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:

ServicesVAT liability pre 1 May 2007VAT liability post 1 May 2007
Abortion - confirmatory certificateExemptExempt
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.ExemptExempt/SR
Benefits Agency (Department for Work and Pensions) fees - examination and report - including attendance allowance exams/reportsExemptSR
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.ExemptSR
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.ExemptSR
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 testExemptExempt
Character reference - Job, shotgun licence, etcSRSR
Children in care - initial and subsequent examinations for ‘at risk’ children.ExemptExempt
Childminder - Ofsted health declaration form - confirmation of medical fitness to be a childminderExemptSR
Clinical trials - see VATHLT2060 aboveEx/SREx/SR
Coroner’s work - post mortem/special examinations and report. But see also statutory services in PN 701/57ExemptSR
Cosmetic services – see PN 701/57  
Court exemption - from attending as a witness on medical grounds. Medical and/or reportExemptSR
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 testsExemptExempt
Disability Living Allowance (DLA) – factual report and completion of DS1500 form (for benefit purposes)ExemptSR
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 activityExemptExempt
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 changedExemptSR
Health & Safety Executive - pathology and X-ray examinations – concerned with preventing injury by detecting early signs of diseases with long gestation periods.ExemptExempt
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 etcExemptSR
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 authoritiesExemptExempt
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 purposesSRSR
Medical examinations and reports to confirm fitness to join registers of medical professions – for example, Nursing and Midwifery Council and General Dental CouncilExemptSR
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 dressingsExemptExempt
National Blood ServiceExemptExempt
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/ExemptSR
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 bodyExemptExempt
Passport countersignatureSRSR
Pilots Application for licence, fitness to fly, etcExemptSR
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/reportsExemptSR
Primary care trust sessions England and WalesExemptExempt
Prison locum work – to provide medical careExemptExempt
Private prescriptionExemptExempt
Rehabilitation services – see PN 701/57  
Probation service - reports for the purpose of the courts, whether or not requestedEx/SRSR
Road accident emergency treatmentExemptExempt
Sporting events/pop concerts - attendance by doctors to treat attendees as necessary - usually where number attendees exceed a specified limit.ExemptExempt
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