In conversation with Alex Rothwell, CEO, NHS Counter Fraud Authority

Fraud Focus is a monthly show for the Counter Fraud community, where leading experts in the industry share their insights and opinions on all things fraud

Last month Mark Cheeseman OBE, interim chief executive of the Public Sector Fraud Authority caught up with Alex Rothwell, CEO of the NHS Counter Fraud Authority for an open, honest conversation about Alex’s passion for data sharing; the role that social engineering still plays in a tech-driven world; the need to change our internal culture so that finding fraud is seen as a good thing rather than a failure; and where he thinks future threats may lie. Watch the full interview here.

How did you start working in counter fraud?

I joined the NHS as CEO in November 2021, off the back of a 30-year policing career that began back in the very early 1990s.

My career has gone in many different directions including organised crime, a spell running the Metropolitan Police’s Cyber Crime Unit and I also briefly ran the Fraud Squad there as well. But what really got me to where I am now was my time with the City of London Police and the national lead force for fraud, which helped the Home Office shape the future of policing and their response to fraud.

It was great to work alongside the Home Office and some really great people in policing and the private sector. In many ways this was a good segway to join the NHS, where I think a little bit more commercial focus is required. It’s a big organisation!

Why is fighting fraud important to you?

If I look at this through the lens of the health service – one of the largest employers in the world – we get the largest share of government funding by department. That is a fraud risk in itself, whether you like it or not. If we haven’t got processes in place to deal with that risk, there are obvious consequences and it’s a lot of money that could otherwise be spent on healthcare. In my business every penny you lose to fraud is money that’s not being spent on making people get better.

Do you have any catchphrases or sayings that sum up your learnings from the past 30 years’ experience?

There’s a concept in policing called the Peelian Principles, established by the founder of the Metropolitan Police Service, Sir Robert Peele. He said, “The test of police efficiency is the absence of crime and disorder, and not the visible evidence of police action in dealing with them”. This makes a lot of sense in a policing context, but when you apply it to fraud it makes less sense because fraud is a hidden crime. I think the test of efficiency for fraud is actually the visibility of fraud professionals getting out there and dealing with it - sort of an anti-Peelian principle.

A second one, is something a colleague said recently that stuck with me: “Absence of evidence is not evidence of absence”. It’s easy to say, “We haven’t got any fraud here” if you haven’t actually looked.

What do you see as the some of the current threats? I could list a whole load of specific fraud threats but there are a couple of things that really stand out for me.

In the current climate there are so many risks for governments and businesses: geopolitics, climate change, cyber security etc. and unless we ensure that countering fraud is embedded as a discipline at all levels, my worry is that it will be ignored. In my policing career we always used to ask ourselves, “What’s happening now that I’m not actually aware of?”. We need to have processes in place to look at emerging threats and see what will be on the horizon in the coming months or years. It’s so easy to let that slip.

To expand on the idea of scanning the horizon, what future fraud risks do you anticipate?

I read that the other day that £2 billion worth of cryptocurrency was stolen last year, but it was stolen through social engineering and a lack of knowledge on behalf of the owners. This is a great example of criminals exploiting new, niche subjects that not many people truly understand. These are the sorts of threats that I think we need to keep an eye on, for example AI and identification technologies that can be used to prove who we are etc. We need to work on fraud proofing these technologies as we go and as they come into play, not once they’re already embedded in our day to day.

What do you think are the most important points when it comes to dealing with fraud?

There are a few things that really stand out for me: We need to create really strong cross-departmental functions, just like the Public Sector Fraud Authority, with government-related Fraud Ministers who really understand and support what we’re trying to do, so that they can translate it into really sound policy. We need to change the culture around fraud so that people know

1) Finding fraud is a good thing and 2) we need to accept that there is always going to be fraud. We have to embed both of these in the culture of any organisation, and it’s up to everyone to get this message out there.

Data sharing is the other one that I’m really passionate about and I think that’s probably where the future lies, to tackling fraud at scale. Easier said than done, though, isn’t it? 

Further Information

To watch the full videocast, and to get a monthly Fraud Focus interview delivered straight to your inbox, visit https://register. govnet.co.uk/fraud-focus-episode-4