This page provides information on supplementary eye examinations provided under General Ophthalmic Services (GOS) arrangements in Scotland, under the following headings:
- What is a supplementary eye examination
- Supplementary eye examination fees
- 3.9 Reason Code - Cataract Referral Advice and Counselling
- Specialist supplementary eye examinations
All references to the "Statement" are to the determination made by Scottish Ministers in exercise of powers conferred by sections 28A and 28B of the National Health Service (Scotland) Act 1978 and regulation 17 of the National Health Services (General Ophthalmic Services) (Scotland) Regulations 2006 ("GOS Regulations"), after consultation with such organisations as appear to them to be representative of contractors providing GOS. The current version of the Statement can be found on the Legislation page of this website.
What is a supplementary eye examination
Under regulation 2 of the GOS Regulations, a supplementary eye examination means an eye health check which is either carried out:
- after a primary eye examination for a particular reason which has arisen during the primary eye examination; or
- in circumstances set out in regulation 22A(2) of the GOS Regulations, where the eye examination is carried out more frequently than permitted as a condition of remuneration by the Statement
and includes the tests and procedures appropriate to the clinical needs of the patient. Appendix D of the Statement provides further information on the tests and procedures relevant to a supplementary eye examination.
Table B of Appendix D of the Statement lists the reason codes to be used in accordance with the carrying out of a supplementary eye examination, and further supporting information on some of these reason codes can be found further below.
Supplementary eye examination fees
The fees payable to GOS contractors for undertaking supplementary eye examinations are set out in Appendix A of the Statement.
3.9 Reason Code – Cataract Referral Advice and Counselling
This code is to be used when providing advice and counselling to a patient (in person or using remote facilities) following an eye examination which has resulted in the patient being considered for referral. This may include providing prognosis or counselling and preparation for consent for cataract surgery, including risk factors.
An Aide Memoire Form has been developed by NHS Scotland to support community optometrists when referring a patient to secondary care for cataract surgery, and can be used to structure the 3.9 Reason Code supplementary eye examination appointment (‘Cataract Referral Advice and Counselling’). Ideally, the patient will already have received an information leaflet about cataract surgery prior to this appointment.
Note: It is not mandatory to use this form, as practitioners may have alternative ways of recording their discussion with the patient and any advice given. However, the College of Optometrists Guidance for Professional Practice on keeping full and accurate records should be noted.
Specialist Supplementary Eye Examinations
Further to the publication of the NHS Scotland Operational Improvement Plan and circular PCA(O)2025(02), the Scottish Government issued a letter to Scottish optometry sector stakeholders on 17 June 2025 providing an update on changes to GOS that will support Independent Prescriber (IP) optometrists and ophthalmic medical practitioners (OMP) via enhanced remuneration to manage patients with specified acute anterior eye conditions. These changes to GOS form a new tier of GOS Specialist Supplementary eye examinations.
GOS Specialist Supplementary is being implemented in two phases:
- Interim Measure (introduced on 1 August 2025 and scheduled to end on 18 January 2026), as set out in PCA(O)2025(04)
- Full Implementation (scheduled to begin on 19 January 2026), as set out in PCA(O)2025(08)
As set out in PCA(O)2025(08), IP optometrists and OMPs who wish to enter into arrangements with Health Boards to provide GOS Specialist Supplementary eye examinations on and after 19 January 2026 must submit an application and have been approved by the relevant Health Board.
Full information on the application process is set out in PCA(O)2025(08). Applicants are strongly advised to ensure they read the full content of this circular (including the planned new Statement in the Annex of the circular) prior to deciding whether or not to submit an application. If, after reading this, an IP optometrist/OMP wishes to proceed in submitting an application then one of the following forms should be submitted:
STREAM A application form - this is for IP optometrists whose GOS Specialist Supplementary application is consistent with the information currently held about them on the Ophthalmic List(s) of the Health Board(s) with which they wish to enter into arrangements to provide GOS Specialist Supplementary. Stream A applications must be submitted from the individual's NHS email account to NHS National Services Scotland at: NSS.psd-GOS-SS@nhs.scot. Guidance on how to complete this form is available here.
STREAM B application form - this is for IP optometrists whose GOS Specialist Supplementary application is not consistent with the information currently held about them on the Ophthalmic List(s) of the Health Board(s) with which they wish to enter into arrangements to provide GOS Specialist Supplementary. Stream B applications (which also apply to all OMPs) must be submitted from the individual's NHS email account to each relevant Health Board via the email address on this webpage.
If additional practices need to be added to either a GOS Specialist Supplementary application, then the Additional Practice Addendum form should be completed and submitted along with the relevant application form.