VATHLT2130 - Doctors: Table 3 Liability of services provided by Doctors
(referred to in paragraph VATHLT2050)
Guidance on the liability of the key services provided by doctors may be found at section 4 of Notice 701/57 Health Professionals and Pharmaceutical Products. However, the following table provides additional guidance on other supplies which may be made:
| Services | VAT liability pre 1 May 2007 | VAT liability post 1 May 2007 |
|---|---|---|
| Abortion - confirmatory certificate | Exempt | Exempt |
| Access to medical records - see PN 701/57 para 4.1 | - | - |
| Adoption and fostering health assessment forms: | - | - |
| Form IHA - health care plan for children | Exempt | Exempt |
| Forms M/B - obstetric neonatal reports | Exempt | Exempt |
| Forms C, D, YP or AME - full medical assessment of child | Exempt | Exempt |
| Form AH/AH2 - health assessment, prospective carer | Exempt | SR |
| Attendance at airports - reason for attendance varies - for example, could be to treat large number of sick passengers or confirm that passenger who has been arrested is fit to be detained. Liability will depend on purpose | Exempt | Exempt/SR |
| Benefits Agency (Department for Work and Pensions) fees - examination and report - including attendance allowance exams/reports | Exempt | SR |
| Blind or partially sighted - examination and completion of forms BD8/BP1 - allows Local Authority to register persons as blind/partially sighted, enabling them to qualify for benefits | Exempt | SR |
| Blood tests-purpose of tests: Diagnostic | Exempt | Exempt |
| Blood tests-purpose of tests: Paternity | SR | SR |
| Blue/orange badge scheme - examination and/or report - periodic assessments required for car-parking badges for disabled and priority housing schemes | Exempt | SR |
| Certificates/reports - see also PN 701/57 para 4.2: Assessment of minor injury - report/exam | Exempt | SR |
| Certificates/reports - see also PN 701/57 para 4.2: Community service certificate for offenders who fail to attend | Exempt | SR |
| Certificates/reports - see also PN 701/57 para 4.2: Cremation certificates | Exempt | Exempt |
| Certificates/reports - see also PN 701/57 para 4.2: Freedom from infection certificate | Exempt | SR |
| Certificates/reports - see also PN 701/57 para 4.2: Validation of Private Medical Insurance claim form | Exempt | Exempt |
| Cervical smear test | Exempt | Exempt |
| Character reference - Job, shotgun licence, etc | SR | SR |
| Children in care - initial and subsequent examinations for ‘at risk’ children | Exempt | Exempt |
| Childminder - Ofsted health declaration form - confirmation of medical fitness to be a childminder | Exempt | SR |
| Clinical trials - see VATHLT2060 above | Exempt/SR | Exempt/SR |
| Coroner’s work -post mortem/special examinations and report. But see also statutory services in PN 701/57 para 4.13 | Exempt | SR |
| Cosmetic services - see PN 701/57 para 4.4 | - | - |
| Court exemption- from attending as a witness on medical grounds. Medical and/or report | Exempt | SR |
| Court of Protection - Certificate CP3 With/without examination | Exempt | SR |
| Court of Protection - Serving notice Form CP7 | Exempt | SR |
| Court of Protection - Power of Attorney including court of protection work | Exempt | SR |
| Court of Protection- Examination and certificate | Exempt | SR |
| Court of Protection - Witnessing power of attorney | SR | SR |
| Diagnostic tests | Exempt | Exempt |
| Disability Living Allowance (DLA) - factual report and completion of DS1500 form (for benefit purposes) | Exempt | SR |
| Domiciliary consultations -Visits (including abortive ones) - to treat patients who are unable to make it to surgery | Exempt | Exempt |
| Domiciliary consultations - Completion of form BD8 - for benefit purposes | Exempt | SR |
| Driving - Full medical and/or report - to determine fitness to hold standard driving/LGV/HGV licence. Includes visual field tests, blood tests, ECGs etc | Exempt | SR |
| Driving - Seat belt exemption - only completed where strong clinical reason (e.g. pregnancy) | Exempt | Exempt |
| Driving - Driving licence signature | SR | SR |
| Drug company reports - Post market surveillance form | SR | SR |
| Drug company reports - Medical research questionnaire | SR | SR |
| Education services - including lectures/presentations/CPD - see PN 701/57 para 4.5 | - | - |
| Employment medicals - see PN 701/57 para 4.11 re occupational health | - | - |
| Certificate of incapacity to do a particular activity | Exempt | Exempt |
| Family Planning - see PN 701/57 para 4.6. Includes: Associated pathological and radiological work | Exempt | Exempt |
| Family Planning - see PN 701/57 para 4.6. Includes: Clinical, family planning sessions for patients or instructing other doctors in family planning | Exempt | Exempt |
| Fire Service - Examination and report New candidate | Exempt | SR |
| Fire Service - Examination and report Officer seeking promotion | Exempt | SR |
| Fire Service - Examination and report Pension approval | Exempt | SR |
| Fire Service - Examination by ophthalmologist | Exempt | SR |
| Forensic physicians - see PN 701/57. para 4.7: Note - charges for trainees attending the same call-out will attract the same liability as that of the forensic physician, as the trainee is a registered doctor | - | - |
| Gender recognition work - to enable Department of Constitutional Affairs to issue documents that person’s gender has changed | Exempt | SR |
| Health & Safety Executive - pathology and X-ray examinations - concerned with preventing injury by detecting early signs of diseases with long gestation periods | Exempt | Exempt |
| Hospital appointments | - | - |
| GP work in hospitals - where local GPs admit, treat and discharge their own patients in community hospitals. Sometimes a casualty service is also provided. Arrangements vary from one CCG to another - some GPs are engaged on an employed basis (OS); others on a self- employed basis (EX). Each case will need to be considered on the individual facts | Outside the scope/Exempt | Outside the scope/Exempt |
| Medical superintendent of psychiatric hospital (employed basis) | Outside the scope/Exempt | Outside the scope/Exempt |
| Liability of other part-time hospital (health) posts held by practitioners will depend on whether the post is held on an employed (outside the scope) or self-employed (exempt) basis | Outside the scope/Exempt | Outside the scope/Exempt |
| Infection - Freedom from Infection certificate - to enable a person to attend school/work etc | Exempt | SR |
| Insurance services - see PN 701/57 para 4.8 | - | - |
| Legal aid regulations (fees under). Includes: | - | - |
| Examinations and/or reports | Exempt/SR | SR |
| MRI/CT scans - fee is for the doctor’s interpretation of the scans, not for the scans themselves | Exempt | SR |
| Attendance at consultation | Exempt | SR |
| Making arrangements to attend court | Exempt/SR | SR |
| Attendance at court (expert witness) | SR | SR |
| Local Authority visiting medical officer - to establishments maintained by local authorities | Exempt | Exempt |
| Local Authority work -Consultant or specialist work: | - | - |
| School ophthalmic session | Exempt | Exempt |
| Dental anaesthetic session | Exempt | Exempt |
| Local Authority work Psychiatric examinations - required to enable person to be treated under Mental Health Act | Exempt | Exempt |
| Medical boards/tribunals - attendance by medical members at hearings for disciplinary or pension purposes | SR | SR |
| Medical examinations and reports to confirm fitness to join registers of medical professions - for example, Nursing and Midwifery Council and General Dental Council | Exempt | SR |
| Medical examinations-see PN 701/57 section 4 re occupational health, insurance services, certificates and reports. Also, medicals for: | - | - |
| Seafarers-to ensure someone working offshore does not go to sea with a medical condition which is likely to detoriorate | Exempt | Exempt |
| Compensation for ex-miners with vibration white finger | Exempt | SR |
| Criminal Injuries Compensation Authority | Exempt | SR |
| Medico-legal work - see PN 701/57 para 4.9 | - | - |
| Mental Health tribunals - see PN 701/57 para 4.10 | - | - |
| Minor surgery for non NHS patients. Fee can be charged for procedure excluding cost of drugs and dressings | Exempt | Exempt |
| National Blood Service | Exempt | Exempt |
| National Society for Prevention of Cruelty to Children | - | - |
| Condition of child visit, examination, certificate - undertaken where vulnerable child unable to give account of medical history. Exams etc enable carer to adequately look after child and ensure ongoing health conditions treated | Exempt | Exempt |
| Attendance at magistrate’s/crown court - see PN 701/57 para 4.9 | - | - |
| NHS complaints and disciplinary procedures (services for) | SR/Exempt | SR |
| Occupational Health - see PN 701/57 para 4.11 | - | - |
| Overseas travel - Private prescription for travel abroad | Exempt | Exempt |
| Overseas travel - Report for patients for self-referral overseas - for patients who have complex medical problems which might necessitate seeking medical treatment whilst abroad | Exempt | Exempt |
| Pacemaker removal - prior to disposal of body | Exempt | Exempt |
| Passport countersignature | SR | SR |
| Pilots Application for licence, fitness to fly, etc | Exempt | SR |
| Police work | - | - |
| Retainers/attendance fees for call-outs to examine body/witness/detainee/victim/ other. Also applies to non-police surgeons | Exempt | Exempt |
| Written report | Exempt | SR |
| Police station Attendance at patient’s request (to document injuries for future medical claims) | Exempt | SR |
| Financial assistance provided for continuing medical education - no direct link between supply and payment | Outside the scope | Outside the scope |
| Post mortem examinations and reports | - | - |
| Examination and report to coroner | Exempt | SR |
| Anaesthetic deaths - where a doctor is instructed to interview a surgeon, anaesthetist or other person on connection with an anaesthetic death | Exempt | SR |
| Pre-employment medicals/reports | Exempt | SR |
| Primary care trust sessions England and Wales | Exempt | Exempt |
| Prison locum work - to provide medical care | Exempt | Exempt |
| Private prescription | Exempt | Exempt |
| Rehabilitation services - see PN 701/57 para 4.12 | - | - |
| Probation service - reports for the purpose of the courts, whether or not requested | Exempt/SR | SR |
| Road accident emergency treatment | Exempt | Exempt |
| Sporting events/pop concerts - attendance by doctors to treat attendees as necessary - usually where number attendees exceed a specified limit | Exempt | Exempt |
| Statutory services - see PN 701/57 para 4.13 | - | - |
| Vaccination and immunisation for travel abroad International certificate of vaccination | Exempt | Exempt |
| Witness testimony and allowances - see PN 701/57 para 4.14 | - | - |
| Work in surgery (not elsewhere covered): | - | - |
| Pharmaceutical trials - certification as to suitability to take part as non-patient volunteer | Exempt | SR |
| Report on a pro-forma - no examination | Exempt | SR |