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Memorandum of Understanding between the NHS Counter Fraud and Security Management Service and the Crown Prosecution Service

Appendix 2 - Particular aggravating factors in offences involving NHS staff or on NHS premises


There is a strong public interest in maintaining the effective provision of healthcare services and prosecutors should always consider whether the offending behaviour has further aggravating features relating to this.

Examples of such aggravating factors in such offences would include:

  • the withdrawal from service of an emergency ambulance and the potential for harm this may cause to those in urgent need of this service
  • the withdrawal of staff from active duty in accident and emergency units and the resultant reduction in service
  • the vulnerability of staff working in the community, particularly those who work alone or at night
  • the potential impact of patients in mental health and learning disability units and the effects that being exposed to such behaviour may have on them.

Consideration should also be given to the fact that there are high levels of violence and unacceptable behaviour in the NHS (see paragraph 3.2) and the following factors from the Code for Crown Prosecutors may be applicable:

  • there are grounds for believing that the offence is likely to be continued or repeated, for example, by a history of recurring conduct; or
  • the offence, although not serious in itself, is widespread in the area where it was committed
  • a prosecution would have a significant positive impact on maintaining community confidence.

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