Mariela Borisova, Income and Cost Recovery Facilitator, International and Private Patient Services, King’s College Hospital NHS Foundation Trust.
Prior to starting her CIPFA apprenticeship, Mariela Borisova joined King’s College Hospital NHS Foundation Trust in January 2019, as an Overseas Visitors Officer. Her responsibilities included identifying and investigating possible chargeable patients from both the UK and abroad, and deciding on their eligibility for free hospital care. As her role developed, she began looking into potentially fraudulent activities by patients, and initiating preliminary fraud investigations for the trust. As a result, Mariela and her managers decided that further specialist training in counter fraud investigation would be a valuable investment; as the trust was reliant on the services of an external team, developing in-house counter fraud expertise would provide the department with a more efficient, timely and effective investigation process.
‘In order for me to be the preliminary investigator, I really needed more knowledge and experience in the area, so I began to research suitable training providers,’ Mariela explains. ‘That’s when I discovered CIPFA’s Level 4 Counter Fraud Investigator Apprenticeship. I recognised immediately that this was the course for me – and I haven’t been disappointed.’
Mariela embarked on the two-year apprenticeship programme in April 2022, and welcomed its blended learning approach, which is tailored to promote the development of professional standards, knowledge, skills and behaviours essential in the field of counter fraud investigation. In September 2023, while on the programme, she was promoted to her current role as Income and Cost Recovery Facilitator.
Satinder Mann is Overseas Visitors Supervisor at King’s College Hospital as well as Mariela’s apprenticeship supervisor, and is a keen advocate of the CIPFA programme. ‘It is a huge asset to the team to have a dedicated person to carry out the initial investigation when there is a potential fraud scenario,’ she says. ‘So-called “health tourism” and patient fraud is very common when it comes to overseas chargeable patients, so having her wealth of knowledge and skills is highly beneficial to us.’
For Mariela, protecting the public purse is vitally important, and she enjoys dealing with the varied aspects of investigations in her role – and the challenges they present. ‘It’s a very interesting job and has been since day one,’ she says. ‘It can be very intense, but the problem-solving side is very engaging, and I can also apply my communications and language skills.’
Mariela says the structure of the apprenticeship and its focus on delivering dynamic, relevant and innovative training has been beneficial throughout the course. ‘It's been really useful for me because I can implement some of the knowledge skills and behaviours I've acquired from the tuition sessions straight away – for example, around the legislative requirements and different forms that are being used. But the main thing is, I've been shown how to plan and carry out fraud investigation, so I can be more independent – my managers can rely on my findings, and we can present the case to the local counter fraud team without having to go back and forth, ensuring the whole process is more efficient.’
Satinder concurs: ‘Mariela’s main role now is to investigate any fraud, and she will advise any team if there are any issues or concerns around potential frauds. She is so dedicated and will always go the extra mile in investigations to find answers. She is always very keen and highly motivated, and that is reflected in her achievements – and in her recent promotion while taking the course.’
The apprenticeship programme has not only enhanced her technical knowledge, Mariela explains: ‘I've developed my analytical critical thinking, too, and I have managed to better work in collaboration – I now know who the key players are and who our partners are in the fraud sector.
‘My knowledge about legislation has increased immensely since the beginning of the course. But remaining focused and keeping an open mind is a very specific skill that I feel I have developed, because I can now decide my cases much quicker – I can clearly see where the case is developing and can present the case to my managers instead of asking them for initial advice.’
Among the aspects of the programme Mariela has enjoyed most has been the practical training. ‘The face-to-face training was really interesting and eye-opening, because you have to react very quickly on the spot and be focused. At the same time, working in collaboration with my peers on the course was very enjoyable. We have very useful discussions during the sessions looking at various types of fraud we encounter, and because each of us works in a different area of the public sector, we can expand our knowledge and see specific types of fraud from a broader sector-wide perspective.’
Mariela believes the CIPFA Level 4 Counter Fraud Investigator apprenticeship provides the depth of knowledge and expertise needed to pursue a career in this fast-developing field, while also delivering the skills needed to enhance her current role.
‘I’m still at the beginning of this journey,’ she says. ‘Fraud is a major problem, not just in the UK but also all over the world, and it’s an area where there is a huge amount to be done. While I currently deal only with patient fraud, all cases are different from each other, which makes it counter fraud extremely interesting. I sometimes discuss some of the aspects of my cases with my tutors, and I find it really helpful for my job to have that knowledge and expertise on hand for advice.’
Working within a healthcare environment, Mariela acknowledges the sensitivities of potential counter fraud investigations with overseas patients treated within the NHS, and the challenges of dealing with people who may be vulnerable. However, it is an area she is keen to specialise in as her career progresses. ‘People are generally not that aware of the issues around this, so there are a lot of opportunities to educate colleagues and raise awareness.’
For Mariela, the apprenticeship journey has been both challenging and fulfilling. ‘I would definitely recommend the CIPFA Counter Fraud Investigator apprenticeship to anyone,’ Mariela says. ‘It’s intense – in a good way – but also immensely rewarding. The training is very structured, we have deadlines, and there’s a blend of practical and written work. There is the opportunity to research and learn about different parts of legislation, but the framework also enables you to acquire more knowledge around your specific role, and to apply the results of that learning in your day-to-day duties and our investigations.’
Satinder Mann endorses that view: ‘The CIPFA Counter Fraud Investigator apprenticeship is a fantastic opportunity to gain invaluable skills and knowledge. But as well as a great opportunity for personal development and career progression for the individual, having someone on the programme who is highly motivated like Mariela has been beneficial for the team, our wider department and the trust generally. I would wholeheartedly recommend it.’
And Mariela’s advice for those considering a CIPFA apprenticeship? ‘Choose the apprenticeship that’s applicable to your role, and don’t let yourself be overwhelmed by the prospect of the assignments, workbook tasks and deadlines – enjoy the journey, because it is a great experience.’