HMRC has published Revenue and Customs Brief 6 (2026), confirming an updated position on the VAT treatment of supplies of temporary medical staff, specifically General Medical Council (GMC) registered locum doctors.
The update follows the First-tier Tribunal decision in Isle of Wight NHS Foundation Trust v HMRC [2025] UKFTT 1114 (TC). Having reviewed the implications of that decision, HMRC now accepts that supplies of GMC-registered locum doctors may fall within the VAT exemption for “the provision of a deputy for a person registered in the register of medical practitioners”.
This is a significant change for NHS bodies, private healthcare providers, employment businesses supplying locum doctors and VAT advisers. Where the exemption applies, supplies that may previously have been treated as standard-rated could instead be exempt from VAT.
However, the scope of the update is limited. HMRC has made clear that the revised position applies only to GMC-registered locum doctors performing medical services in that professional capacity. It does not extend to other healthcare professionals, general staffing services, allied health professionals, anaesthesia associates or physician associates. It also does not apply where a GMC locum is acting in an area that they are not registered with the GMC for.
Businesses that have charged VAT at the standard rate on affected supplies may be able to claim a refund of overdeclared output tax, provided the supplies were made within the last four years and they now consider the supplies should have been exempt. HMRC will review claims on a case-by-case basis and may consider issues including unjust enrichment, partial exemption and whether VAT has been correctly accounted for across the supply chain.
Only the person who made the supply and charged the output tax can submit a claim. HMRC may also request supporting documentation and will not process claims where there is ongoing litigation or where further assurance activity is required.
Organisations affected by the change should review historic VAT accounting, contracts and invoicing arrangements for locum doctor supplies. It will also be important to consider the wider VAT consequences before submitting any claim, particularly where input tax recovery or partial exemption calculations may be affected.
If you supply or receive locum doctor services and would like to understand what HMRC’s updated position means for your organisation, speak to our VAT specialists for guidance before taking action.
