Hopes were dashed last week when the government announced that from April 1, 2024 the GOS sight test fee would increase by just 39p to £23.53 in England.
Equally disappointing, there would be no increase in the domiciliary visiting fee nor in the pre-registration training grant nor, for the second year running, the CPD grant.
In early negotiations, the Optometric Fees Negotiating Committee (OFNC) highlighted to the Department of Health and Social Care (DHSC) and NHS England that the NHS pays less than 50% of the cost of a GOS sight test.
Taking into account wider NHS cost pressures, the OFNC proposed a ‘reasonable’ increase of £2.86 to the NHS sight for 2024/25 and at first, the government appeared to be listening.
Minister for public health, start of life and primary care Rt Hon Dame Andrea Leadsom met with the OFNC at the start of the year and acknowledged the vital role of NHS sight testing.
‘I was delighted to meet with the OFNC to discuss the essential role played by NHS sight testing in the prevention of avoidable sight loss, the current challenges facing eye care services and how an expanded role for the primary eye care workforce could help alleviate ophthalmology pressures,’ she said at the time.
By March 5, the OFNC revealed to the profession that it had refused to accept an ‘unacceptably low offer’, challenged the DHSC and NHS England and requested an urgent meeting with Leadsom to review the offer.
In subsequent correspondence with officials, the OFNC highlighted the impact of cost and wage inflation, the history of previous under-inflationary settlements and the impact of fuel and transport increases on the domiciliary sector.
It pointed out the cost increases resulting from the changes to the education and training for optometrists plus the cost of administrative burdens on GOS providers resulting from changes to the referral process.
Also raised was the impact of the proposed fee increase on a sector already under strain, including smaller community practices caring for the poorest people in their community.
Sadly, these efforts were to no avail, with ministers repeatedly relying upon the GDP deflator to determine the NHS sight test fee and ignoring requests for a ministerial meeting to discuss the offer.
OFNC chair Paul Carroll said that the ‘derisory’ increase showed that ‘talk is cheap’: ‘Despite effusive praise for the important role that primary eye care plays in meeting the nation’s vision and eye health needs, once again we find ourselves at the back of the NHS queue. It is hard to take seriously warm statements made by ministers, when they are not backed up by action.’
The OFNC added that the news would have a massive demoralising effect on the sector at a time when they need to take on more NHS work to help hospitals struggling with waiting lists and to meet needs. It said that it would be writing to the sector to survey the impact of this latest real-terms cut to NHS eye care.
Optometrist Neil Donnelly, owner of independent practice Eyelines in Sevenoaks, told Optician the increase in fees showed the government and NHS did not value what primary care optometry can provide.
‘There was an opportunity to make better use of the services that we provide on the high street but it was decided not to,’ he said.
Commenting on the future for optometry, Donnelly said: ‘I think for a lot of practices this may well speed up the move towards withdrawing from providing NHS services.’
With a Labour government looking increasingly likely, Donnelly added: ‘I would like to think that a new government would listen to the industry and work together to make better use of our skills but I fear that this will not happen regardless of who is in power.’