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NHS:
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2000
PCA(O)9
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Health
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St Andrew’s
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INTRODUCTION
OF REVISED GOS FORMS Edinburgh PSD site
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Addresses Chief Executives, Health Boards Chief Executive, Common Services Agency Director, Practitioner Services Division Head, Fraud Investigation Unit _________________________ |
Aberdeen PSD site
Glasgow
PSD site
6.
The revised forms can be identified by the revision date of “9/00” which
appears in the top-right corner. Further supplies of the revised forms
should be ordered from the Stationery Office in the usual way. Primary
Care Trusts/Island Health Boards will not be able to obtain further stocks
of the revised forms until the initial supply has been issued for their
area. 7.
Copies of the Memorandum to this letter are being sent under separate
cover for urgent distribution to all ophthalmic medical practitioners
and optometrists on Primary Care Trust/Island Health Board lists. Yours
sincerely
DR HAMISH WILSON MEMORANDUM
TO NHS: NATIONAL
HEALTH SERVICE 2.
New Optical Character Recognition readable GOS forms were introduced with
effect from 17 August 1998. It was envisaged at that time that these forms
would be suitable for scanning once Practitioner Services Division’s (PSD)
new ophthalmic payments system was put in place. However, a number of
further amendments were required to the GOS(S)1, GOS(S)3, GOS(S)4 and
GOS(S)5 forms in order to further streamline operations by minimising
manual intervention by PSD. (The GOS(S)2 will also being revised and further
guidance on this will be issued in due course.) 3. The revised forms have been developed in consultation with representatives of the optical profession. 4. Practitioners are asked to note the guidance on the new forms contained in the attached Annex. 5.
The revised forms will be introduced in stages as follows: Edinburgh
PSD site
Aberdeen
PSD site
Glasgow
PSD site
6. Further supplies of the revised forms should be ordered from your Primary Care Trust/Island Health Board in the usual way. 7.
Practitioners should continue to use the existing forms until the date
quoted for the changeover for their area. 7.
Any enquiries arising from this Memorandum should be taken up with your
Primary Care Trust/Island Health Board.
ANNEX
TO THE MEMORANDUM TO NHS: GUIDANCE ON COMPLETION OF THE REVISED GOS FORMS 1. The changes to the previous versions of the forms are described below. Copies of the revised forms, and how to complete them, are attached in black and white. The revised forms will remain the same colour as the present forms, with the exception of the GOS(S)5 which will be lighter, and the information to be completed will continue to be contained in white “drop out” boxes. GOS(S)1 - Application for NHS Sight Test 2. The note at the head of the form (and also the GOS(S)3 and GOS(S)4) has been amended to remove the reference to a check of the patient’s entitlement being made with the DSS, etc. This is now contained in the patient declaration — see paragraph 8 below. 3. Part 1 includes a new field “Sex”. This is also on the GOS(S)3, GOS(S)4 and GOS(S)5. Enter “M” or “F” in the appropriate box. 4. Part 1, “Date of Last NHS Sight Test” field. Enter the date of last NHS sight test. If this is not known enter approximate month and year. If it is the first NHS sight test which the patient is receiving leave blank. 5. Part 1, the field for diabetic/glaucoma sufferers and those at risk of developing glaucoma have been separated out. The patient should put a cross in the appropriate box to indicate entitlement. The patient should provide the name and address of their GP. In the case of someone at risk of developing glaucoma the patient should provide the name and address of the hospital which they attend/attended. 6.
Part 1 includes a new field “Evidence not produced”. Leave this field
blank. Further guidance on this field will be issued at a later date.
This is also on the GOS(S)3, GOS(S)4 and GOS(S)5. 8. Part 2A includes a new patient declaration consenting to the disclosure of relevant information in order to check the patient’s claim for entitlement. A new field has been added to indicate whether the patient or the patient’s representative is signing the form. The patient or their representative should enter “x” in the appropriate box. Where someone signs on behalf of the patient they must provide their name and address. This is also on the GOS(S)5. 9.
Parts 3 and 4 of the existing GOS(S)1 have been amalgamated into Part
3 of the revised 10. Part 3, the field for “reason for domiciliary sight test” should be left blank. Further guidance on this field will be issued at a later date. This also relates to the GOS(S)5. 11 . Part 4, the voucher and supplements field has been split to indicate whether the voucher issued, and any associated supplement(s), is for distance or near vision. For the voucher field you should enter the voucher letter code in the appropriate box(es) as per following examples:
Where supplements are prescribed enter ‘x” in the appropriate box(es), eg where a tint is prescribed for distance vision enter ‘x” in the first box, where a tint is prescribed for near vision enter ‘x” in the second box, where a tint is prescribed for both distance and near enter ‘x” in both boxes. Where supplements are prescribed for bifocals enter ‘x” in the first box of the appropriate supplement(s). This is also on the GOS(S)3, GOS(S)4 and GOS(S)5. 12. Part 4 includes a new “reason code” field. Enter the reason code for a sight test undertaken within two years of the previous test. 13. Part 4 includes a new field “address where the sight test took place if not the practice or the place where the patient resides”. This field should be left blank. Further guidance on this field will be issued at a later date. This is also on the GOS(S)5. 14. Part 4 includes a new practitioner’s declaration confirming that the information provided is correct and complete and advising that if it is not action may be taken. This is also on the GOS(S)3, GOS(S)4 and GOS(S)5. 15. Part 4 includes a new field “payment location code This is a unique 5-digit code which will identify the location to which payment must be made. These codes will be issued by PSD. The code will be used by the new payment system to ensure that the correct creditor is clearly identified on claim forms. It is particularly relevant where practitioners operate from different premises. Leave this field blank until you are notified of the code by PSD. This is also on the GOS(S)3, GOS(S)4 and GOS(S)5. GOS(S)2 — Patient’s Optical Prescription or Statement Further guidance on the revised GOS(S)2 will be issued in due course. GOS(S)3 — NHS Optical Voucher and Patient’s Statement 1. NHS Optical Voucher, date of last sight test field. Enter the date of the sight test to which the voucher relates. 2. NHS Optical Voucher, the layout of the prescription has been revised to allow the new ophthalmic payments system to read the prescription. The new prescription should be completed as per following example:
Repeat for left eye. Fill in details of near prescription if applicable. This is also on the GOS(S)4. 3. Part 1 includes a new patient declaration consenting to the disclosure of relevant information in order to check the patient’s claim for entitlement. A new field has been added to indicate whether the patient or the patient’s representative is signing the form. The patient or their representative should enter “x” in the appropriate box. 4. Part 2 includes a new field for the patient to indicate whether glasses or contact lenses were issued. Patient should enter the number of pairs of glasses/contact lenses received in the appropriate box. 5. Part 2 includes a new field to indicate whether the patient or the patient’s representative is signing the form. The patient or their representative should enter “x” in the appropriate box. Where someone signs on behalf of the patient they must provide their name and address. 6. Part 3 includes a new field to show where the cost of the glasses or contact lenses exceeds the cost of the voucher and any supplements. Enter “x” where appropriate. 7. Part 3 includes a new field to show the date the glasses/contact lenses were supplied. Where only one pair of glasses/lenses were supplied enter date they were issued in the first box. Where two pairs of glasses/lenses were supplied enter the date(s) they were issued in the appropriate boxes. 8. Part 3 includes a new field “GOC Number”. This should be completed where glasses are supplied to children under 16 and the registered blind/partially sighted or where contact lenses are supplied. This is also on the GOS(S)4. GOS(S)4 — NHS Optical Repair/Replacement Voucher Application Form 1. Part 1, date of sight test field. Enter the date of the sight test to which the voucher relates. 2. Part 1 includes a new field for full-time students aged 16, 17 or 18. Patient to enter “x” where appropriate and provide name and address of School, etc. 3. Part 1 includes a new field for patients over 16 to provide an explanation of the loss or damage to their glasses/contact lenses — a separate note explaining the circumstances will no longer be required. All claims for repair/replacements where the patient is over 16 must be sent to PSD for prior approval. If no explanation is provided PSD will not be able to decide if the patient is entitled to help. 4. Part 2 includes a new patient declaration consenting to the disclosure of relevant information in order to check the patient’s claim for entitlement. A new field has been added to indicate whether the patient or the patient’s representative is signing the form. The patient or their representative should enter “x” in the appropriate box. Where someone signs on behalf of the patient they must provide their name and address. 5. Part 4 includes a new field to indicate whether the patient or the patient’s representative is signing the form. The patient or their representative should enter “x” in the appropriate box. GOS(S)5 — Help with the Cost of a Private Sight Test 1. Part 1, date of last NHS sight test field. Enter date of last NHS sight test, if known. An approximate month and year will be sufficient if the actual date is not known. Where the patient has never received an NHS sight test enter N/A. 2. Part 5 a new field “The patient was referred to their GP” has been added. Enter “x” where appropriate. 3. Part 5, the supplements field will be amended on re-print to mirror the similar fields on the GOS(S)1, GOS(S)3 and GOS(S)4 — see paragraph 11 of the section headed GOS(S)1 Application for NHS Sight Test above.
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