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The £14m thread

Navigating safe passage through the labyrinth of VAT is a tricky business.

But, like Theseus following Ariadne’s thread, health chiefs in the north east have emerged from the maze triumphantly.

Northumbria Healthcare Foundation Trust, rated “outstanding” by the Care Quality Commission, is set to reclaim up to £14m from Her Majesty’s Revenue and Customs after winning a judicial review.

The trust brought the case to the high court after HMRC dismissed an application to reclaim the money over a car leasing scheme run under the name NHS Fleet Solutions.

Anyone with a strong interest in the minutiae of VAT regulations can read the 13-page judgment in its entirety here.

However, Daily Insight – which must abide by a strict brevity bias – would summarise the outcome as follows: The trust won the case because it successfully proved NHS Fleet Solutions did not count as a “business or economic activity” for VAT purposes. It successfully argued the scheme is part of the trust carrying out its statutory obligations – in other words, treating patients.

Unfortunately for any finance directors leaping up to review their own trust’s VAT arrangements for in-house services, it is unlikely that the case will spark a glut of similar cases against HMRC.

One legal expert told us HMRC is likely to tweak the rules to ensure such challenges would not be successful in future.

Meanwhile, the trust faces one last wait before cashing in as HMRC could still appeal against the decision.

Blast from the past

Junior doctors are “losing faith” in a system used to monitor their workload, with new data suggesting only a fraction of their concerns are leading to changes to services or rosters, HSJ has reported.

The system of “exception reporting” was introduced after the junior doctors’ strike in 2015-16, allowing a medic to file a report when they work beyond their contracted hours, or without a break, as well as other contract breaches.

But data now obtained by the Hospital Consultants and Specialist Association through a freedom of information request suggested there is huge variation in how trusts respond to these reports, with less than 3 per cent leading to service or rostering changes.

Meanwhile – in another reminder of the 2015-16 antics – the BMA and the government/NHS Employers have finally nearly settled on a deal, which will now go to BMA members for a vote. The government is having to shell out more than it was willing to do so at the height of the conflict; but has also secured some of the big prizes it was after.

These echoes come as Jeremy Hunt, health secretary at the time of the row, seeks points in the Tory leadership race for, as he would see it, driving through tough reforms in the face of concerted opposition from the docs.