Scottish Ministers have approved the National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 2025 (SSI 2025/337), made on 5 November 2025, laid on 7 November, and commencing on 1 January 2026. The instrument amends the 2006 General Ophthalmic Services (GOS) Regulations to establish a defined referral route for acute anterior eye conditions within NHS Scotland, and is signed by Jenni Minto on behalf of the Scottish Ministers.
The Regulations introduce a statutory definition of “anterior eye condition” by listing ten diagnoses: anterior uveitis, blepharitis, corneal foreign body, episcleritis, herpes simplex keratitis, herpes zoster ophthalmicus, infective conjunctivitis, marginal keratitis, ocular allergy and ocular rosacea. This codifies the clinical scope of the new community-facing service that Scottish Government flagged in its NHS Scotland Operational Improvement Plan.
For patients presenting with signs of an anterior eye condition, referrals under the existing eye-examination provisions in Schedule 1 must now be directed only to a “specialist ophthalmic medical practitioner” or a “specialist optometrist independent prescriber”. These are new terms tied to service arrangements under the Regulations rather than generic professional titles. The change builds on the pre‑existing duty in paragraph 14 to refer appropriately where injury, disease or abnormality is suspected.
The referring practitioner must take account of where the patient normally lives when selecting a recipient service. This geographic test is designed to route patients to local capacity and reduce unnecessary cross‑Board activity while preserving clinical discretion within the GOS framework.
Acceptance of referrals is capacity‑managed. A specialist may agree to accept only where they reasonably expect that they, or another specialist working from the same practice premises, will be able to undertake any necessary examination. This establishes a formal gate to prevent referrals into services without near‑term availability.
A new paragraph 14A enables each Health Board to enter written arrangements with ophthalmic medical practitioners and optometrist independent prescribers to provide GOS for specified anterior eye conditions. Those parties become “specialists” solely for the purposes of the arrangement. Eligibility is limited to providers already on the Board’s Ophthalmic List, and the agreement must be made on a form supplied by the Agency as defined in the 2006 Regulations.
Operationally, Boards now have a clear implementation task before 1 January 2026: identify eligible providers on their Ophthalmic Lists, issue the Agency form, finalise local specifications for the conditions covered, and publish referral information so practices know which premises can accept specialist referrals. Providers entering arrangements should review appointment templates, stock essential therapeutics aligned to independent prescribing, and update internal standard operating procedures so front‑of‑house teams can direct calls for anterior eye symptoms into the correct pathway.
For optometry and ophthalmic practices, the immediate change is procedural rather than diagnostic. A sight test and clinical assessment continue to follow paragraph 14 requirements, but where signs point to an anterior eye condition, onward referral is restricted to named specialists who have agreed to accept. Practices that do not intend to act as specialists should keep an up‑to‑date directory of local specialists and record consent and referral decisions in line with existing GOS record‑keeping rules.
The legislative change sits within a wider policy aim to shift more eye care into the community. The NHS Scotland Operational Improvement Plan signalled an acute anterior eye condition service through GOS and indicated most Boards would be operational by March 2026, with an indicative capacity release of around 40,000 hospital appointments annually. A subsequent ministerial update described an estimated impact of around 20,000 appointments a year and confirmed corneal foreign body removal would be included from January 2026. The Regulations provide the legal architecture for those pathway changes.