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GOS Information for Practices

 

The NHSBSA are responsible for facilitating Contract Management applications, terminations and variations for contractors based in England.

The briefing below is only applicable if you wish to apply for a new GOS contract; vary your existing contract; or terminate your existing contract.

National Contract Management Website Briefing

GOS Contract Application Process and Declaration Form

 

GOS 3 Voucher Prices

GOS 4 for Adults

PCSE require all GOS4 claims for adults to be pre-authorised now.

Briefing/ Guide:

GOS 4 Briefing

Under the Lens – Ophthalmic Services – Article 1 – GOS 4 vouchers

 

GOS 4 Pre Authorisation Template:

GOS 4 Template

 

Vouchers for 2nd Pair – Adults and Children

Patients are not automatically entitled to a spare pair of spectacles of the same prescription under GOS, however, they may seek permission from the NHS England Regional Local Team (RLT)  by submitting a second pair application form, for the supply of a second pair in “exceptional circumstances”.

A second pair should not be provided where there is no evidence of needed. The guidance states what is normally considered to be “exceptional circumstances” for these reasons.

Second pairs for children:

  • A child is 7 or under and the prescription falls into the GOS 3 Band B or above & there is a history of spectacle loss of breakage (2 or more pairs in 6 months).
  • A child is aged over 7 or is a “looked after child” and they have a further illness that causes the frequent breakage/ loss, the prescription falls into the GOS 3 Band B or above, there is a history of spectacle loss/ breakage (2 or more pairs in 6 months) & there is evidence to suggest that the patient’s education or quality of life is likely to be affected if they are without their spectacles

May also be approved with discretion for children of any age if:

  • The prescription falls into the GOS 3 Band, is in Voucher A (those children with high A values may still be at risk) and a clinical adviser has reviewed the case and is satisfied that the application meets the necessary criteria.

Second pairs for adults:

  • It is rare for an adult second pair request. However, the criteria for approval will be similar to that for older children where an application is made.

Applications for second pair or non-tolerance vouchers must be sent to your NHS England Local Team using the standard national templates.

Applications for a new GOS 3 voucher on the grounds of non-tolerance can be submitted to NHS England RLT if the following criteria are met:

  • The tolerance problem has been present from the time of supply (rather than starting later)
  • The cause of the problem has been shown to be related to the prescription (i.e. the strength of the lenses), not the type of lens or appliance.

Therefore, requests for an additional GOS 3 to allow a change from single vision to bifocal/varifocal or vice versa will not be considered as meeting the acceptance criteria unless there is also a change in prescription.

Patients who have received their original spectacles from the Hospital Eye Service should apply to the individual NHS Trust concerned if they have a problem adjusting to the prescription.

How to submit:

  1. Complete the second pair application form
  2. Submit the completed form to your NHS England Local Team
  3. The local team will normally notify you of their decision in 1 week
  4. Once you have received a decision from NHS England, you must retain a copy of the application form for your records for  post-payment verification
  5. If the application has been approved, you should submit a GOS 3 to PCSE.

Other General info and the sources can be found on the website: GOS Contract Management | NHSBSA

Integrated Care Board (ICB) and Optometry Contact Email Addresses can be found here.

 

Special Facial Characteristics GOS Supplement

The guidance around the use of Small Glasses Supplement has been clarified and updated in 2019. The guidance permits the use of frames with modifications, frames include but are not limited to, “Tomato Glasses” and “Mira Flex”.

Additional and full guidance can be found here.

Any queries regarding this revised guidance should be directed to:  england.primarycareops@nhs.net

 

GOS 18 for Routine Referrals

GOS 18 referral forms have been traditionally used by Community Optometrists for routine referrals.

Downloadable forms:

GOS18 Electronic

GOS18 Electronic with Digital Signature

GOS 18 Signature Guidance

 

GOS Payments

Payments are now processed by Primary Care Support England (PCSE). Their website can be found here.

General Ophthalmic Payments Information can be found here.

Making Accurate Claims Guide

Guidance on how to use early re-test codes 1 – 6 on GOS forms in England can be found here. There is also CPD available on completion of the articles.

NHS Eligibility for Sight Tests, Glasses and Contact Lenses

You’re entitled to a free NHS sight test if you:

  • are aged 60 or over
  • are registered blind or partially sighted
  • have been diagnosed with diabetes or glaucoma
  • are aged 40 or over and have a close relative (parent, sibling or child) with a history of glaucoma
  • have been advised by an ophthalmologist that you are at risk of glaucoma

You’re entitled to a free NHS sight test and help with the cost of glasses or contact lenses if you:

  • are aged under 16, or under 19 and in qualifying full time education
  • are eligible for an NHS complex lens voucher
  • are a prisoner on leave from prison
  • are included in an award of:
    • Income Support
    • Income-based Jobseeker’s Allowance (not contributions-based Jobseeker’s Allowance paid on its own)
    • Pension Credit Guarantee Credit (not Pension Credit Savings Credit paid on its own)
    • Income-based Employment and Support Allowance (not contributions-based Employment and Support Allowance paid on its own)
    • Universal Credit, and your earnings during the most recent assessment were £435 or less (or £935 or less if your Universal Credit includes an element for either a child or limited capability for work)
  • are named on or entitled to a valid NHS tax credit exemption certificate
  • have a valid HC2 certificate for full help with health costs

The amount of help you can get towards the cost of your glasses or contact lenses is known as a voucher value, which depends on the strength of your prescribed lenses. Your optician will tell you which voucher value applies to you. If your glasses or contact lenses cost more than your voucher value, you will have to pay the difference.

More information can be found here.

 

PCSE and NHS Email Address

PCSE

From 1st April 2024, there is new guidance setting out fees for general ophthalmic services, including:

  • ​NHS sight test fee and NHS domiciliary fees
  • NHS optical voucher values
  • Continuing Professional Development (CPD) payment for 2023, payable in 2024
  • Grant payable to supervisors of pre-registration trainees

You can read the guidance in full here.

The new fee structure has been updated in PCSE Online and will be applied to all GOS1, GOS5 and GOS6 claims submitted from 1 April 2024 onwards.

The new fees will be applied to all GOS3 and GOS4 claims with a date of 1 April 2024 or onwards in Part 4 patient declaration date (collection date).

We would like to also remind you of the validity period for GOS claims:

  • GOS1, GOS5 and GOS6 – this is 3 months from date of sight test, and includes the submission, processing and payment of the claim
  • GOS3 and GOS4 – this is 3 months from date glasses/contact lenses are supplied/collected, and includes the submission, processing and payment of the claim

Read PCSE’s full  April 2024 Ophthalmic Bulletin

Contractor Change of Bank Account

If you need to request a change to your bank account, please contact NHSBSA pao-cm@nhsbsa.nhs.uk. You will be asked to complete a declaration of banking details form, to be signed by all directors, partners, or Individuals party to the contract.  NHSBSA will apply to Shared Business Services (SBS) for a new financial reference code and, once complete, they will inform PCSE to make future GOS payments to your new bank account.  Please be aware that the process can take several weeks. In the interim, please continue to submit your GOS claims as normal and do not close your old bank account until you receive confirmation that we have completed your request.

NHS Email

NHSmail is available to all GOS Ophthalmic Contractors (GOS) and their optometrists & dispensing opticians in England, that have 10 or fewer sites. It enables safe and secure exchange of patient or sensitive information with other health and social care professionals.

Upon joining NHSmail, each organisation will have one shared mailbox account and up to three user accounts per site.

Registration Route

National Administration Service (NAS)

GOS contractors can apply for NHSmail via the online portal below and be managed centrally through the NAS; a dedicated team that perform Local administrator functions.

Before registering, please ensure you have the following:

To begin the registration process please use the portal registration tool.

Find out more about NHSmail on the support site pages.

If you already have an existing NHS email account and are unable to access it, please call 0333 2001133 for further assistance or visit the NAS FAQs.

Data Security and Protection Toolkit (DSPT) requirements

To access NHSmail, health and care organisations are required to have a Data Security and Protection Toolkit (DSPT) rating of ‘Standards Met’ or ‘Standards Exceeded’.

The DSPT can also be completed via https://www.qualityinoptometry.co.uk/ and a help video is available on https://help.optom-referrals.org/article/303-qio-tutorial-optical-dspt-checklist.

Please visit the DSPT registration page for further information.

 

 

Additonal Contact Information can be found here. 

 

 

 

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