Health & social care

Fraud

Capsticks’ Fraud Response team is an established national leader in healthcare fraud response. We work with national bodies, healthcare providers, commissioners, insurers and regulators in ensuring a strategic, efficient and cost-effective response to fraud, recovering losses and preventing recurrence. We have handled some of the most complex and high-profile healthcare fraud cases on behalf of groups of NHS bodies, including cases involving complex financial and clinical evidence.

Our service focuses on the strategic objectives of fraud response, namely recovering losses and preventing recurrence. We ensure that, from the outset, an overall strategy is devised reflecting the strategic objectives and reflecting the potential routes of redress including criminal, civil and regulatory action. 

Cases we have handled include:

  • procurement fraud
  • overclaiming by primary care providers
  • organised multi-party timesheet fraud by employees
  • collusion between employees and contractors
  • fraudulent mis-statement of qualifications and training

Hotline service

NHS bodies can contact Capsticks’ team of senior lawyers specialising in fraud response.  Up to 30 minutes’ advice is available, without charge, to discuss the stage reached in the investigation and the options available to NHS bodies that are looking to recover sums lost through fraud.

For further information please call our fraud team on 020 8780 2211 or get in touch via your usual Capsticks contact.

Investigation

Capsticks’ trained team of investigators (ranging from partners to paralegals) can provide immediate investigatory support and help to prepare evidence to the standards required by a court.

Case planning

Capsticks can prepare an advisory report, focussed on the decisions you will have to make, dealing with the prospects of a successful claim, including further investigations, the prospects of enforcing judgment, the parameters for settlement, and any parallel penalties that are available.

Funding

Costs are rightly a primary concern when contemplating litigation.  Our fraud response service addresses this key issue by making costs as transparent and as certain as possible. We have also introduced innovative risk-sharing options:

  • fixed fees: We will undertake investigatory, advisory and litigation work for a capped fee that is agreed in advance.
  • CFAs: We will enable NHS bodies to mitigate or share risk through conditional fee agreements (CFAs).