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HMRC internal manual

VAT Health

Doctors: Other NHS income

GP practices receive a monthly statement detailing payments due to the practice. All of these payments (other than accounting or timing adjustments) are consideration for the practice’s supplies of medical services.

Payments relating to specific patient care activities meeting the purpose test (eg, anti-coagulant monitoring, childhood immunisations, flu and pneumococcal vaccinations) are exempt. However, payments relating to services which are not principally for the purpose of protecting, maintaining or restoring the health of the individual concerned are taxable at the standard rate. Payments recorded under ‘collaborative fees’ are payments for services commissioned from the NHS by local authorities and will cover both taxable and exempt supplies. Individual services will therefore need to be identified.

‘General’ payments and reimbursements of practice costs (e.g., GMS global sum, MPIG correction factor, computer costs, notional rent) are also exempt unless the practice has dispensing activity, in which case they will cover taxable and exempt supplies. In such cases, they will need to be apportioned in accordance with the guidance inNotice 700.