Interviews of Doctors in NHS Counter-Fraud Cases
The NHS investigates allegations of fraud perpetrated against the NHS by its employees. Doctors might be investigated for fraud occurring in their workplace or in relation to moonlighting when they should be at work or in relation contracts that they may have been involved in to provide services to the NHS. NHS Counter-Fraud can investigate any loss to the NHS or alleged dishonesty relating to contracted hours or services, whether relating to contracts for services or contracts of service, or other contracts.
A doctor who is suspected of committing fraud will usually be invited to attend a voluntary interview, to explain themselves. If they have acted in a manner that is dishonest or they have failed to carry out their duties in a manner that was honest, and their conduct (by act or omission) has caused intentional loss to the NHS, the doctor will be confronted with the evidence during the interview.
A doctor, prior to their voluntary interview, is entitled to a certain amount of information about the allegations, called ‘Advance Disclosure’. From this disclosure, the doctor will have a broad understanding of the case that is being investigated, and the likely scope of the questions they will face.
A doctor is not obligated to attend a voluntary interview with NHS Counter-Fraud. However, a failure to do so could lead to a formal arrest by police, who have the power to hold an interview. for more information on interviews conducted by the police, see our article: Police Interviews with Doctors. That article also has some relevance to how NHS Counter-Fraud interviews are conducted. The more serious the allegation the greater the likelihood of police involvement.
An involuntary interview might also be the opportunity for a doctor to clear their name. We have attended a number of interviews with doctors, who have been cleared of wrongdoing. Good preparation for the interview is key, and we can advise doctors on how to prepare for interview, by compiling tables and analysis for the interviewing officer.
In some cases doctors have made errors but they have not acted dishonestly. Following our involvement, fraud investigations have been closed following a voluntary interview, because we have assisted the doctor to evidence their innocence. Doctors are generally not inherently dishonest, and a careful explanation or formal statement can go a long way to demonstrate that there is no case to answer.
See our other articles, for more information on NHS Counter-Fraud Investigations. It should be noted that a number of NHS Trusts now sub-contract fraud investigations work to third-party commercial companies. Investigators must act professionally and fairly. Many such investigators are ex-police officers, with significant experience of interviewing suspects. They will be knowledgable about the Police and Criminal Evidence Act 1994 (known as PACE) which governs the way interviews are conducted. A letter sent to a doctor will usually mention that the interview is to be conducted under PACE.
PACE procedures offer procedural safeguards to doctors but can also lead to adverse inferences being drawn, if certain types of questions are not answered by the doctor. It is therefore not always wise to go ‘No Comment’. The counter-fraud interview is there to clear up misunderstandings as much as it is to explore whether the doctor has committed a criminal offence. Many doctors remove suspicion by participating in PACE interviews, and we would recommend in most instances that a doctor should attend them. However, due to the technical nature of interviews we would recommend that all doctors are legally represented.
Doctors can also be investigated for submitting a false CV to a NHS employer or potential employer (which would be a form of criminal fraud), and so great care should be taken in relation to all documentation that is submitted to the NHS. Dishonesty allegations and criminal convictions for fraud can also be referred to the GMC. Allegations can also be submitted to the Performance Advisory Groups (PAGs), where a doctor is on the GP performers list.
If you are a doctor facing a police or NHS Counter-Fraud interviews, call us without obligation on 0800 10 88 739 to discuss our legal advice and representation services.