For a medical service to be exempt from VAT it must generally be performed by a registered health professional or a staff member who is directly supervised by a registered health professional. Pharmacists can also deliver VAT exempt medical services but until recently that exemption did not apply to services delivered by pharmacists' staff.
The amount of your state pension is largely determined by how many years of NIC you have completed during your working life. You can check your NIC record in your online personal tax account (www.gov.uk/personal-tax-account).