Another real terms cut imposed on NHS primary eye care

Optometric Fees Negotiating Committee

Like other areas of the NHS, primary eye care has been hit over the past 18 months by inflation, including the rising costs of fuel and salary pressures. The impact has been made worse however in primary eye care by years of severe GOS underfunding.

OFNC had submitted an evidence-based bid for an increase in both fees and grants but, once again, this evidence was disregarded by NHS England who offered an increase of only 4.5% from 1 April 2023 in GOS fees and optometrist pre-registration training grants. Made worse by no increase in CPD grants.

The OFNC had made clear to NHS England that:

  • Based on the evidence from more than 750 NHS providers in England, the NHS is paying 50% of what it costs on average to provide this essential health care
  • The sight test is a vital NHS service and a core part of primary care on which the NHS depends to meet eye health needs and prevent avoidable sight loss
  • Primary eye care infrastructure in England is at risk due to chronic NHS underfunding. 

This meant that the OFNC could not accept NHS England’s offer on behalf of the profession. NHS England therefore has imposed its below inflation 4.5% increase.

Following last week’s news of 5% settlements for employed NHS staff groups, OFNC wrote to the NHS for a further 0.5% to grounds of parity. This again was rejected on the basis that the 5% pay offer for employed NHS staff is not directly comparable with GOS. 

On 22 March sector leads met with Primary Care Minister Neil O’Brien in his offices in Parliament at which this disparity was raised. The issue of joint work with NHS England to obtain agreed data on which to base future negotiations was also raised.  Although this does nothing to help with fees in the current year, it does help lay the ground for a more constructive engagement in the future. 

Gordon Ilett, OFNC chair said: “We held a positive meeting with the Minister about the future of eye care but meanwhile the system continues to undervalue and underpay us. Once again, we have had a lower settlement imposed on us than some others in healthcare despite official figures that show inflation remains high. The Minster is fully aware of the importance of primary eye care for the nation’s health and the key role that our workforce, skills, facilities, and equipment will need to play if the government is to turn around its capacity problems in the hospital eye service, improve access for patients and relieve pressure on GPs. This meeting has opened a new dialogue about the value of the primary eye care sector and we also hope it will allow a better way forward for evidence-based fee discussions with officials in the future.”

The OFNC will also shortly be issuing FAQs to help providers who have asked for advice on how to manage NHS capacity in light of rising costs and underfunding of the sight test. 


About us

The Optometric Fees Negotiating Committee (OFNC) is the national negotiating body for eye care in England with the Westminster Parliament, the Department of Health and Social Care and NHS England.  It comprises the leaders of the UK representative bodies: ABDO, AOP, FODO and BMA (for OMPs) and works in partnerships with the College of Optometrists and the General Optical Council. 


Taking account of other NHS pay awards, NHS budgets and wider economic forecast data, the OFNC had bid for an affordable and fair fee increase of 17% to reflect current inflationary pressures and as a partial correction to the historical funding shortfall. Read the full submission.

GOS Fees and Grants 2023-24 

The Department of Health and Social Care has proposed fees from 1 April 2023 will be:

  • Sight test £23.14  
  • Domiciliary £40.80 for first and second test; £10.21 for third and subsequent tests  
  • CET grant £596  
  • Pre-registration optometrist supervision grant £4,010


At the request of contractors, the OFNC will be issuing FAQs with advice and information on the hard choices facing contactors about the NHS capacity they can provide for patients in light of rising costs and underfunded sight test fees. 

GOS vouchers  

GOS vouchers are a patient benefit and do not therefore from part of OFNC negotiations.  However, OFNC has published a statement on the government’s decision to increase GOS vouchers by 4.5%. The optical bodies have updated vouchers at a glance.