Scottish Ministers have made regulations amending the National Health Service (General Ophthalmic Services) (Scotland) Regulations 2006, with commencement on 1 January 2026. The instrument updates definitions and referral pathways for acute anterior eye conditions within GOS.
A new legal definition of “anterior eye condition” is inserted into the 2006 Regulations. For GOS purposes, the term covers anterior uveitis, blepharitis, corneal foreign body, episcleritis, herpes simplex keratitis, herpes zoster ophthalmicus, infective conjunctivitis, marginal keratitis, ocular allergy and ocular rosacea.
Two role definitions are added: “specialist ophthalmic medical practitioner” and “specialist optometrist independent prescriber”. These terms are used to identify who may receive referrals for anterior eye conditions under the revised Schedule 1 framework.
Referral rules are tightened for patients who show signs of an anterior eye condition during a GOS examination. A referring ophthalmic medical practitioner or optometrist may only refer to a specialist ophthalmic medical practitioner or a specialist optometrist independent prescriber who has agreed to accept the case. The referring clinician must consider where the patient normally resides, and a specialist may accept when they reasonably anticipate that they, or another specialist working at the same practice premises, can carry out any necessary eye examination.
Health Boards are given an explicit power to commission these services. A new paragraph 14A to Schedule 1 enables a Board to enter into arrangements with an ophthalmic medical practitioner or an optometrist independent prescriber for general ophthalmic services covering specified anterior eye conditions in the Board’s area. Practitioners engaged under such arrangements are treated as “specialists” for the purposes of those services.
Only practitioners on the Board’s List may enter these arrangements and the agreement must be made on a form supplied by “the Agency” as defined in the 2006 Regulations. Each arrangement must specify which anterior eye conditions it covers in that Board area.
For providers, the administrative tasks are immediate. Practices should identify which clinicians are contracted as specialists under local Board schemes, update referral protocols to secure acceptance before transfer, record the patient’s usual residence in referral notes, and ensure systems can route accepted cases to the correct premises ahead of 1 January 2026.
For patients, the intent is clearer routes to treatment in community optometry for the conditions listed above, with less routine dependence on hospital eye services. The Scottish Government’s operational plan indicates that anterior eye services will expand through 2025, with most Boards expected to be fully operational by March 2026 and a projected saving of around 40,000 hospital appointments each year.
National Services Scotland has begun setting out implementation detail through PCA circulars, including references to the specialist supplementary element of GOS, Health Board anterior eye schemes, digital submission changes and professional training. Providers should track PCA(O)2025 updates for commissioning and remuneration guidance.
Community pharmacies should expect knock‑on effects as independent prescribing optometrists manage more complex anterior eye conditions under GOS. Sector guidance signals an increase in prescriptions issued by optometrists for these cases, with no change to NHS Pharmacy First Scotland Stage 1 arrangements.
The statutory change does not alter entitlement to an NHS eye examination. It formalises the referral pathway for specified anterior eye conditions and creates a commissioning route for Health Boards to contract named specialists within GOS. Providers should align clinical governance and record‑keeping in advance of commencement on 1 January 2026.