Sad and Bad news on Optical Fees

NHS disregards evidence and imposes more real terms cuts on GOS

Today the Department of Health and Social Care (DHSC) has confirmed it will impose yet more real terms cuts on NHS primary eyecare services. GOS1 fees will rise by just 2.5% to £24.13 for financial year 2025/26.  All other payments and grants will be frozen at 2024/25 levels. This follows a freezing of patient benefits (NHS voucher values) announced earlier in the year.

OFNC Chair Paul Carroll said: “Once again primary eye care seems to be singled out for unfair treatment despite the growth in the NHS budget and Lord Darzi’s independent recommendations about rebalancing NHS spending and rebuilding primary care. It is hard to fathom why, other than the low priority the NHS always gives to eye care outside hospitals.”

GOS fees

The fees and grants imposition by DHSC comes after nearly seven months of discussions with NHS England, during which NHS England acknowledged the strength of OFNC’s evidence but continued to disregard the evidence on actual costs, and instead use its own forecasting data which it recognised as being suboptimal.

The Minister requested for the OFNC to engage constructively with the process, and in good faith, we proceeded to work collaboratively with officials with the goal of ensuring the GOS sight test fee was uplifted as much as possible within centrally pre-set spending constraints. We made a very credible case for at least a £25 sight test fee within NHS England’s £17.6m budget headroom, but this was rejected by NHS England on supposed grounds of affordability.

NHS England therefore continued to seek to impose an unrealistic 2.39% uplift to the sight test fee, although this was later increased marginally to 2.5%. This was not an offer OFNC could accept on behalf of the primary eyecare sector, because it fails to recognise how much the sight test fee has been, and is still being, systematically underfunded and because NHS England’s approach is based on modelling assumptions which we know to be unsound.

As a result, DHSC has now taken the decision to impose the below inflation increase on practices – the sight test fee increases by just 60p. This will be backdated to 1 April 2025. All other payments will remain frozen at last year’s rates including domiciliary visiting fees, CPD grants and pre-registration optometrist training payments.

We have left officials in no doubt about how furious and disappointed practices and practitioners will be about this latest imposition given all the evidence shows that the real costs of a providing a sight test exceed £49, that is before counting the increases in national insurance, the national living wage and other taxes the government now requires primary eye care providers to fund.

This year has been exceptional in many ways, not only in the very disheartening outcomes but also in the fact that NHS England was not in a position to even start discussing fees until May when budgets had already been set and agreed with Ministers based on unreliable data. We are therefore taking the step of publishing a timeline and summary of our engagement with the NHS below, with the usual link to official correspondence so that all practice owners can see the arguments put forward.

We know that many practices will now be struggling with the question of whether they can continue to offer NHS eye care as in the past, so, at your request, we have produced some FAQs to help practices shape their thinking .

CPD window extended but no more cash 

Owing to the delays, this year’s CPD grant claim window (for CPD undertaken in 2024/25) will run from 8 December 2025 to 31 March 2026.  The grant remains at £596.

Clinical placement training payment

One element of the new arrangements which may not immediately be noticed is that, through separate discussions, OFNC has agreed with NHS England and DHSC that there will be a clinical placement training payment available to contractors in respect of students on long practice placements under the new MOptom programmes at UK universities. This will also be available to contractors in respect of pre-registration optometrists enrolled on the College of Optometrists Scheme for Registration until that is phased out.

The rate of payment will be the same as the pre-reg grant for the current year (2025/26) – £4010 but will be claimable in two half-placement ‘blocks’ or for a full placement (two blocks) from PCSE within three months of the end of the block (half placement) or whole placement. This change of time limit for claims will bring clinical placement training payments in line with the time limits for other GOS claims.

The College of Optometry responds

College comments on the DHSC’s update on GOS sight test fees for England and clinical placement training payments for 2025/2026

This week, the Department of Health and Social Care published details of its confirmed NHS sight test fee and NHS domiciliary fees from 1 April 2025, continuing professional development payments for 2024, and clinical placement training payments from 1 April 2025.

GOS1 sight test fees for England

The GOS1 fees in England will rise by 2.5% to £24.13 for financial year 2025/26. All other payments and grants will be frozen at 2024/25 levels. This follows a freezing of NHS optical voucher values for 2025/2026 announced earlier in the year.

Dr Gillian Rudduck MCOptom, President of The College of Optometrists, said, “In real terms, the 60p increase in the NHS sight test fee represents a below inflationary increase for primary eye care in England, where many practices are already struggling to deliver NHS services after years of underfunding. This is a deeply disappointing outcome following the long delay for confirmation of GOS1 fees for the current financial year.

“As one of the four pillars of primary care, optometry is central to the government’s shift from hospital to community services as part of its 10 year health plan for England. However, without adequate investment in primary eye care services, we risk England falling further behind the rest of the UK and the shift from secondary to primary care will not be fully realised.

“Failure to invest properly in primary eye care will only lead to increased pressure on hospital eye departments and worsening patient outcomes.  The Department of Health and Social Care needs to recognise the value of optometry and provide fair and sustainable funding for these services.”

Clinical placement training payments from 1 April 2025

Dr Gillian Rudduck MCOptom, President of The College of Optometrists, continued, “We are pleased to have confirmation that NHS England and DHSC have updated the clinical placement training payment for 2025/2026 to include the College’s Clinical Learning in Practice placements as part of the new master’s degrees in optometry at UK universities. This payment will also continue to be available to contractors with all remaining Scheme for Registration trainees until the qualification ceases enrolment.

“However, it is very concerning that the funding for employers has not been increased for 2025/2026 to reflect the increased costs for practices to provide pre-registration clinical experience and supervisors.  DHSC must value and support the future workforce if it is to realise the aims of its 10 year health plan.”