Two NHS managers have been sentenced in the space of a week for lying to get jobs - with one former primary care trust director jailed for three months.
The cases have prompted concerns that trusts may regularly be failing to check credentials, raising the possibility of undiscovered fraud across the health service.
They have also revived calls for the introduction of a formal accreditation system for managers.
Former Stoke on Trent PCT director of planning and service modernisation Lee Whitehead was sentenced to 12 weeks in prison for lying that he had an MSc in clinical psychology and a doctorate in psychology.
The 44-year-old father of two from Buckinghamshire also falsely claimed he was a chartered psychologist and full member of the British Psychological Society.
Mr Whitehead resigned in August 2007 ahead of a planned disciplinary hearing and as a criminal investigation continued.
Yet he was hired again on a short-term contract as associate director of programme delivery at Northamptonshire teaching PCT four months later. He was asked to leave in July 2008 when the PCT learned of the situation. The PCT refused to say whether Mr Whitehead had repeated the false claims or whether a reference had been sought from Stoke.
Two days after Mr Whitehead's sentencing, 41-year-old Attah Okoji was given a six-month suspended prison sentence and a 100-hour community punishment order.
He had admitting lying to get temporary work in three separate stints as an assistant human resources manager at Northumberland, Tyne and Wear Mental Health trust.
Mr Okoji had failed to declare his past criminal convictions, also for defrauding the NHS, in 2001 and 2004, to an employment agency which sent him to the trust.
NHS Employers - which published new guidance on recruitment checks last year - insisted trusts generally have correct procedures.
Joint acting director Alastair Henderson said references should always be checked but with qualifications trusts had to consider relevance to the role and the risk posed to patients.
"Alongside that there is the issue around honesty and probity [if it emerges that an individual has lied]," he said. "There is no evidence that employers are not by and large following all the guidance."
But others suggested failure to check may be more widespread.
Managers in Partnership chief executive Jon Restell said: "I think a bit too much may be taken on trust and we need to be a little more rigorous."
CV fabrication was always a "very serious disciplinary matter" though it may not automatically lead to dismissal, he said.
The Institute of Healthcare Management believes a formal accreditation system, which was dismissed for the immediate future in the next stage review, could help avoid such cases.
Institute south central chair Mik Horswell said: "Managers are a critical part of the whole system that delivers patient care. If you have a central registration body it is not left to the myriad of local organisations to independently check."
Philip Farrar, a partner in the NHS employment team at law firm Hill Dickinson, agreed: "I think most people work on the basis of trust, particularly when someone has been in the [NHS] already."
Northamptonshire teaching PCT said it viewed the matter "very seriously". A statement said: "Rigorous checks are carried out in accordance with our HR recruitment policy."
Stoke on Trent PCT said it had further tightened its procedures: "We have strict pre-employment checks in place to ensure that our staff are qualified to do their jobs."
Northumberland, Tyne and Wear trust said it had "made a number of internal changes including not relying on agencies to carry out all necessary employment checks on behalf of the trust".
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