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Practices at risk due to ‘historic underfunding’ of NHS sight test fees, OFNC says

The OFNC has written to NHS England and the DHSC to warn that multiple primary eye care practices across England are struggling

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The Optometric Fees Negotiating Committee (OFNC) is warning that ‘a record number’ of primary eye care practices across England are struggling due to ‘historic underfunding’ of NHS sight test fees, the cost of living crisis, and lack of recovery post COVID-19.

The OFNC, which is made up of representatives from the AOP, ABDO, FODO and the BMA and is the national negotiating body for eye care in England, has written to NHS England (NHSE) and the Department of Health and Social Care (DHSC) to make the plight of primary eye care clear.

The committee has warned that the NHS has “for many years, unfairly relied upon patients who pay for spectacles to subsidise the cost of NHS sight tests.”
It noted that ‘such cross-subsidisation is unsustainable’ with inflation at 11% and the cost of living crisis taking hold.

The challenges are compounded by the fact that fixed costs, including wages, are increasing rapidly, the OFNC said.

The effects of the cost-of-living crisis on patient behaviour are also causing concern for practices.

The OFNC has emphasised that “as a result of these multiple pressures, many practices are now struggling and there is genuine concern there will be practice closures, resulting in a significant reduction in primary care capacity at a time when the NHS requires growth in eye health delivery outside hospital.”

In the context of Chancellor Jeremy Hunt committing £3 billion per year to the NHS for the next two years in his Autumn Statement, the “NHS must now invest to support primary eye care if a growth in avoidable sight loss and the personal and economic impacts this brings are to be avoided,” the OFNC said.

The committee is awaiting an outcome after submitting a bid for a “substantive but fair uplift to the GOS sight test fees and grants in 2023-24" to the DHSC and NHSE in September.

The OFNC said: “We await the outcome of the NHS’ recommendations and subsequent ministerial decision.

“In the meantime, please keep updating us on the challenges you are experiencing so we can share these with DHSC and NHSE on your behalf.”


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