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HMRC internal manual

VAT Health

The services of the medical and paramedical professions: opticians: introduction

The supply of optical services by a person registered or enrolled in ‘either of the registers of ophthalmic opticians or the register of dispensing opticians kept under the Opticians Act 1989 or either of the lists kept under section 9 of that Act or bodies corporate carrying on business as ophthalmic opticians or as dispensing opticians …’ are generally considered to be for the principal purpose of protecting, maintaining or restoring the health of the person concerned and are exempt from VAT under item 1 (b) of Group 7, Schedule 9. This will include the provision of sight tests, eye examinations, the dispensing of spectacles and the fitting of contact lenses by those opticians qualified to perform these clinical functions.

Increasingly opticians are also providing ‘Enhanced Eye Health Services’ which include:

  • Glaucoma referral refinement
  • Cataract services pre and post Operation
  • Treatment of red eye and minor ocular emergencies
  • Stable Glaucoma monitoring
  • Diabetic Retinopathy screening

All such services are exempt from VAT. Exemption also extends to services of unregistered staff under Note (2) to Group 7, if they are directly supervised by an optician who is registered or enrolled as above.

The supply of the basic goods, i.e. the tangible spectacles and contact lenses, is standard-rated. Usually, the charge for spectacles or contact lenses will include an exempt dispensing element and a taxable supply of goods making an apportionment necessary.

Like Opticians, ophthalmic medical practitioners (OMPs), who are registered general medical practitioners under item 1(a) of Group 7, make both taxable and exempt supplies of health services depending on the purpose of the service provided. Again, most services are likely to be in the course of diagnosis, treatment and protection of health and therefore exempt.

However, OMPs also undertake sight and related vision field tests for the DVLA to ensure a person continues to be fit to drive. As these are to enable a third party to make a decision, they are standard-rated.