An initiative, which will focus on preventing fraudulent and mistaken patient claims for exemption from dental treatment costs under the NHS Tax Credit category, will be launched in September 2015 by NHSScotland Counter Fraud Services (CFS).

NHSScotland, under the Family Health Services banner, provides Medical, Optical, Pharmacy and Dental services in Scotland. Charges are payable for receiving most treatment for Optical and Dental services, unless the patient is entitled to an exemption from, or help with paying them.

The NHS Tax Credit exemption category was highlighted as an area of concern from CFS patient exemption checking data which identified that approximately £3.25m was lost to fraud and error in Scotland last year.

Working initially on a pilot basis within Forth Valley, the project will see members of the CFS team visit dental practices across the area to reinforce the important prevention role that practice staff can play in reducing claims made wrongly by patients.

CFS has a dedicated patient claims team, which is responsible for checking exemption claims. Claim details are checked with relevant agencies, e.g. Department for Work and Pensions (DWP) or HM Revenue and Customs (HMRC). If an exemption cannot be confirmed, patients are contacted and requested either to provide proof of their entitlement or to pay for their treatment. If proof or payment is not forthcoming, this could result in a penalty charge and surcharge being added to the statutory charge for the service provided under the NHS (Penalty Charge) (Scotland) Regulations 1999.

The CFS initiative is consistent with the Scottish Government’s counter fraud strategy entitled “Protecting Public Resources in Scotland”. The strategy, launched in June 2015, signals an enhanced emphasis on prevention as part of efforts to combat financial crime.

Fraser Paterson, National Counter Fraud Prevention Manager, at CFS said, “It was Benjamin Franklin back in the 1800s who coined the phrase, ‘An ounce of prevention is worth a pound of cure’.

In current times of financial austerity, that message is perhaps more relevant now than it’s ever been and we welcome the Scottish Government’s enhanced prevention message.

This initiative intentionally focuses on prevention and not monitoring and enforcement. We believe that a well supported, planned and coordinated venture of this type can significantly reduce the amount wrongly claimed by patients for this category of dental exemption.”

For further information, please contact:

Stephen Frier
Communications Manager, CFS
Tel: 01506 705240
Mobile: 07717 881894