29 November 2024

OFNC Update - Clinical priority codes

NHS England has published new clinical priority codes for use by GOS contractors in England. This is due to an error in the current PCSE system which NHS England commission. This means that some sight tests, which should not require an early retest code, are erroneously requiring a code to be entered to process the sight test. 

As an interim measure, practitioners should use the new clinical priority codes to process claims in four distinct categories:

• Under 7 years - corrected refractive error - Code 7.1
• Under 16 years - binocular vision anomaly - Code 7.2
• 7-16 years - rapidly progressing myopia - Code 7.3
• Ocular hypertension and not in a monitoring scheme - Code 7.4

For the avoidance of doubt, the Memorandum of Understanding (MoU) between the optometry profession and Department of Health and Social Care remains unchanged and is not impacted by these new clinical priority codes. 

These codes differ to normal early retest codes. Early retest codes are subject to PPV metrics and should be used when a patient is seen at an earlier than expected interval. However, these codes are excluded from those metrics. NHS England have apologised to the eye care sector for the lack of prior notification and acknowledged that this may cause significant inconvenience and operational challenge for practices. 

NHS England have assured OFNC that a permanent fix to the PCSE system will be implemented in the 2025/2026 financial year. 

ENDS

Note for Editors

The Optometric Fees Negotiating Committee (OFNC) is the national negotiating body for eye care in England with the Westminster Parliament, the Department of Health and Social Care and NHS England. It comprises the leaders of the UK representative bodies: ABDO, AOP, FODO and BMA (for OMPs) and works in partnerships with the College of Optometrists and the General Optical Council.