Goodbye GOS: the story behind one practice’s transition to private care

Brian Tompkins has had GOS forms at his Northampton practice since they were “green and ancient.” He tells OT  why it was time to change

Brian Tompkins

Tucked away from the High Street, in a Victorian building with chandeliers and bay windows that overlook a park, Tompkins Knight & Son Optometrists is an optical practice steeped in tradition.

Remnants of the Northampton practice’s 152-year legacy can be found in the 1890s tiled flooring and former stables converted into an academic training space.

But in October, practice staff said goodbye to one aspect of the business that forms part of the institutional fabric of optometry across the UK – the General Ophthalmic Services form.

Anecdotally, whether to continue offering NHS care is a conundrum that many practices in the UK are grappling with as they consider how to remain financially viable in the context of a pandemic.

“The practice has had GOS forms in it since they were green and ancient. The constant paperwork, administration and keeping on top of the forms - we wanted to take all of that away and concentrate on time with the patients and looking after them,” optometrist Brian Tompkins told OT.

“Of course, it was a difficult decision to make, but it is one that many optometrists are currently making. We are not alone,” he added.

The shift to only offering private care has come in the form of care plans, which have been offered at the practice since 2006 but were optional for spectacle wearers.

It is a bit like the AA – you may never need it, but when you do, it is useful to have somebody come out at 3am in the morning to change your tyre on the motorway


Now, every patient who comes through the practice will sign up to a care plan, where a regular payment gives the customer eye care when they need it in a similar manner to a subscription.

It is a change that Mr Tompkins, fellow directors and the practice team have welcomed.

“The whole point of the care plan is peace of mind and continuous care,” Mr Tompkins explained.

“It is a bit like the AA – you may never need it, but when you do, it is useful to have somebody come out at 3am in the morning to change your tyre on the motorway,” he observed.

Regular payments from contact lens wearers on care plans provided a financial buffer to the practice during the challenges posed by COVID-19.

While the practice was seeing limited numbers of patients through the door because of social distancing, there was an opportunity to step away from the day-to-day routine and look at the big picture of how the business was operating.

“When COVID-19 hit, one of the things that saved us from being in trouble, apart from Government financial support, was that we were getting a very consistent direct debit pay in,” he said.

“We realised that the GOS was not fit for purpose – it has not been fit for purpose for a very long time. I think COVID-19 gave us a push. We had time to think and examine our business,” Mr Tompkins shared.

To explain the new way of working the practice produced a video that was shared on social media channels. So far, 1500 patients have signed up to the scheme.

As well as providing patients reassurance, the care plan also gives practitioners flexibility to tailor their treatment to individual needs.

“We can sleep easily at night knowing that if any of our patients have any problem, we don’t have to think ‘We’ve seen them twice now, that means we are going to have to charge them again.’ The pay as you go system is not the practical way to do it for many of the emergency cases and problems that we see,” he said.

A Tompkins Knight & Son Optometrists video explains the new care model to patients

OT  asks…

Has your practice reconsidered offering GOS following the pandemic?
  • Yes – and we decided to stop offering GOS sight tests

    24 13%
  • Yes – but we continue to offer GOS sight tests

    107 61%
  • No

    43 24%