Once or twice a year between about 2000 and 2010, when I was practising as a solicitor, I represented pharmacists who were prosecuted in a criminal court accused of defrauding the NHS.

Typically, they were accused of endorsing prescriptions for E45 cream to claim for the supply of small pack sizes when less expensive large tubs had been supplied. Alternatively, they were accused of not submitting prescription forms for inexpensive medicines to profit from the difference between the prescription charge and the NHS reimbursement. Most of my clients were acquitted. Indeed, the conviction rate was so low that the NHS counter fraud authority (NHSCFA) stopped bringing prosecutions.

Read more: Government to target pharmacy contractor fraud under new strategy

If a few pharmacists did defraud the NHS over pack sizes or not submitting prescription forms, those frauds can no longer be committed because of electronic prescribing and because E45 cream is no longer prescribed on the NHS. However, a recent Department of Health and Social Care (DH) policy paper sets out pharmacy contractor fraud as a priority area for its new counter-fraud strategy, relying on data from a 2022 NHSCFA assessment that says the sector is "vulnerable" to fraud worth £122 million a year.

I have previously commented on bogus statistics of this kind. It is simply a percentage of total NHS expenditure on pharmacy. It is obvious to you and me, but evidently not to the NHSCFA, that it is possible to know the amount of fraud that is detected, but not the amount of fraud that is not detected. In my view, the NHSCFA is just plucking a figure from the air to justify its existence.

I am not saying there is no fraud at all. There is likely to be a rotten apple in every barrel, but the NHSCFA assumes that because there is a risk of fraud, fraud must be being committed. In particular, it focuses on the opportunity to make exaggerated claims for payment and an increase in the number of allegations of fraud it had received.

Why should we assume that pharmacists take advantage of such an opportunity? Allegations are plainly not proof that fraud has been committed. It seems reasonable to expect the NHSCFA to have investigated these allegations. If they were found to be substantiated, I am confident we would have been told about them.

If you look at the NHSCFA’s website, you would have to go back to October 2019 to find a report of a pharmacist convicted of fraud. He had supplied medicines in tablet form but claimed reimbursement for supplying a more expensive liquid form. That fraud totalled £76,000. When C+D reported the court case, it revealed it had found only one other pharmacy owner had been dealt with for fraud in the preceding 18 months.

Read more: NHS to pay company £750k to crack down on alleged pharmacy fraud

The NHSCFA’s accounts for 2021/22 show that it cost the taxpayer about £14m. Is that value for money? It is too late for the 2022/23 report, which is due out very soon, but I would like to see future annual reports from the NHSCFA provide the same kind of information that the General Pharmaceutical Council (GPhC) provides in its annual reports. This includes information like the number of allegations received, the number of allegations investigated and the number of referrals to a fitness-to-practise (FtP) committee as well as the number of prosecutions in a criminal court and the outcomes of prosecutions.

With that kind of information, we may be able to see whether the NHSCFA really is providing value for money and can genuinely justify its existence.

David Reissner is a solicitor and chair of the Pharmacy Law & Ethics Association