Particularly in the last ten years, optometrists across the UK have been increasing their skills and investing in new technologies so enabling them to extend their scope of practice to take on more advanced roles and extra responsibilities. However, following devolution in 1999, the four countries of the UK have taken different policy paths in relation to health which has led to divergent methods of eye care, both in terms of structure and delivery.
Since 1948, when the National Health Service (NHS) was first formed, the NHS sight test has been used as the delivery model for primary eye care services in the UK. The rules relating to injury and disease of the eye 1999 (GOC, 1999), clarified the management of patients presenting with signs of injury, disease or abnormality in the eye or elsewhere. However, the UK-wide General Ophthalmic Service (GOS) sight test rules did not allow for other presentations, e.g. a recent onset red eye or painful eye, nor did the contract allow or pay for repeat appointments to refine clinical decision making. .