Fraud Prevention and the Benefits of Record Keeping
8 minute read
What you will learn
- Define fraud and give examples in pharmacy practice
- Describe techniques that prevent prescription, stock and cash fraud
- Explain the principle of separation of duties
- Define a record and list the records kept in a pharmacy
- State the benefits of record keeping
- Say what to do when fraud is suspected
Key points
- Fraud is dishonest deception for gain. In pharmacy it can involve prescriptions, stock, cash and records.
- Prescription fraud includes forged, altered or stolen prescriptions and repeated use of the same prescription.
- Prevention rests on checking, recording, separating duties and counting regularly.
- No one person should receive, record, bank and check the same money or stock.
- Records give accountability, show what stock and money there should be, and help trace problems.
- Records are also needed for ordering, audit, recall of faulty batches and legal reasons.
- Suspected fraud is reported to the pharmacist or manager, not handled alone.
What is fraud?
Fraud is dishonest deception to gain something unfairly, such as money, stock or medicines. A pharmacy is at risk because it holds stock that has value and can be sold, handles cash, and receives prescriptions that can be copied or altered.
Where fraud happens
| Area | Examples |
|---|---|
| Prescriptions | Forged prescriptions, altered quantities or doses, stolen prescription pads, the same prescription used at several pharmacies, or a repeat prescription used again and again |
| Stock | Theft, issuing without a record, false counts, "ghost" issues to units that did not receive anything, and selling stock for personal gain |
| Cash | Money taken from sales, sales not recorded, receipts not issued, and false expenses |
| Records | Altered entries, missing pages, and forged signatures on vouchers |
| Suppliers | Short deliveries, goods of the wrong quality, or false invoices |
Techniques to prevent fraud
Prescriptions
- Check the prescription for signs of alteration, such as different handwriting or ink, or changes to the dose or quantity.
- Check the prescriber's name, signature and registration details, and that the date is recent.
- Be careful with new patients asking for strong painkillers, sedatives or other medicines that can be abused.
- Record the prescription, and mark it when it has been dispensed, so it cannot be used again.
- Phone the prescriber if you are unsure.
- Keep controlled drugs in a locked cupboard, with a register that is checked.
Stock
- Count stock regularly, and compare it with the ledger.
- Use bin cards and issue vouchers for every movement.
- Lock the store, and keep the keys with an authorised person.
- Do not allow bags into the store.
- Carry out surprise checks.
Cash
- Issue a numbered receipt for every sale, and keep the copy.
- Count the cash with a second person.
- Bank the money regularly and intact.
- Check the bank statement against the cash book.
- Never mix personal money with the pharmacy's money.
Separation of duties
The most important rule: no single person should control all the steps of a transaction. For example, one person receives the stock, another records it, another issues it, and another checks the count. A loss or a false entry is then more likely to be seen.
Other helpful steps:
- Rotate duties now and then.
- Have all voucher entries signed.
- Audit the records by someone who does not keep them.
- Create a culture of honesty, where staff know that checks are routine and that they can raise concerns safely.
What to do if fraud is suspected
- Do not accuse anyone or act alone.
- Keep the evidence, such as the prescription or the record.
- Tell the pharmacist or manager at once.
- Write down what you saw, with dates, times and names.
- Follow the pharmacy's policy, which may include reporting to the regulator or the police.
What is a record?
A record is a written (or electronic) account of something that happened, kept for later use. In a pharmacy, records include prescriptions, stock cards, vouchers, books of account, and registers of controlled drugs. The following lessons describe the main ones.
Benefits of record keeping
| Benefit | Why it matters |
|---|---|
| Accountability | It shows who did what, and where stock and money went |
| Control of stock | It shows what is in stock and what is needed |
| Better ordering | Past use is the basis for the next order |
| Detecting loss and fraud | Differences between records and stock show a problem |
| Patient safety | A dispensing record shows what a patient was given, for follow-up |
| Tracing and recall | Batch records let a faulty batch be found and withdrawn |
| Legal and audit needs | Records prove that rules were followed |
| Planning and budgeting | Totals show costs and use over time |
| Continuity | A new worker can take over, using the records |
Good record keeping
- Write clearly, in ink, with the date and signature.
- Record at the time things happen, not later from memory.
- Never erase or use correction fluid. Cross out with a single line, write the correction, and initial it.
- Keep records safe and for the time required by the rules.
- Keep copies of important records in a different place.
Exam focus
- List three examples of fraud in pharmacy and one prevention technique for each.
- Explain separation of duties.
- List the benefits of record keeping.
- Common mistake: thinking that fraud is only theft of cash. Prescriptions and stock are also at risk.
Quick check
Test yourself before you move on. Pick an answer to see the explanation.
1.Which is an example of prescription fraud?
2.Separation of duties means:
3.Which of these is a benefit of keeping records?
4.A prescription for a strong painkiller looks as if the quantity has been changed in a different pen. The dispenser should:
5.Why are batch numbers recorded when stock is received and issued?