Hi pirateman,
.Care services can be exempted when a medic not is enrolled on a statutory medical register as long as they are supervised by a registered health professional.
Please see :
5. Exemption for care services performed by suppliers that are not enrolled on a statutory professional register
Supervision would be where:
The services are supervised by a registered health professionals and the supervisor is professionally qualified to perform and supervise the service.
The service requires supervision by a registered health professional, and is provided predominantly to meet the medical needs of a client.
The supervisor has a direct relationship with the staff performing the service, and is contractually responsible for supervising their services.
A qualified supervisor is available for the whole time that the care service is provided.
No more than 2,000 hours per week of staff time are supervised by a single health professional.
A supervisor has a say in the level of care to be provided to the client, and will usually see the client prior to the commencement of the care service..
The supervisor must be able to demonstrate that they monitor the work of the unregistered staff.
If the supervision is provided remotely then each one of the above criteria would need to be met for the supply to be exempt from VAT.
Thank you.