Counter Fraud - Drug seekers
Wessex LMCs hosted a meeting with NHS Counter Fraud services to discuss the issue of patients who try to obtain drugs (usually opiates and benzodiazepines) under false pretences. This is a summary of some useful points we believe are worth sharing with practices across Wessex
- Some patients may use a totally false identity whereas others may just change their date of birth slightly or use a false address or a false story or 'legend' e.g. on holiday and left medication at home, going abroad for extended period, medication/prescription lost or stolen, relatives deceased or very ill.
- False registrations may be temporary or permanent. The previous registration details provided are often false i.e. GP doesn't exist or patient never registered with them
- The types of drugs requested are normally benzodiazepines and/or opioid analgesics, often 'piggy-backed' onto more innocuous requests. The patient maybe very knowledgeable about the drugs they are requesting and know the contra-indications if less addictive drugs are offered as an alternative
- False registrants will normally request to be seen immediately and are unlikely to return for a new patient health check or further consultations, they will also normally fail to attend any referrals to secondary or specialist care
- Some prolific false registrants are well practised con-artists and therefore appear polite, confident and genuine. Appearance and manner cannot be used to judge whether patients are authentic, this can only be based on the evidence available (so the more evidence the better!)
- The advice is not to prescribe any benzodiazepines and/or opioid analgesics for new patients without reference to the previous GP, medical notes or the Clinical Application Spine. It is suggested that the patient be asked to take a seat in the waiting room or come back later whilst these enquiries are made. If the patient is not genuine they are unlikely to wait around or return.
- If this is not possible and prescribing is unavoidable, we would suggest that the patient only be given sufficient medication to allow their story to be checked i.e. 24 or 48 hours supply
- Please report suspected false registrations to their LCFS, giving as much detail as possible. The details of these patients can then be circulated and all related incidents can be collated by the Counter Fraud Service to identify serial offenders.