Lecture 15: NHS GOS services

Question 1

When was the NHS and GOS established?

Answer 1

by an act in 1946

Question 2

What are GOS contractors?

Answer 2

An entity that has a direct contract with GOS to provide GOS services in their practice. This may be an individual business owner or body corporate

Question 3

What are GOS performers?

Answer 3

An individual ophthalmic practitioner who is registered to provide the GOS eyecare e.g. sight tests and issuing vouchers

The GOS Performer must be registered on the relevant national Performers List

For England this is Primary Care Support England (PCSE)

Question 4

When can you apply to the PSCE?

Answer 4

once you have almost completed your pre-reg. Currently 3 months before

Question 5

When must NHS make the decision about the application for a performer?

Answer 5

make a decision about the application within 7 days of you notifying that you have been included on the full GOC register.

Question 6

Who has GOS eligibility?

Answer 6

-Age (Under 16, 17 or 18 in full time education, Over 60)
-Wears Complex Lenses
Has a power of 10.00D or more in any one meridian
Prism controlled bifocal lenses
Registered Sight Impaired or Severely Sight Impaired
-Prisoner on leave from prison
-Patients suffering from Diabetes or Glaucoma. Includes
Patients with previously treated Glaucoma
Patients with High IOP at risk of Glaucoma
40 or over with parent, brother, sister or child of a person who has been diagnosed as suffering from Glaucoma

-Income support
-Pension Credit Guarantee Credit
-Income based job seekers allowance (not Contribution based)
-Income related employment and support allowance (not Contribution based)
-Entitled to, or named on a valid NHS tax credit exemption certificate
-Universal credit
-A member of the same family of a person who is in receipt of the above financial support
Patients named on a HC2

Question 7

What is the NHS low income scheme (LIS)?

Answer 7

-Patient completes a relevant HC1 form
-Allow patient to apply for help with cost of eye examination and spectacles on grounds of low income
-Also prescriptions, wigs, dental treatment, travel to hospital and supports
-Eye examination fee & spectacle costs can be refunded on filling in appropriate form
If issued with an HC2 form Full help received
If issued with HC3 form – Partial help received (stated on the certificate)

Question 8

What are the types of GOS forms?

Answer 8

GOS 1: application for NHS funded eye test
GOS 2: patient prescription
GOS 3: NHS optical voucher
GOS 4: NHS optical repair voucher
GOS 5: help with cost of a private sight test
GOS 6: application for a mobile NHS funded ST

Question 9

Who do GOS forms need to be signed by?

Answer 9

The Patient
The GOS performer
The GOS contractor if different from the performer

Question 10

What is the frequency of eye examinations?

Answer 10

Under 7 years with binocular vision anomaly or corrected refractive error – 6 months

7 to 16 with binocular vision anomaly or rapidly progressing myopia – 6 months

Up to 16 years, in the absence of any binocular vision anomaly – 1 year

16 to 70 years – 2 years

70 years and over – 1 year

Patients over 40 with a family history of glaucoma or with ocular hypertension not part of a monitoring scheme – 1 year.

Patients with diabetes not part of a diabetic retinopathy monitoring scheme – 1 year.

Question 11

What are the early re-test reason codes?

Answer 11

1. px at risk of frequent changes to rx. referral not needed
2. px has pathology likely to worsen (AMD, cats, corneal dystrophy, congenital abnormalities)
3. px has symptoms or concerns requiring investigation
   3.1 referral to GP
   3.2 changed prescription
   3.3 no change or no referral

4.1 px needs complex lenses
4.2 corrected vision of less than 6/60 in one eye

5.1 presented for eye test at request of medical practitioner
5.2 managed by an optometrist under GOC referral

6. other unusual circumstances requiring clinical investigation

Question 12

When can optometrists issue a voucher to those eligible?

Answer 12

There is a change in prescription

Spectacles need replacing due to fair “wear and tear”

Question 13

What are GOS 4 vouchers?

Answer 13

Automatically available to under 16’s

Older patients may be eligible:
Not automatic
Only applicable if damage a result of illness
Nobody else eligible

Question 14

Can you issue contact lenses with a NHS voucher?

Answer 14

Spectacle Vouchers can be used towards CL

A replacement voucher can be issued if the CL are unserviceable (only applies to conventional CL)

If they are used towards buying disposable CL, a new voucher cannot be issued on the basis of fair wear and tear

Question 15

What is small glass supplement?

Answer 15

Glasses for a child under 7 years who needs a custom made or stock spectacle frame which requires extensive adaptation to ensure an accurate fit and has a boxed centre of no more than 55 mm

E.g. Changes to side length, bridge width
Consult HA if required for patient older than 7 years

Question 16

What prescription changes should you consider before issuing a voucher?

Answer 16

Small clinically insignificant change: no new vouchers

New vouchers only when spectacles are to be replaced due to fair wear & tear

Question 17

Can tinted lenses be prescribed with NHS voucher?

Answer 17

Can only be prescribed if judged to be clinically necessary. E.g. Albinos

ARC and UV blocking tints cannot be normally supplied

Coloured filters for children with Dyslexia are not covered

Question 18

What are the NHS rules about non-tolerance?

Answer 18

If second test is undertaken due to Rx Intolerance, GOS form must be marked accordingly

A new voucher cannot be issued without the permission of the HA

Question 19

What happens if a px can show NHS eligibility following a private ST and before ordering glasses?

after ordering glasses?

Answer 19

Practitioner simply fills GOS 3 form

A patient applying for a refund must establish eligibility within 3 months of the date on which they paid for their Rx