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London Borough of Croydon: Tackling health tourism and those with no recourse to public funds fraud

The bid was based on a proactive review of two fraud risk areas, no recourse to public funds (NRPF) and health tourism. In NRPF the classification of destitution has meant that councils from London and the metropolitans have tended to place in regions where housing and associated costs are cheaper. This undoubtedly saves considerable funds but can increase the risk of fraud by creating a perception of being ‘left to their own devices’ that distance inevitably creates.

Issues, challenges and barriers

The NRPF work has required only the data and resources of the council and has proved easy to organise and implement. The joint work with NHS colleagues has proved difficult to progress, with objections raised initially by NHS Information Governance staff and then from the Cabinet Office’s National Fraud Initiative (NFI) team with whom NHS and the council were unable to agree a privacy impact assessment. The issue being the definition of patient data.

Outputs and outcomes

The NRPF work has progressed well and the funding has enabled investigators located in both of the out of borough locations used by the council. As a result investigators have carried out unannounced visits to all out of region NRPF placements in Wolverhampton and Birmingham twice. Despite an increase in demand for NRPF in Croydon there has been a reduced caseload since taking this proactive approach. At the point of the funding bid in 2014, there were 120 live NRPF cases. Over the four years since using the Counter Fraud Fund (CFF) to proactively verify both residency and circumstances the council has opened 61 cases for investigation, with seven resulting in withdrawn or reduced support and one investigation ongoing.   


The impact has arguably been half what it could have been in that a part of the project has yet to happen with the local NHS partner. The NRPF work has been highly effective, both in terms of money saved as well as the less quantifiable benefits that such a programme of long distance visiting can achieve. Officers heard comments such as ‘I didn’t know you could just turn up’ and ‘I thought Croydon had abandoned us here’ that suggested that timely visits had not previously been possible. Some of the NRPF cases may have crossed that line into fraud and the council has succeeded in preventing that.

Size of grant

£77,430 with savings of £89,600 yielding a RoI of 1.2.

Contact details

David Hogan, Head of Anti- Fraud, London Borough of Croydon, [email protected]