trust on 23rd September
The Economic Crime Unit of Hammersmith                                      2008 shortly after allegations were first
Police has commenced confiscation                                           made. She was charged at Hammersmith
proceedings to recover the money.                                           and Fulham police station on 11th August
Tomkins abused her positions of trust, to                                   2009 and at a disciplinary hearing held by
divert public money, firstly as a general                                   the Trust on 27th November 2009 she was
manager at the former Hammersmith Hospital NHS Trust                        dismissed for gross misconduct. The
(now Imperial College Healthcare NHS Trust) and then as     investigation also prevented the payment of a substantial
interim Director of Operations for Ealing Hospital NHS      redundancy package of £41,944.00 about to be given to
Trust.                                                      Tomkins, to settle a grievance she had brought against
In order to pay the high costs of her private horse and     the Trust.
stud farm business, she fabricated and manipulated          Even while under investigation, she continued to seek
invoices which she took into work and then authorised for   employment in the NHS using employment agencies,
payment by the NHS. Tomkins ensured her employers           under the guises of ‘Tonka Joud’ and ‘Rosemarie Joud’.
paid for numerous goods and services that the hospitals     Kevin Cane, London Regional Team Manager of the NHS
did not require nor receive, including the import of        Counter Fraud Service, said after sentencing: “This was a
thoroughbred horses and horse semen from world class        very serious matter. Louise Tomkins flagrantly abused
stud farms in several European countries.                   her very senior positions- positions of trust. She
A huge number of invoices for hundreds, or thousands, of    deliberately diverted NHS resources away from frontline
pounds each were doctored by Tomkins, who was               services and patient care for her own gain. Anyone who
imaginative in disguising them as legitimate payments to    seeks to defraud the NHS needs to understand that they
NHS suppliers: she altered one invoice for £3,000 to        will be investigated, and could ultimately go to jail and
claim it was for a “titanium skull cap” for a patient;      destroy their career.”
another to “prosthetic limbs”. A £4,000 bill for a new      Tomkins was prosecuted by the Crown Prosecution
                                                            Service. (June 2010)

                                       Trust calls time on agency worker
An agency worker who was overpaid by over £18,000 after submitting forged timesheets was sentenced on 1st July
2010 at Sheffield Crown Court to 12 months imprisonment. David Steven Sammons, earlier pleaded guilty to four
counts of fraud under the Fraud Act 2006. This followed an investigation by Rotherham NHS Foundation Trust’s
Local Counter Fraud Specialist (LCFS), supported by the NHS Counter Fraud Service (NHS CFS).
Sammons, 30, was employed at Rotherham General Hospital in August 2007 in the hospital’s medical records
department through the Adecco UK Employment Agency. He was required by the agency to submit his timesheets to
them after they had been countersigned by a hospital staff member. Adecco then invoiced the hospital for payment.
In February 2008 it emerged that Sammons had been submitting falsified timesheets with forged signatures. These
included claims for a period after he had finished working for the Trust. Between 10th August 2007 and 29th October
2007 he also submitted timesheets containing false details of shifts he had never worked.
In total, Sammons made false claims totalling £18,000 and made attempts to defraud a further £3,000, which were
blocked as a result of the investigation. The LCFS obtained timesheets and witness statements from staff both within
the NHS and at Adecco and was assisted by Rotherham Police and the NHS Counter Fraud Service’s East Midlands
Steve Guillon, East Midlands Operational Fraud Manager for the NHS CFS said:
“Any suspicions of fraud against the NHS should be reported. They will be followed up and, wherever appropriate,
we will thoroughly investigate, pressing for prosecution and the strongest sanctions.”
In sentencing Judge Robertshaw described the offence as a “calculated, systematic, deliberate fraud”
perpetrated against “a cherished public body providing a valuable service to the nation”. (July 2010)

Fraudulent Times: Volume 4, Issue 2.                                                                                     6
                                                                        EAST MIDLANDS               Local Counter Fraud Services

Honesty is the best Policy!                The subject was requested to              and dishonesty, he had brought the
                                           attend an Interview Under Caution         reputation of his profession into
On 24th June 2008, a referral was          (IUC) to answer all allegations and       disrepute and public confidence in
received by the LCFS for the               provide evidence to the Counter           the regulatory process would be
University Hospitals of Leicester          Fraud team. At the IUC, as from the       undermined if the subject’s fitness
NHS Trust, regarding an agency             start of the investigation, the subject   to practice was not found to be
worker who had admitted to his             offered full co-operation and made        impaired.
agency that he had submitted               a full admission of the offence; he       The panel decided that a caution
timesheets for work at Leicester           also presented mitigating evidence        order be placed against the subject
General Hospital, that he did not          surrounding his personal situation        on the professional register for a
actually complete.                         and health at the time.                   period of 5 years. (July 2010)
The LCFS contacted the agency              As the £3602.49 was repaid to the
involved and the relevant ward             Trust and in view of the subject’s ill
manager to obtain verification of the      health, a decision was taken that no
shifts actually worked by the              criminal proceedings be brought
subject. It was found that he had          against him. However, all evidence
submitted falsified timesheets over        was forwarded to the subject’s
a 3-month period totalling £3602.49        professional health body- the
in value. The LCFS obtained                Health Professionals Council. A
agreement that the subject and             hearing took place on 30th July
consequently the agency, would             2010, where the panel determined
reimburse the Trust in full.               that due to the subject’s misconduct

                                                                              Welcome back to Dawn Pendenque
                                                                              from her maternity leave. Dawn
                                                                              returns to her post in the Nottingham
                                                                              team. However, as one returns one
                                                                              departs, as Laura Hampson recently
                                                                              commenced her maternity leave! We
                               New recruits!                                  wish Laura all the best and look
                                                                              forward to seeing the new arrival!
          East Midlands Counter Fraud Services is pleased to
          welcome our two new Counter Fraud Support Specialists:
          Antony Upton joins with a great deal
          of investigatory experience, gained
          during a varied 9-year career with HM
          Revenue & Customs. His experience to
          date has included work in anti-
          smuggling, VAT, Excise and National
          Minimum Wage compliance, which
          included joint working with the Police
          and other agencies. Antony will be                                   Congratulations
          working with our Leicester team.                                     to our Fraud
                                                                               Team Manager,
                                  Stacey Clarke graduated with a Law           Penny      Gee
                                  & Criminology degree from Keele              (pictured)   on
                                  University in 2007 & completed the           successfully
                                  Legal Practice Course at Nottingham          achieving a BSc
                                  Law School in 2008. She previously           (Hons)        in
                                  worked for the NHS in Clinical               Counter Fraud
                                  Governance, as a Quality and Safety          &     Criminal
                                  Facilitator. Stacey will be working for      Justice Studies
                                  our Nottingham & Derby Teams.                with Portsmouth
                                                                               having     been
                                                                               supported by East Midlands NHS
                                                                               Local Counter Fraud Services.

Fraudulent Times: Volume 4, Issue 2.                                                                                          7
                                                                  EAST MIDLANDS           Local Counter Fraud Services

                                       LCFS CONTACTS
Allan Mason                                              Penny Gee
Deputy Head of Internal Audit                            Local Counter Fraud Team
and LCFS                                                 Manager

Telephone: 0116 225 5968                                 Telephone: 01332 868931
Email:                          Email:
Responsible for – NHS East Midlands.                     Responsible for – Nottingham University Hospitals NHS
                                                         Trust and NHS Nottinghamshire County.

Richard Holmes                                           Gary Roe
Head of Counter Fraud                                    LCFS

Telephone: 0116 295 3166                                 Telephone: 01332 868931
Email:                       Email:
Responsible for – NHS Leicestershire           
County and Rutland, NHS Leicester City, Leicestershire   Responsible for – Derby Hospitals NHS Foundation
Partnership NHS Trust and NHS Bassetlaw.                 Trust, Derbyshire County PCT, NHS Derby City and
                                                         Derbyshire Mental Health Services NHS Trust.

Joanna Clarke                                            Dawn Pendenque
LCFS                                                     LCFS

Telephone: 0116 295 3159                                 Telephone: 0115 9555392
Email:                        Email:
Responsible for – University Hospitals of      
Leicester NHS Trust.                                     Responsible for - Sherwood Forest Hospitals NHS
                                                         Foundation Trust, NHS Nottingham City and Notting-
                                                         hamshire Healthcare NHS Trust.

Matthew Curtis                                           Ruth Leachman-Koko
LCFS                                                     Support LCFS

Telephone: 0116 295 3164                                 Telephone: 01332 868898
Email:                       Email:

Antony Upton                                             Stacey Clarke
Support LCFS                                             Support LCFS

Telephone: 0116 295 3162                                 Telephone: 01332 868898
Email:                         Email:

Fraudulent Times: Volume 4, Issue 2.                                                                                8

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