HMRC have published 'Revenue & Customs Brief 6 (2026): VAT liability of the supply of temporary medical staff'. The Brief sets out HMRC's finalised position on the supplies of GMC-registered locum doctors, including whether supplies via an employment business may fall within the VAT exemption under Item 5, Group 7, Schedule 9, VAT Act 1994.
Following the First Tier Tribunal (FTT) decision in The Isle of Wight NHS Trust v HMRC [2025] TC09640, this new Brief replaces HMRC's Brief 9 (2025) and now provides their settled view on the VAT treatment of the supply of locum doctors.
- Item 5, Group 7, Schedule 9, VAT Act 1994 exempts "the provision of a deputy for a person registered in the register of medical practitioners."
- The FTT determined that this exemption applied to locum doctors, including those provided by employment businesses, and was not limited to out-of-hours GP cover.
HMRC have now confirmed that supplies of GMC-registered locum doctors, including where supplied via an employment business, may fall within the exemption. In presenting their position, HMRC has kept the scope narrow.
- They consider that the exemption applies only where the individual is a GMC-registered medical practitioner performing a role that such a practitioner is required to perform.
- They also do not view the exemption as extending to other GMC-registered health professionals, such as allied health professionals, anaesthesia associates or physician associates, nor to general staffing services outside Item 5.
Claims
The Brief confirms that refund claims for overdeclared output tax will be considered on a case-by-case basis.
- Claims are restricted to output tax on supplies made in the last four years.
- HMRC will not pay claims that would result in a taxpayer's Unjust enrichment.
- Partial exemption will need to be considered when making a claim. If affected, a claimant would only be able to claim for the net amount after making the appropriate adjustments.
- HMRC will also consider whether overdeclared VAT has been correctly accounted for across the supply chain.
HMRC may request supporting documentation and will not process claims if litigation is ongoing or assurance activity is ongoing.
Claims should be made by:
- Completing form VAT652: Notification of errors in VAT Returns.
- Emailing the completed form to
This email address is being protected from spambots. You need JavaScript enabled to view it. . - Putting 'Locum doctors claim RCB 6/26' in the email's subject line.
The claim must:
- Set out the basis of, and the reason for, the claim.
- Show the amount being claimed.
- Show how that amount has been calculated.
- Break the amount down by reference to VAT return periods.
Useful guides on this topic
Reclaims and unjust enrichment
When can VAT reclaims be made? What are the time limits? What is unjust enrichment? Why might unjust enrichment prevent HMRC making VAT repayments?
Partial exemption & input VAT
How do you calculate the amount of input tax you can recover under the VAT partial exemption rules? What are the de minimis rules?
Correcting VAT errors
What are the VAT error correction time limits? Can you correct errors through the VAT return? Do you have to notify HMRC?
Health and welfare: VAT
When do reduced rating, zero-rating and VAT exemption apply to services relating to medical care, health and welfare? What are the rules?
External link
Revenue and Customs Brief 6 (2026): VAT liability of the supply of temporary medical staff