To help provide clarity on the subject, the British Healthcare Trades Association (BHTA) has created this useful guide to help our members understand the rules.
There are a number of myths around this topic, so let’s start by dispelling one: It’s not VAT exemption! When you sell a product to a customer without charging VAT, you are providing “VAT relief for disabled persons” – an action also known as zero-rating because what you are doing is applying 0 per cent VAT.
You can only do this when the product is for someone who is disabled or has a long-term condition, and it is for his or her own personal use.
The product also has to be eligible, as it has to be “designed solely for use by disabled persons”. You must never assume that everything you sell qualifies.
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Companies selling zero-rated products do not have to inform HMRC but your customer must make a declaration which you keep with your VAT records. HMRC will look at the declarations if they carry out an inspection.
Importantly, the retailer does not have to provide proof of an individual’s disability, but you must have the customers’ declaration, which requires them to state what their disability or long-term condition is.
You can use this declaration form from the government to show your customer is a disabled person getting goods or services for their personal or domestic use, and will claim relief from VAT.
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It is important to remember that if you are selling a product for short-term use, then this must not be sold without VAT. For example, someone might buy a manual wheelchair because they cannot cope with crutches whilst they are recovering from a broken leg but it is a short-term problem so they must pay the full VAT.
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When a customer provides you with their declaration, collecting information about that individual’s illness or disability, then you should take steps to ensure that data is stored, handled and managed correctly.
BHTA recommends that you should state in your privacy policy that you have to keep VAT relief declarations for at least six years to meet legal requirements, before taking further actions to delete or anonymise the data.
Remember, the ICO highlights that you must not keep personal data for longer than you need it, and you need to think about – and be able to justify – how long you keep personal data. This will depend on your purposes for holding the data.
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When it comes to displaying product pricing relating to zero-rated VAT products, it is important that both prices are clearly shown and identified. This is because not all of your customers may qualify for VAT exemption, and must know what the total price is before they reach the till or check out.
Under our Code of Practice, being clear and transparent regarding pricing is one of the core requirements that you must uphold.
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There are some instances when assistive technologies are sold as zero-rated, which are not. The important element to remember is that the item must have been solely designed for use by someone with a disability or long-term condition, or must be designed solely for use in or with such an item.
For example, the batteries used for most mobility products can be used for other purposes as well. They do not meet the “designed solely” stipulation so if you are simply selling someone a battery, you should always charge full VAT.
Anything designed for use by both disabled and able-bodied people will not be eligible and this means it is not always obvious whether some of the aids for daily living are eligible.
A can opener, for example, which is actually useful for anyone lacking in hand strength, is unlikely to qualify. However, cutlery designed and shaped in a way which makes it unlikely an able-bodied person would use it will probably be eligible.
You can gain invaluable insight regarding which products qualify to be zero-rated on the government’s ‘Reliefs from VAT for disabled and older people (VAT Notice 701/7)‘ guidance.
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Certain assistive technologies are always eligible, such as wheelchairs and class 2 pavement scooters. Also, so are items like rollators, however, all are dependent on the need of the person buying the product having a disability or long-term condition.
Riser-recliner chairs with a lift and tilt function are eligible but recliner chairs without that function are not.
There are also some potentially grey areas that you are required to navigate as well. Revisiting the example mentioned above regarding the need to charge VAT to a disabled person if you are simply supplying a battery, then there are circumstances where zero-rating this may be appropriate – such as if the battery is supplied as part of a wider service of repair and maintenance. You would, however, need to ensure your records show that it was supplied in that context or HMRC would expect to see full VAT applied.
Class 3 mobility scooters are normally intended or adapted for use on the road (tipping them into primarily being regarded as a type of vehicle), so in that context, they do not qualify for the purpose of VAT relief. However, you can zero-rate a class 3 mobility scooter that is designed solely for use by disabled persons. Only the manufacturer can confirm the design intent.
To gain a better understanding of the procedural guidelines and conditions that HMRC applies when deciding on VAT relief for disabled people, see ‘HMRC internal manual: VAT Relief for Disabled People Manual.’
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While zero-rating relates to products created for disabled consumers, people over the age of 60 are eligible to pay a reduced rate of VAT (5%) on certain aids when they are bought and installed into their homes.
Eligible products for reduced VAT rates for older people include grab rails, ramps, stairlifts, bath lifts, built-in shower seats or showers containing built-in shower seats, as well as walk-in baths with sealable doors.
Importantly, your customer does not have to order and pay for the product themselves – it could be a friend, local council, charity or housing association placing the order on their behalf.
However, they would not qualify for the reduced rate if it is to repair or replace the goods after they’ve been installed. Also, the product purchased must be installed – your customer would not qualify for a reduced rate by just buying the aid. Also, the product has to be for a private home – it would not qualify for a residential home, for example.
You’ll need to have your customer confirm in writing that they meet these conditions, and it may be worthwhile creating your own declaration form that your customers can sign.
The declaration that you would require your customer to sign and date is simple, and should use this standard wording: I [full name] of [the address where the installation is taking place] declare that I am aged 60 or over and that this supply and installation qualifies for the reduced rate of VAT in accordance with The Value Added Tax (Reduced Rate) Order 2007.
You can learn more about reduced VAT rates for older people at the government’s ‘Tax on shopping and services‘ guide.
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If HMRC carries out an inspection and decides you have incorrectly zero-rated, they will issue you with a demand for the VAT and they can go back a number of years. Importantly, this can add up to a lot of time and money.
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If unsure regarding eligibility, you should always ask the manufacturer whether the product qualifies for zero-rating: Has it been designed solely for use by disabled persons? HMRC will expect you to be able to show them evidence to support your decision.
To discover the procedural conditions that HMRC works to when deciding on VAT relief for products and services for disabled people, read ‘HMRC internal manual: VAT Relief for Disabled People Manual.’
The mantra should always be: if in any doubt, it is always safer to charge the full VAT.
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If you have insights and information that you would like to contribute to this resource,
then we would love to hear from you.
Send your contribution to marketing@bhta.com
– your contributions help us to improve advice for everyone and raise industry standards.
To learn more about zero-rating products, see these useful resources:
The guidance was last updated: 31st May 2022
As a BHTA member, you are obliged to tell your customers that you are signed up to our Code of Practice, and that we will provide mediation (and ultimately arbitration) if they have exhausted your complaints process and remain dissatisfied.
You must also add the option of approaching a formally recognised “Alternative Dispute Resolution” (ADR) provider. However, you do have the right to indicate if you would not like to participate in any mediation that an ADR might offer.
You can find out the formally listed ADR bodies for the UK at:
www.tradingstandards.uk/consumers/adr-approved-bodies
You will need to choose one which you think could give advice to your customers and provide the ADR’s contact details.
BHTA members requiring any further assistance regarding ADR can contact: info@bhta.com
This guide will help you to understand what this logo means and represents, and why you should look for it the next time you are purchasing products or services in the healthcare, mobility, independent living and assistive technologies market, as well as other sectors.
Launched in 2013 by the Chartered Trading Standards Institute (CTSI), the Consumer Codes Approval Scheme (CCAS) is an initiative to improve customer services standards and bolster consumer protection through ‘facilitated self-regulation’.
It seeks to achieve this through having businesses sign up and abide by voluntary codes of practice, administered by Code Sponsors, such as the British Healthcare Trades Association (BHTA) and our Code of Practice.
Only Code Members who belong to a Code Sponsor and have proven that they meet the requirements set out in a code can display the CTSI approved CCAS code logo. This logo means the businesses are reliable, trustworthy and ethical.
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The operator of CCAS, CTSI has represented the interests of the Trading Standards profession since 1881. The organisation works towards creating fairer, better informed and safer consumer and business communities.
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Code Sponsors are organisations that represent market sectors and have a membership base, and are themselves carefully selected and vetted by CTSI for their expertise in a field.
These organisations are responsible for the administration and promotion of their codes of practice, helping to reduce consumer detriment and raise standards within their membership.
There are currently 18 code sponsors who have 23 approved codes of practice and almost 80,000 businesses that are Code Members who can display the CCAS logo.
The BHTA is the Sponsor of our Code of Practice – the first and only code in the healthcare, mobility, independent living and assistive technologies industry to have been approved by CCAS.
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A Code Member is an organisation that has signed up to a Code Sponsor’s code of practice, and has been approved by the Sponsor. These organisations commit to upholding the requirements set out in the respective code of practice.
Only businesses that belong to a Code Sponsor can display the CTSI approved code logo, helping consumers to identify that organisation as trustworthy and reliable.
There are around 400 Code Members of the BHTA, all dedicated to providing customer service that goes above and beyond their legal requirements. This includes having clear pre-contractual information, transparent terms and conditions, a robust customer complaints procedure, and access to mediation in the event of a dispute.
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The robust, independent code approval scheme ensures that all parties involved are doing their part to raise customer service standards and protect consumers through strict, comprehensive audits, assessments and monitoring.
The CTSI process for approving a Code Sponsor is rigorous, and organisations, such as the BHTA, are only approved once they have clearly demonstrated that they are committed to the reduction of consumer detriment and improving service standards.
Once approved, CTSI also regularly audits its Code Sponsors, ensuring the codes of practice are being correctly administered and its Code Members are complying with the requirements of their respective code of practice.
To ensure Code Members are meeting their requirements, Code Sponsors also conduct ongoing Code Member audits and compliance checks. At the BHTA, this also includes conducting a number of mystery shops on a percentage of its members each year, alongside rigorous member audits.
Through this continuous assessment, auditing and monitoring by CSTI and Code sponsors, consumers can have full confidence in using companies that proudly display the CTSI approved CCAS logo.
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If you have had an experience with a Code Member that you believe contravenes the requirements of the code of practice that the company has committed to abide by, then you can raise this through the respective Code Sponsor.
At the BHTA, you can learn more about how to initiate a member complaint and the process to follow at our ‘Making a member complaint’ page.
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As per the CTSI’s policy, consumers wishing to make a complaint about a Code Sponsor should raise the issue with the Code Sponsor first, to give them the opportunity to resolve the matter. In the event a resolution cannot be agreed upon, consumers can raise a complaint about a Code Sponsor (not individual Code Members) by emailing ccab@tsi.org.uk
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Consumers can find out more information at https://www.tradingstandards.uk/commercial-services/consumer-codes-approval-scheme/i-am-a-consumer/
Learn more about how the BHTA supports consumers or download our helpful consumer guide.
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As the Department of Health & Social Care (DHSC) introduces new reforms in its efforts to better integrate the health and social care system in England, there will be increasing use of a range of unfamiliar terminology: Integrated Care Systems (ICSs), Integrated Care Boards (ICBs), and Integrated Care Partnerships (ICPs). To help provide clarity, the British Healthcare Trades Association (BHTA) has produced this simple guide, highlighting and defining some key terms.
Integrated Care System (ICS): Broad, regional, health & social care delivery area/operating unit that brings together providers/commissioners of NHS services, Local Authorities, and other stakeholders to collectively plan and deliver health & care in an integrated fashion, joining up hospital and community-based services, physical and mental health, and health and social care; all parts of England are now covered by one of 42 ICSs.
Integrated Care Board (ICB): Legally constituted leadership & governing body for an ICS.
Integrated Care Partnership (ICP): Planning body of an ICS, operating at the “Place” level (see ICSs – Mission & Components below).
As part of the Health & Care Bill 2021 – and in line with the January 2019 NHS Long-Term Plan – the government is reforming the way health & care services are planned, delivered, and funded by shifting to Integrated Care Systems (ICSs). ICSs have grown out of organic efforts by some NHS Trusts and Clinical Commissioning Groups to work more collaboratively over the last two decades in Sustainability and Transformation Partnerships (STPs), and some have already begun operating, voluntarily, as ICSs.
The government is now placing ICSs on a statutory footing, meaning they will have basis in legislation, with formal powers and accountabilities. As part of this process, DHSC, NHS England, and NHS England Improvement are beginning to publish guidelines and policies setting out how ICSs and their constituent/related parts will work.
ICSs – their evolution, structure, and future operations – are a very complex topic, and forward-looking analysis of their development and operation is made more difficult by the fact that their ways of working and governance structures are in constant flux. By far the best all-in-one-place, plain-English summary of ICSs is a May 2021 “explainer” published by The King’s Fund – Integrated Care Systems Explained – Making Sense of Systems, Places and Neighbourhoods – although even its analysis is being overtaken by events as ICSs (and the government’s guidance for them) continue rapidly to evolve.
Integrated Care System (ICS): A partnership between the organisations (NHS, Local Authorities, social & care bodies, and other stakeholders) that meet health and care needs across an area, which allows for planning and coordination in ways that improve population health and reduce inequalities between different groups.
The core purpose of an ICS is to:
ICSs operate, broadly speaking, at three levels:
Integrated Care Board (ICB): Responsible for the commissioning of healthcare services in an ICS area, bringing together the NHS, Local Authorities, and other stakeholders to improve population health and care. If the Health & Care Bill 2021 is passed into law:
Integrated Care Partnership (ICP): A broad alliance of organisations and representatives concerned with improving the care, health, and wellbeing of the population, jointly convened by Local Authorities (LAs) and the NHS. The ICP will:
For a brief (7-page) overview of the different levels of management that make up an ICS – including their core functions, the rationale behind them, and how they will work together – please see the NHS’ June 2019 guidance document Designing Integrated Care Systems (ICSs) in England. For more detail on ICSs, ICBs, and ICPs, please see the NHS’ June 2021 guidance document Integrated Care Systems: Design Framework.
Summary of Integrated Care Partnership (ICP) Engagement Document: Integrated Care System (ICS) Implementation (Government guidance, published 15-Sep-21)
The top-line takeaway of this document is that – howsoever it purports to be guidance – it operates under DHSC’s clear and repeated caveats that the government does not foresee much detailed guidance at all with regard to ICPs or their operation, so as to preserve maximum flexibility at local levels, viz:
That said, DHSC sets out several expectations for ICPs.
ICPs will:
ICPs’ central role is in the planning and improvement of health and care. They should support place-based partnerships and coalitions with community partners which are well-situated to act on the wider determinants of health in local areas.
ICPs will be required to develop an integrated care strategy to address the broad health and social care needs of the population within the ICP’s area, including determinants of health such as employment, environment, and housing issues.
ICPs are expected to highlight where coordination is needed on health and care issues and challenge partners to deliver the action required.
The greatest detail in the guidance is around examples and suggestions – not requirements or prescriptions – as to how DHSC expects ICPs to “add value” in the areas that form DHSC’s five key expectations of ICPs:
DHSC expects that all ICSs will have at least an interim ICP up and running when statutory ICBs commence as planned in April 2022, subject to the passage of the Health and Care Bill 2021 through Parliament.
In closing, DHSC “now ask all 42 integrated care systems to take the following five steps, [and for] NHS ICB Chairs Designate to ensure these steps are carried out in their system, in partnership with local government”:
The guidance closes with an FAQ document.