Practice manager Karen Evans was jailed for three years this month after stealing nearly £700,000 from two GP surgeries in Greater Manchester, which forced doctors out of their jobs.
Meanwhile, practice manager Carolyn Lightwing was jailed for two years after defrauding the surgery she worked for in York of almost £600,000.
In response to the cases the Association of Independent Specialist Medical Accountants (Aisma) warned that accountants were not engaged to spot fraud and may only identify it when preparing the end of year accounts, by which time it would be too late.
The body recommended that GPs should keep on top of the practice finances throughout the year, not just once a year when they and their practice manager are preparing information to send to their accountant.
Aisma also offered the following advice to GP practices on how to avoid fraud.
Tips on how to avoid insider fraud
- Don’t let any one person be the sole signatory on the bank account for amounts over a set level – for most practices a sensible figure would be between £500 and £1,000.
- The person approving the invoices should not be the person making the payments.
- Invoices should always be reviewed by the person approving the amounts to be paid. Be careful not to approve both the invoice and the statement to create a double payment.
- The partner responsible for staff should review salary payments before they are made to check for unknown names or unusual payments. In particular check for unexpected pay increases or overtime.
- Review your locum payments regularly and investigate unrecognised names. Insist on accounting records disclosing who the locum is covering for and why.
- Have a detailed budget and compare with actual figures monthly, or at least quarterly, to pick up anything unusual. For example, use key ratios to check that drugs costs v reimbursements are on track. Drugs, medical consumables and staff wages/locum costs are usually the easiest places to hide fraudulent payments.
- Use a specialist medical accountant who will break down income and expenses in suitable detail and question movements that seem unusual. If you don’t understand your accounts because there is not enough detail, potential fraud is harder to identify.
There is more advice on how to prevent fraud in your practice available to subscribers to our sister site Medeconomics here.