VATHLT2130 - Doctors: Table 3 Liability of services provided by Doctors

(referred to in paragraphVATHLT2050)

Guidance on the liability of the key services provided by doctors may be found at section 3 of Notice 701/57 Health Professionals. 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
Adoption and fostering health assessment forms Form IHA - health care plan for children Forms M/B - obstetric neonatal reports Forms C, D, YP or AME - full medical assessment of child Form AH/AH2 - health assessment, prospective carer	Exempt Exempt Exempt Exempt	Exempt Exempt 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 Paternity	Exempt SR	Exempt 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 Assessment of mining injury – report/exam Community service certificate for offenders who fail to attend Cremation certificates Freedom from infection certificate Validation of Private Medical Insurance claim form	Exempt Exempt Exempt Exempt Exempt	SR SR Exempt SR 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	Ex/SR	Ex/SR
Coroner’s work - post mortem/special examinations and report. But see also statutory services in PN 701/57	Exempt	SR
Cosmetic services – see PN 701/57
Court exemption - from attending as a witness on medical grounds. Medical and/or report	Exempt	SR
Court of Protection Certificate CP3 With/without examination Serving notice Form CP7 Power of Attorney including court of protection work Examination and certificate Witnessing power of attorney	Exempt Exempt Exempt SR	SR SR 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 Completion of form BD8 - for benefit purposes	Exempt Exempt	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 Seat belt exemption – only completed where strong clinical reason (e.g. pregnancy) Driving licence signature	Exempt Exempt SR	SR Exempt SR
Drug company reports Post market surveillance form Medical research questionnaire	SR SR	SR SR
Education services - including lectures/presentations/CPD - see PN 701/57
Employment medicals - see PN 701/57 re occupational health.
Certificate of incapacity to do a particular activity	Exempt	Exempt
Family Planning - see PN 701/57. Includes: Associated pathological and radiological work Clinical, family planning sessions for patients or instructing other doctors in family planning	Exempt Exempt	Exempt Exempt
Fire Service Examination and report New candidate Examination and report Officer seeking promotion Examination and report Pension approval Examination by ophthalmologist	Exempt Exempt Exempt Exempt	SR SR SR SR
Forensic physicians - see PN 701/57. 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 PCT to another – some GPs are engaged on an employed basis (Ex); others on a self- employed (OS). Each case will need to be considered on the individual facts. Medical superintendent of psychiatric hospital (employed basis) 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/Ex Outside the scope Outside the scope/Ex	Outside the scope/Ex Outside the scope Outside the scope/Ex
Infection - Freedom from Infection certificate - to enable a person to attend school/work etc	Exempt	SR
Insurance services – see PN 701/57
Legal aid regulations (fees under). Includes: Examinations and/or reports MRI/CT scans - fee is for the doctor’s interpretation of the scans, not for the scans themselves Attendance at consultation Making arrangements to attend court Attendance at court (expert witness)	Ex/SR Ex Ex/SR SR SR	SR SR SR 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 Dental anaesthetic session Psychiatric examinations - required to enable person to be treated under Mental Health Act	Exempt Exempt Exempt Exempt	Exempt Exempt 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 PN701/57 re occupational health, insurance services, certificates and reports. Also, medicals for: Seafarers - to ensure someone working off-shore does not go to sea with a medical condition which is likely to deteriorate Compensation for ex-miners with vibration white finger Criminal Injuries Compensation Authority	Exempt Exempt Exempt	Exempt SR SR
Medico-legal work – see PN 701/57
Mental Health tribunals - see PN 701/57
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. Attendance at magistrate's/crown court - see PN 701/57	Exempt	Exempt
NHS complaints and disciplinary procedures (services for)	SR/Exempt	SR
Occupational Health - see PN 701/57
Overseas travel Private prescription for travel abroad Report for patients for self-referral overseas - for patients who have complex medical problems which might necessitate seeking medical treatment whilst abroad	Exempt Exempt	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 Written report Police station Attendance at patient’s request (to document injuries for future medical claims) Financial assistance provided for continuing medical education - no direct link between supply and payment.	Exempt Exempt Exempt Outside the scope	Exempt SR SR Outside the scope
Post mortem examinations and reports Examination and report to coroner Anaesthetic deaths - where a doctor is instructed to interview a surgeon, anaesthetist or other person on connection with an anaesthetic death.	Exempt Exempt	SR 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
Probation service - reports for the purpose of the courts, whether or not requested	Ex/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
Vaccination and immunisation for travel abroad International certificate of vaccination	Exempt Exempt	Exempt SR
Witness testimony and allowances – see PN 701/57
Work in surgery (not elsewhere covered) Pharmaceutical trials - certification as to suitability to take part as non-patient volunteer Report on a pro-forma - no examination	Exempt Exempt	SR SR

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