This was an appeal from the First-tier Tribunal (FTT) to the Upper Tribunal (UT) concerning the application of the medical exemption. The appellant provided various healthcare services in prisons in England pursuant to a contract with NHS England ("NHSE"). The appellant argued that its supplies of prescription drugs and non-prescribed contraceptives are separate non-exempt supplies subject to VAT at the zero and lower rate of VAT, entitling it to register for VAT and recover input tax on these purchases.  

The FTT decided that the appellant made a single exempt composite supply of "primary healthcare or health and social care" services. The FTT went on to make findings regarding the procurement and bidding process for the contract, detailing the invitations to tender, and service specifications. The specification included a reference to medical services being "delivered as part of an Integrated Primary Care Service…"