The objective of General Ophthalmic Services (GOS) is to provide, through community optician practices, preventative and corrective eye care for children, people aged 60 and over, adults on low incomes and those suffering from or predisposed to eye conditions and diseases.
Eye care services in England
Eye care services are available “on-demand”, largely in the high street from the private sector. In August 2008, the Primary Ophthalmic Services Regulations came into force in England. Full detail on the regulations can be accessed online. The 2014 amendments to the regulation can also be found online
These regulations for Government-funded services cover such issues as patient eligibility for sight tests, how patients apply for a sight test and eligibility for domiciliary sight tests. There are no reporting requirements explicitly set out in the regulations.
Although such data are not centrally collected, a large number of sight tests are delivered on an entirely private basis, with no support from Government funding. Private sight tests are discussed later in this document.
GOS forms
Activity data on NHS sight tests, optical vouchers and repairs/replacement are collected via a series of GOS forms:
- GOS1 – NHS sight tests, including information of patient eligibility status.
- GOS2 – The optical prescription or statements given to the patient. This form is not used as a basis for reporting.
- GOS3 – NHS optical vouchers, including information on patient eligibility status.
- GOS4 – NHS optical repair/replacement vouchers – including information on patient eligibility status and voucher type.
- GOS5 – Private sight tests with partial help towards the full costs.
- GOS6 – Domiciliary sight tests.
GOS forms can be completed and submitted on paper, or electronically, for input into the Central Ophthalmic Payments System (COPS).
Paper completion and submission of GOS forms
To 1 April 2013
The large majority of forms were sent as paper returns to the relevant Primary Care Trust (PCT) or an agent acting on their behalf, who then input the information into COPS. Practice around this input differed from area to area. Some PCTs/agents input all forms into COPS whereas others made batched or aggregate returns which do not have the same level of detail as the full return.
From 1 April 2013 – 31 March 2016
Forms continued to be sent by practitioners in the same way to agents or direct to the Area Teams for processing; often these were input into COPS in batched or aggregate returns, yielding limited detail. Additionally, some practitioners’ data were sent directly from their systems to COPS, providing greater detail (see ‘Electronic data pilot’ section below). This variation in reporting means that data quality varied between area teams. Users should therefore refer to the Data Quality section of the reports, where these issues and any means of mitigating their effects are detailed.
From 1 April 2016
Forms are no longer processed by Area Teams; instead, they are processed centrally by Primary Care Support England (PCSE). A new provider is due to provide a new system to capture all the data recorded on all submitted GOS forms for input into the Central Ophthalmic Payments System (COPS), but this new system is not yet operational. Therefore, the amount of detail currently available from these forms is reduced, and the quality of the data unknown. For this reason, the amount of information included in the 2016-17 report is reduced as compared with previous years, particularly in respect of patient eligibility.
Owing to the batch or aggregate inputting of data from GOS forms into COPS, it is likely that data fields which do not form part of the payments methodology or are not under regulation (such as patient eligibility fields), suffer from under–reporting or data quality issues.
Electronic completion and submission of GOS forms
In May 2007 an electronic links pilot was started, offering practices with accredited systems the ability to submit electronic claims directly to COPS. A small proportion of practitioners use this facility to input GOS1 and GOS6 forms directly into the system. The majority of Area Teams include a practitioner that makes electronic submissions.
The management of these data is less resource intensive than paper-based returns. Figures are subject to a series of automated validation checks that manage the quality of submitted information. Further, these data are individualised, rather than aggregated. Electronic data allow systematic checking of duplicate claims and offer greater scope for widening the content of our publications.
Central Ophthalmic Payment System (COPS)
Information from GOS forms is input into COPS (see ‘GOS forms’ section above) centrally. All data from electronically submitted forms are input into the system, but ‘batch-entry’ of paper forms means that only some of the data recorded on the forms are input.
Most data included in our publications are collected through the COPS, an NHS Digital product. The system keeps a record of claims, automates the payments process, generates necessary statistical returns and provides fraud prevention tools. COPS was designed to manage payments for eye care. Although the system has additional functionality, it was not designed as an information system and is not universally used as such across the sector. There is no obligation for Area Teams to use the system and no requirement to use it beyond its payments function.
More information on COPS is available here
Improving data quality - additional samples
Up to and including the reporting year 2015-16, a manual collection of data was made via the OMNIBUS system from those area teams where the availability of data in COPS concerning patient eligibility for sight tests was limited (for example, in Area Teams where few practices submit data electronically). A two per cent sample of data was collected from those Area Teams. Figures were grossed up to estimate local and national sight test volumes for each eligibility status, and provided in both the written reports and the annex files.