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The Alarming Reality of Fraud in Healthcare

The Alarming Reality of Fraud in Healthcare

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The Alarming Reality of Fraud in Healthcare

30 Jan 2017 administrator

The appeal of overseas job opportunities and the ongoing shortage in professionals to meet enhanced investment in infrastructure and social services has created a lucrative market for unqualified individuals to embellish or forge their academic or professional documents, taking advantage of the prevalent need to bridge the gap between supply and demand. In countries that import labour to support future growth and development, this trend is creating an increasingly acute problem.

In recent years, nearly 87% of new overseas registrations in the United Kingdom have come from the European Economic Area (EEA), with British medical professionals topping the list of ‘Negative’ cases at 52%[1]. With regards to foreign labour, an investigation by The Guardian found that aggressive recruitment sees doctors from at least 27 countries hired in 32 of the 160 hospital trusts in England[2] – a figure that is only set to grow moving forward. In 2014, the National Health Service (NHS) alone employed 150,273 qualified doctors, 377,191 qualified nurses, 155,960 qualified scientific, therapeutic and technical staff and 37,078 qualified managers[3] within its extensive network of provider and commissioner organisations. This being said, if we consider the possibility of document forgery, we will find that there is a significant number of unqualified healthcare professionals currently practicing in the United Kingdom.

With the healthcare sector in the United Kingdom and the world at large evolving at such a rapid pace, ensuring that medical professionals have the skillset, expertise and ethics they claim has become of paramount importance. This is especially true in critical sectors such as healthcare where potential repercussions of malpractice could be fatal, and could also lead to lawsuits and loss of credibility for employers, regulators and governments alike – yet another concerning issue.

To put things into perspective, since 2013, the DataFlow Group has screened 375,000 doctors, nurses and allied healthcare professionals migrating to work in the Gulf Cooperation Council (GCC) region. More than 10,000 of those were found to have used fake or misrepresented academic credentials, professional licenses or work history in their visa or licensing applications. Nurses were the most likely to misrepresent their backgrounds, with 4.4% of applicants having a negative background screening result, followed by allied healthcare professionals such as a pharmacists and medical technologists, coming in at 3.8%[4]. The most commonly misrepresented information received from nurses and allied healthcare workers was employment history, particularly the tenure, position and type of institution stated in their work experience. Alternatively, physicians were more likely to have negative results related to false academic credentials.

The issue is deeply unsettling for the healthcare sector in particular, not only in the GCC region, but also globally, especially given the alarming rise in diploma mills – unaccredited universities and colleges that sell effectively worthless degrees, often without any previous requirements from students. Further complicating efforts to effectively screen job applicants, governments and regulators have traditionally relied on a system of notarisation and Apostilles to ensure documents presented by migrant workers are genuine. This approach is flawed in that a notarisation only attests that a copy of a document such as a diploma is a true likeness of the original. It does not guarantee, for example, that a diploma itself is real, the person whose name is on the diploma attended the school or that the institution granting the qualification is recognized by a competent authority.

On the other hand, notarisation can also be faked. Most of the counterfeit documents the DataFlow Group has uncovered are imprinted with ‘genuine’ stamps, attestations and endorsements. The Hague Conference on Private International Law – an international organization facilitating agreements on legal matters – expressed serious concerns about the potential abuse of notarisation, saying: “An official looking certificate may be issued to a copy of a diploma mill qualification, and then subsequently issued with an Apostille, without anyone having ever verified the signature on, let alone the contents of, the diploma. The addition of seals, certificates and Apostilles lends credibility to these documents in the eyes of those who are unaware of what is actually being certified.” The common misconception that ‘original’ documents are equivalent to primary source authentication is at the core of the matter.

To safeguard against employee fraud and misconduct, an advanced screening methodology – namely Primary Source Verification (PSV) – was introduced. As the term indicates, PSV refers to the attainment of data directly from the issuing source. As such, this guarantees optimal information accuracy and integrity, and ultimately helps organisations – particularly those within the healthcare sector – avoid possible regulatory implications, reputational damage, financial losses, and most importantly, internal risks that could pose a threat to the physical wellbeing of patients. The problem is, however, that until this day, many governments and regulators continue to utilize to a large extent online portals to conduct verifications. Understandably, these lack a robust PSV element as they rely purely on checking only against digitised documents as opposed to approaching the original source or issuing authority.

The best way to ensure that both medical institutions and practitioners maintain excellent quality standards and serve their respective communities to the best of their abilities is by affirming and sustaining integrity, competence and professionalism across all levels of the value chain. This can only be done with such effectiveness by leveraging the most rigorous verification solution available to date – PSV – thus enhancing the overall level of care within the healthcare sector and ultimately protecting global communities.


[1] Royal College of Nursing: RCN Position Statement on International Recruitment

[2] The Guardian: Denis Campbell, Haroon Siddique, Ashley Kirk and James Meikle. Wednesday 28 January 2015: http://www.theguardian.com/society/2015/jan/28/-sp-nhs-hires-3000-foreign-doctors-staff-shortage

[3] NHS Confederation Key Statistics: http://www.nhsconfed.org/resources/key-statistics-on-the-nhs

[4] Arab Health Magazine: Combating the Challenge of Counterfeit Documents, May 2016: http://www.arabhealthmagazine.com/press-releases/2016/issue-3/combating-the-challenge-of-counterfeit-documents/

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