Doctors’ Job Plan Fraud in the NHS

Doctors and Allegations of Job Plan Fraud

Senior doctors in the NHS are required to work to job plans. While the NHS Job Plan system can be highly productive in practice, the requirements can also be burdensome and feel at odds with the working life of a doctor. In turn, any failures to adhere to job plans can lead to concerns being raised about a doctor’s alleged lack of commitment to the timetabled activity, and on occasions significant criticism where a doctor has actively chosen (without permission for the variation) to work to a different programme of work, or they have not met their job plan requirements at all.

In some instances, a doctor will have received an income for work that they did not do, albeit they may have a genuine and good faith explanation that it was due to the pressure of work, and the competing interests of patients, staff, departments, and their own work. Striking the balance in the interests of getting through the week may be reasonable when under pressure in a given week, but if the NHS cannot easily verify whether the doctor has earned more than they are entitled to, they might face a fraud investigation. Where a doctor is considered to have received income that they were not entitled to, or where a doctor has worked elsewhere for pay during a period that they should have been working within another employer’s agreed job plan timetable, they might face an investigation into whether they have committed fraud.

The NHS Counter Fraud Department will usually be invited by an NHS hospital to investigate the concerns raised. They will often invite a doctor to a PACE interview to answer questions, and we would recommend that a doctor attend with a legal representative in all instances that they choose to attend.

A doctor might, in some instances, be arrested if the fraud is serious and the doctor refuses to attend a PACE interview. Nevertheless, on occasions, it will be possible to answer questions in a typed statement, without attending an interview, and it might be reasonable to decline a PACE interview. However, non-attendance at an interview might reduce the prospects of legitimate, nuanced answers being asked/given that allow follow-up by the interviewer and, ultimately, a decision that there is insufficient evidence of intent.

Doctors Defence Service can provide a representation in interviews conducted by the NHS Counter Fraud Authority. For more information about NHS Counter Fraud interviews themselves, see our article: Doctors Facing NHS Counter Fraud Interviews

Job Plans In Practice: Programmed Activities (PAs) and Supporting Professional Activities (SPAs)

A doctor will often need to agree a job plan annually. In some instances, there will be a job plan variation every year. However, in many arrangements, a job plan will be considered effective and workable and so might stay in place, by agreement, for many years. Usually, a formal sign-off of a job plan is required before the employer and employee can rely on it and hold each other accountable for any departure from it. The lack of sign-off can lead to confusion, on some occasions, and there may be a misunderstanding as to which job plan is in force at a given time.

Also, a doctor might, due to the pressures of work, arbitrarily and without agreement, change their times or days for completing Programmed Activities (PAs) or  Supporting Professional Activities (SPAs), and later be challenged by the NHS about having done so.

In some instances, a doctor may have worked elsewhere during the PA or SPA scheduled timeframe, without agreement with one or both employing parties, and then be suspected of having committed fraud against one or both.

Timesheet Fraud

Where a doctor submits an inaccurate timesheet, or fails to update a timesheet to reflect breaks taken or their going home early, they might subsequently face accusations of ‘timesheet fraud’ in the NHS. A failure to work to a job plan can lead to dismissal for gross misconduct, as can a fraudulent act or omission.

Legal Support, Legal Advice, Legal Representation in Job Plan Fraud Cases

If you are a doctor facing criticism or challenge about an NHS job plan that might lead to a fraud investigation or prosecution, Doctors Defence Service can assist. Call us on 0800 10 88 739 for a no-obligation discussion about the provision of legal advice and representation, and attendance at NHS Counter-Fraud interviews.