Making accurate claims
To check current eligibility for NHS sight tests and vouchers go to the NHS website. You can also call the Help with Health Costs helpline on 0300 330 1343 to receive advice on all aspects of entitlement.
The Department of Health’s Memorandum of Understanding on the frequency of sight tests is also available for download, as is the AOP produced document Making Accurate Claims in England 2022.
Additional advice on second pairs and non-tolerances was issued in April 2018. Please download the relevant documents:
Applications should be sent to your NHS regional team. PCSE also has advice on this. When non-tolerance or 2nd pairs are authorised by NHSEI, please remember to retain evidence in the clinical record that authorisation has been provided to issue a second voucher.
NHS General Ophthalmic Services GOS 4 pre-authorisation information
A new process for authorisation of adult GOS4 claims commenced in November 2018. Requests may now be emailed, from another nhs.net address to nhsbsa.paos@nhs.net.
The NHS Business Services Authority (NHSBSA) has published an article to help ophthalmic contractors with GOS 4 pre-authorisation requests to repair or replace a patient’s glasses. The article covers: what is a GOS 4 voucher, how to check your patient qualifies and how to get pre-authorisation from the NHSBSA. To read the article in full, visit Under the Lens: Pre-authorising your GOS 4 vouchers.
Additional guidance on the small glasses supplement was issued in June 2019.
Remember that the GOS only pays for a ‘sight test’, and only if it is clinically necessary. Therefore if the patient attends with an eye problem but does not require a sight test, this is not covered by the GOS, and the patient would need to be seen privately (or referred). See the June 2015 rules and regulations on sight testing and contact lens fitting and supply for more information.
Flashes & floaters are a grey area. The AOP’s clinical & regulatory officer has advised us that: “The official AOP view is that it should be possible to use GOS for seeing patients with flashes and floaters, but it is not advisable as the amount of work required to investigate these symptoms properly and issue advice, in addition to performing a full sight test, far exceeds the level of remuneration offered by GOS.”