OFNC Statement: Clinical Priority Codes

3 February 2025

NHS England has published new clinical priority codes for use by GOS contractors in England. This is due to an error in the current PCSE system which NHS England commission. This means that some sight tests, which should not require an early retest code, are erroneously requiring a code to be entered to process the sight test.

As an interim measure, practitioners should use the new clinical priority codes to process claims in four distinct categories: These are already available to use in PCSE Online

• Under 7 years – corrected refractive error – Code 7.1
• Under 16 years – binocular vision anomaly – Code 7.2
• 7-16 years – rapidly progressing myopia – Code 7.3
• Ocular hypertension and not in a monitoring scheme – Code 7.4

For the avoidance of doubt, the Memorandum of Understanding (MoU) between the optometry profession and Department of Health and Social Care remains unchanged and is not impacted by these new clinical priority codes.

These codes differ to normal early retest codes. Early retest codes are subject to PPV metrics and should be used when a patient is seen at an earlier than expected interval. However, these codes are excluded from those metrics. NHS England have apologised to the eye care sector for the lack of prior notification and acknowledged that this may cause significant inconvenience and operational challenge for practices.

NHS England have assured OFNC that a permanent fix to the PCSE system will be implemented in the 2025/2026 financial year.