.png)
.png)
HMRC have clarified their policy on the VAT treatment of supplies of health professionals, nursing auxiliaries, care assistants and support workers by employment businesses.
Staff supplied by an employment agency may be either employees of that firm, or self-employed and engaged by an employment business.
When the worker is under the direction and control of the client, this is a supply of staff.
The Revenue says the employment business must account for VAT, when appropriate, on the full charge to the client because, in these circumstances, the firm is acting as the principal.
However, if the employment agency maintains the direction and control of its staff members to make a supply of welfare or medical services directly to the final consumer, HMRC consider this to be providing health or welfare services rather than a supply of workers and, subject to relevant criteria, say the business is making an exempt supply of welfare or health services.
When an employment firm supplies registered health professionals, other than nurses and midwives, as a principal to a third party, where the health professional is working under the control and guidance of the third party, it is making a taxable supply of staff to the third party.
This is the case even where the employment business is responsible for ensuring the workers provided are properly trained and qualified when they work under the control of the third party.
By concession, nursing agencies may, under specific circumstances, exempt the supply of nursing staff and nursing auxiliaries supplied as a principal to a third party.
For the supply of nursing auxiliaries or care assistants to benefit from the concession, they must undertake some direct form of medical care, such as administering drugs or taking blood pressures, for the final patient.
The concession does not apply to supplies of general care assistants who are only involved in providing personal care such as catering, washing or dressing the patients or who are working in care homes without nursing where they do not require supervision by health professionals to provide their services.
With regard to supplies of contracted-out welfare services provided to the final consumer, these services remain exempt even if they are contracted and paid for by a local authority or other third party.
For more details, see here.
