Expanding Our Expertise in NHS VAT, Employment Taxes, Corporate Taxes, Land Taxes & Custom Duties

For years, CRS VAT has been the trusted partner for NHS bodies seeking to maximise VAT recovery, strengthen compliance, and reduce HMRC risks. From 1 October 2025, we will evolve into CRSTAX, reflecting our ability to deliver a broader range of tax services to the NHS while maintaining the same unrivalled VAT expertise you know us for.

This change brings together our established VAT specialists with experts from across our group, creating a single, dedicated team supporting NHS organisations covering all areas of taxation – including employment taxes, corporate taxes, land taxes, and customs duties.

Why the Change Matters for the NHS

We understand the pressures facing NHS finance teams – rising costs, compliance challenges, and the constant need to maximise savings. Employment tax obligations are growing more complex each year as well and even small errors can result in costly penalties and underfunding of vital services. With CRSTAX, you have a partner who not only understands the NHS but has the technical expertise to protect its financial future.

Our Expanded NHS Tax Services

As CRSTAX, we continue to offer our full suite of NHS VAT services – including recovery reviews, compliance checks, COS re-reviews, training, and HMRC enquiry support. Alongside this, our enhanced service portfolio now includes:

HMRC Compliance Reviews

HMRC continues to carry out compliance reviews of NHS organisations, often focusing on expenses and benefits, salary sacrifice, IR35 compliance, Construction Industry Scheme (CIS), and termination payments. Errors can lead to significant liabilities and penalties.

We have a proven record of achieving positive outcomes for NHS bodies. In one case, HMRC initially calculated a liability of over £400,000, but following our intervention the final settlement was reduced to just £30,000.

Expenses and Benefits

We advise NHS organisations on the full tax treatment of staff benefits – from salary sacrifice arrangements and staff awards to P11D reporting/payrolling of benefits and PAYE Settlement Agreements. This ensures benefits remain tax-efficient while fully compliant.

Status and Off-Payroll Working (IR35)

With the revised IR35 rules placing responsibility for assessing employment status onto NHS bodies, we provide practical support. This includes drafting or revising policies, assisting with individual status determinations, supporting SDS appeals, and managing HMRC disclosures.

Construction Industry Scheme (CIS)

NHS finance teams can often be unfamiliar with the complexities of CIS, leading to errors in reporting. We deliver training, audit checks, and practical guidance to ensure compliance – reducing the risk of penalties.

Termination of Employment

Payments made under settlement agreements or redundancy schemes can have complex tax implications. We advise NHS bodies to ensure these payments are structured correctly, avoiding unexpected liabilities.

Pension Planning and Education

Working closely with NHS finance and HR teams, we deliver pension education and tailored planning advice to ensure compliance and optimise staff outcomes.

Corporate Taxes

NHS organisations engaged in trading or commercial activities may face corporation tax obligations. We provide guidance on structuring, compliance, and disclosure to ensure that NHS bodies meet their obligations while minimising liabilities.

Land Taxes (SDLT, LTT, LBTT)

Property transactions such as lease arrangements, acquisitions, or disposals can give rise to Stamp Duty Land Tax (SDLT in England), Land Transaction Tax (LTT in Wales), or Land and Buildings Transaction Tax (LBTT in Scotland). Our advisers ensure that NHS organisations apply the correct tax treatment, claim available reliefs, and avoid costly errors.

Customs Duties

Where NHS organisations import medical supplies, pharmaceuticals, or specialist equipment, customs duties can apply. Our team advises on tariff classification, duty reliefs, and the correct use of import documentation to avoid overpayments or penalties.

Case Studies – Delivering Taxation Value to the NHS in Practice

• VAT COS Re-review Savings – Our secondary reviews frequently uncover £30K to £800K in additional recoveries, after a competitor has already completed a review.
• HMRC Settlement Success – As highlighted above, we reduced one NHS organisation’s HMRC liability from £400K to £30K, delivering immediate savings and future compliance confidence.
• Employment Tax Clarity – We have helped NHS bodies rewrite IR35 policies and successfully defend HMRC challenges, ensuring correct application without unnecessary costs.

Taxation Built for the NHS

Unlike generic tax advisers, CRSTAX is a dedicated full-taxes team focused exclusively on NHS organisations. Our advisers include Chartered Tax Advisers and former HMRC officers, combining frontline knowledge with practical sector experience.

This unique expertise ensures we don’t just identify issues – we deliver solutions that [provide value/save money], improve compliance, and strengthen internal processes.

HMRC Announces Making Tax Digital Delay

HMRC has announced a further deferral of Making Tax Digital (MTD) for all Government Information and NHS Trusts (GIANT) system users. The new implementation date is set for April 2026, offering affected organisations additional time to prepare for the transition.

How will MTD affect VAT rules?

It is currently unclear from HMRC whether this deferral will coincide with the anticipated reforms to the contracted-out services (COS) VAT rules, but we will endeavour to keep you informed on both developments.

Currently, Government and NHS bodies are still required to submit monthly returns via the GIANT system together with a VAT 21 Form analysing VAT recovery by input tax and COS headings. It is our understanding that HMRC’s current MTD platform cannot accommodate the additional VAT 21 information.

Future Expectations

Despite the deferral, GIANT users should not wait until the last minute to adapt. The April 2026 deadline will require:

• Digital Record-Keeping: Start transitioning to systems that support MTD requirements.
• Process Audits: Review existing VAT return processes to ensure compliance with future MTD standards.

Support for NHS Clients and GIANT Users

HMRC has stated that once a decision has been made regarding the start date for using MTD software, notification will be provided at least 12 months in advance. This will allow sufficient time to prepare for and complete the transition to MTD.

If you are not sure whether you are prepared for the changes, we offer an MTD readiness review to compare current record-keeping and VAT return processes against the MTD requirements.

Please contact us for further assistance. We will keep our NHS clients updated on any developments.

If you have any questions or comments, please do not hesitate to contact our team today via the button below.