Being GOS compliant
OT poses a monthly scenario from a practitioner. This month, we look at GOS contract assurance
Daniel, AOP member“I recently became a practice owner for the first time, opening up an independent on the south coast of England. We will be offering GOS sight tests in the practice and have applied for a contract. As this is the first time that I have set up a practice, I wanted to ensure that my practice is compliant with its GOS contract. Would you have any advice on the key steps that I should take and what processes you would recommend that I put in place?”
Henry Leonard, AOP head of clinical and regulatory
There are currently two types of General Ophthalmic Services (GOS) contract – a ‘mandatory services’ contract for fixed premises, and an ‘additional services’ contract for those wishing to offer domiciliary sight testing.
As you have applied for a ‘mandatory services’ contract, NHS England will want to arrange a practice visit to satisfy itself that the premises are suitable for providing GOS sight testing, and to confirm that you have adequate equipment, and the correct policies and procedures in place to provide the service safely.
Ensuring you are able to meet the requirements can seem quite daunting at first, but fortunately there’s an excellent resource to help ensure that you have everything in place ahead of NHS England’s visit
Quality in OptometryEnsuring you are able to meet the requirements can seem quite daunting at first, but fortunately there’s an excellent resource to help ensure that you have everything in place ahead of NHS England’s visit.
I would recommend visiting the Quality in Optometry website, creating a free account, and then following the instructions to create a GOS contract checklist.
The checklist contains detailed guidance on each requirement, along with templates for the policies you’ll need, which you can download and adapt for use in your practice.
Policy book for eye healthNHS England also publishes a Policy Book for Eye Health, which sets out how it manages GOS contracts. Although this guidance is mainly aimed at commissioners, it helpfully sets out how NHS England deals with contract applications, assurance, variations, breaches, disputes, post-payment verification (PPV) and termination. You will also find a copy of the form NHS England uses when conducting its contract assurance visit, including the list of equipment they will expect to see.
It’s important to spend some time understanding when to claim under GOS
Making accurate claimsNHS England may conduct PPV checks periodically in order to ensure that contractors are submitting claims appropriately. In many areas, NHS England will attempt to reclaim fees from contractors if it believes claims have been submitted inappropriately so it’s important to spend some time understanding when to claim under GOS. The AOP has published guidance on Making Accurate Claims in England, which includes a link to the Optical Confederation’s in-depth PDF guide on making accurate claims.
GOS audit toolThe AOP has created a secure online GOS audit tool, which allows contractors to audit their GOS claiming and can help identify any areas where they may be vulnerable to a reclaim from NHS England.
The tool allows contractors to enter the details of GOS1, GOS3 and GOS4 claims and performs a series of checks to see whether the claims are likely to be justifiable in the event of an inspection. It’s designed to ask for the minimum amount of information necessary to verify the claim, to ensure it’s as quick and accurate as possible. As you go along, the tool shows what percentage of GOS1, GOS3 and GOS4 claims it believes can be justified, explaining why each claim is or isn’t likely to be adequate, and highlighting areas where the practice may need to record more information, or change the way they claim.