How sight tests are funded in the UK
A guide for media and policy makers as to what is and isn't included in NHS sight tests across the UK
This guide explains how sight tests are funded in each of the four nations of the United Kingdom.
The NHS-funded sight test is a nationally commissioned service in each UK nation.
General Ophthalmic Services (GOS)
Optometrists, like many other primary care professionals, are contracted by the NHS to deliver NHS services. The General Ophthalmic Services (GOS) contract pays a standard amount of money for each sight test that is conducted by an optometrist or ophthalmic medical practitioner (OMP) on behalf of the NHS. GOS also pays fees to deliver domiciliary sight tests for people that cannot attend an appointment on the High Street.
Each year the price of GOS test in England, Wales, and Northern Ireland is set by government after discussions with the Optometric Fees Negotiating Committee (ONFC). The OFNC is made up of representatives from the Optical Confederation, the Local Optical Council Support Unit (LOCSU) and the British Medical Association (BMA), who negotiate this fee with the Department of Health and NHS England.
In Scotland, Optometry Scotland negotiates this fee with the Scottish Government.
The following groups are eligible for free NHS sight tests in England, Wales and Northern Ireland:
- Under 16 years of age, or under 19 and in full time education
- Aged 60 or over
- Registered as sight impaired or severely sight impaired
- Diagnosed with diabetes or glaucoma
- Aged 40 and over and a close family member has been diagnosed with glaucoma
- Considered to be at risk of glaucoma
- Prisoners on leave from prison
- Eligible for NHS complex lens voucher
- Receive income support, or income based job seekers allowance
- Receive pension credit, income based employment and support allowance, or universal credit
- Are entitled too, or named on a valid NHS exemption certificate or a valid NHS certificate for full help with health costs
Private sight tests
In England, Wales and Northern Ireland, people who do not qualify for an NHS sight test pay for their sight tests privately. The fees for this are market driven and vary. The basic requirements for NHS and private sight tests are identical but some practices have invested in equipment which allows them to provide more specialised examinations, and they may charge extra for this.
- The fee for the sight test as of April 2016 is £21.31; this represents a freeze from the previous year. The domiciliary site test, when an optometrist attends a patient’s home or care home, attracts an extra £37.56 for the first and second patients seen within one visit, and then £9.40 for third and subsequent patients
- There are a number of extended primary eye care services which deliver services above and beyond the remit of the current GOS sight test. These are commissioned locally by Clinical Commissioning Groups (CCGs)
In Scotland, NHS eye tests have been extended to the entire population since 2006. This means that there are no exemptions and anyone from the UK can access a sight test in Scotland free of charge.
There are two types of examination that are covered by GOS in Scotland with different fees:
- The Primary Eye Examination (PEE) fee is £37 per test for under 60s and £45 for over 60s. The higher figure for older people is due to the need for extra procedures
- The Supplementary Eye Examination (SEE) can be claimed for extra tests or to investigate any symptoms that present themselves during the initial examination. The fee for this is £21.50
The NHS in Wales funds sight tests for exempt individuals. The sight test fee in Wales is £21.31.
However, the Welsh NHS has nationally commissioned a number of enhanced eye services that go above and beyond the remit of services that are covered by GOS. These services are delivered through the Eye Health Examination Wales (EHEW) scheme and include a number of banded services.
- The Eye Health Examination (EHE) (Band 1): £60
- Further investigation/ examination (Band 2): enables optometrists to do further investigations after a GOS or private sight test, but not an EHE: £40
- EHE follow-up examination (Band 3): £20
The sight test fee in Northern Ireland has been increased to £21.31 to bring it in line with the fee in England and Wales.
Sight tests are available for free on the NHS for exempt individuals. These are the same as the exemptions in England.