An inspectorate of the Department for Work and Pensions.

Report

Charter Mark - Awarded for excellence

Appendix C – Counter-fraud measures and processes

Introduction

This appendix looks at some of the counter-fraud processes and initiatives at Ashford during our inspection.

Fraud referrals

Ashford uses a slightly amended version of the BFIS referral form. Benefits staff have a supply of these to complete and pass to the fraud section when they suspect fraud.

The SIO returns referrals to individuals in the benefits section if he thinks they do not warrant an investigation. However, the benefits section is not given formal feedback or training on the reasoning behind referral rejection. Formal feedback and training could help to improve referral success in the future. Greater success rates would encourage more referrals.

Proactive work

Proactive counter-fraud work can help the security of the benefits system by:

finding fraud that might not otherwise have been detected; and

deterring potential fraudsters from attempting to defraud the benefit system.

Ashford refers to past proactive work in its ‘initiatives’ document. The business plan states Ashford's intention to carry out more proactive work.

Ashford has undertaken joint fraud drives with the police and BFIS. Members spoke to us about their wish to see Ashford undertake more proactive work on its own. We recommend that Ashford develops a proactive counter-fraud strategy. This might include reference to the number of proposed proactive exercises in a year, measures of success, and a commitment to evaluating the results of each exercise.

Fraud hotline

Ashford runs its own freephone hotline for fraud referrals from the public. The SIO reported that numbers of calls to the hotline were so few that he added them to figures for public calls to his own direct line. In 2000/01, the combined figure was 15, representing just 6% of the 247 successful referrals that year.

We would expect this percentage to be higher and have doubts about the effectiveness of Ashford’s publicity for its fraud work in general and its hotline in particular. We recommend that Ashford develops its publicity campaign, and that it experiments with different approaches to analyse the effect these have on referrals from the public.

Data matching

Ashford participates in the Housing Benefit Matching Service (HBMS) run by the DWP and the National Fraud Initiative (NFI) run by the Audit Commission.

XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX .

XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX XXXX X.

Fraud files

Fraud files are important because they contain the working papers of an investigation. They are also the source of any sanction that an authority wishes to pursue against a claimant.

We saw examples of good practice in this area. All files sampled had a control sheet, giving details such as the date the case was opened, date closed, whether or not fraud had been established, the type of fraud, value and type of overpayment, and so on. Where relevant, copies of SLA1 and SLA3 forms were retained on file. Our sample showed that all files contained a completed ‘request for determination’ form and a written overpayment determination where relevant.

We were concerned that paperwork was not bound (by treasury tags, for example), raising doubts about the integrity of the file itself. This makes it all the more important that there is a complete log of all work undertaken on file, and of all documentary evidence. Unfortunately, our sample showed that logs were rarely complete and this failing was confirmed by the SIO.

We recommend that Ashford reviews its fraud file system, and in particular considers the use of a tagging method, and ensures that a complete log of actions and documents is contained on each file.

Case management system

A good fraud case management system can be used to provide:

Ashford uses standard reports from the FIMS system to contribute to the Benefits Service monthly performance statistics.

This information was being used to monitor team performance. Our inspection also revealed that although FIMS has a reporting tool, nobody in Ashford is able to use it to produce specified reports.

We recommend that Ashford assesses individual performance and uses its data to generate ideas for improvement and to tackle areas of under-performance. We also recommend that (at least) the SIO is trained how to use the reporting tool in First Software’s fraud system (which is due to go live at Ashford in August 2001).

Training

Following the publication of the Green Paper BEATING FRAUD IS EVERYONE’S BUSINESS: securing the future, BA and LAs were encouraged to establish teams of highly skilled specialist investigators, working within a professional framework to the highest standards or performance and integrity.

To support this, a PINS project was established to provide specialist training for investigators.

Ashford has secured three places on the second round of PINS training for the investigation manager and two VOs. The training started while we were on site. We were encouraged by this commitment to training and by the SIO’s wish to seek funding for another VO.

Liaison with BFIS

BFIS is the BA operational unit responsible for counter-fraud activity. Ashford interfaces with Ashford BFIS team. The SLA covering performance between the two for 2000/01 has been agreed and signed off.

Ashford and BFIS notify each other of all new investigations on SLA1 forms. Outcomes of investigations are notified on SLA3 forms.

DWP has encouraged joint working between LA and BFIS staff by providing funding for joint initiatives. Ashford VOT and BFIS have successfully bid for funding for the last three years, but have only undertaken one joint exercise so far. We discuss joint working further in the main body of this report.

Conclusions

Ashford VOT has many sound procedures to counter benefit fraud. It has undertaken Government initiatives as required by the ‘security’ BVPI. It demonstrates elements of best practice on file management, such as the use of control sheets and formal requests for determination and replies to these requests. The partnership arrangement with Weald Police and commitment to PINS training offer further examples of good practice. We were also pleased with the use of standard reporting from the case management system to provide performance information.

XXXX XXXX XXXX XX

We recommend that Ashford reviews its file management, and that someone is trained to use the new case management system’s reporting tool. We would also like to see the development of a team training strategy.

Previous
Next