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Special Facial Characteristics GOS supplement – includes Tomato and MiraFlex range

12 October 2024

If you have had a GOS claim for a SFC supplement refused by the RBHT because the frame dispensed was not custom made, ie. from the  “Tomato” or “MiraFlex” range, please be aware that you are able to challenge this under the SGS additional guidance, details below:

Small Glasses Supplement

Additional guidance

NHS England and NHS Improvement

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Small Glasses Supplement(SGS) – Additional guidance.

In April 2016 the Optical Charges and Payments Regulations were amended to allow the Special Facial Characteristics (SFC) supplement (Link to the guidance is below) to be claimed by GOS contractors in Primary Care. The supplement is payable where a frame has to be custom made, or specially adapted.

Following consultation, it has also been agreed that frames which have been designed with appropriate modifications should also attract the Special Facial Characteristics supplement Examples of these types of frames include, but are not limited to, “Tomato glasses” and “MiraFlex”.

Where the Special Facial Characteristics supplement is being applied, there must be a clinical need for the specialist frames.

In order to ensure equity, these frames should be available via the Small Glasses Supplement (SGS). For this to happen the current requirement for SGS must also be met and the specialist frame must be provided for clinical need rather than choice. The SGS guidance should be consulted for qualifying criteria.

Special Facial Characteristics Guidance link (see item 6)

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/509601/Sight_test_fee_associated_fees_and_vouchers.pdf

Any queries regarding this revised guidance should be directed to

england.primarycareops@nhs.net

small-glasses-supplement-additional-guidance

 

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