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Why is the General Ophthalmic Services (GOS) Contract that underpins primary eye care in the UK contrary to the public health interest?
Shickle, D. Davey, Christopher J. Slade, S.V.
Shickle, D.
Davey, Christopher J.
Slade, S.V.
Publication Date
2015
End of Embargo
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(c) 2015 BMJ Publishing Group. Full-text reproduced in accordance with the publisher's self-archiving policy.
Peer-Reviewed
Yes
Open Access status
openAccess
Accepted for publication
13/09/2014
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Department
Awarded
Embargo end date
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Abstract
The model for delivery of primary eye care in Europe
varies from country to country with differing reliance on
ophthalmologists, optometrists and dispensing opticians.
Comparative analysis of models has tended to focus on
interprofessional working arrangements, training and
regulatory issues, rather than on whether a particular
model is effective for delivering public health goals for
that country. National Health Service (NHS) primary eye
care services in the UK are predominantly provided
under a General Ophthalmic Services (GOS) Contract
between the NHS and practice owners (Contractors).
Over two-thirds of sight tests conducted in England,
Wales and Northern Ireland and all in Scotland are
performed under a GOS Contract, however many people
entitled to a GOS sight test do not take up their
entitlement. The fee paid for sight tests conducted under
a GOS Contract in England, Wales and Northern Ireland
does not cover the full cost of conducting the
examination. The shortfall must be made up through
profits of sale of optical appliances but this business
model can be a deterrent to establishing practices within
socioeconomically deprived communities, and can also
be a barrier to uptake of sight tests, even though many
people are entitled to a NHS optical voucher towards the
cost of spectacles or contact lenses. This paper critiques
the GOS Contracts within the UK. We argue that aspects
of the way the GOS Contract is implemented are
contrary to the public health interest and that different
approaches are needed to address eye health inequalities
and to reduce preventable sight loss.
Version
Accepted manuscript
Citation
Shickle D, Davey CJ and Slade SV (2015) Why is the General Ophthalmic Services (GOS) Contract that underpins primary eye care in the UK contrary to the public health interest? British Journal of Ophthalmology. 99: 888-892.
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Article