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Post-payment verification (PPV)

Each month, we will select a sample of GOS Contractors to take part in a PPV exercise. If you’re selected, we will check a sample of your GOS submissions against clinical evidence over a quarterly period. This will provide assurance to NHS England that claims are being made appropriately.  There are four types of GOS form in scope: GOS 1, GOS 3, GOS 4 and GOS 6. 

If contacted to take part in a PPV exercise, you will need to submit evidence to support your payment claims. 

You are obliged to keep on-going, full and accurate records under your GOS contracts. 

We are clinically led and guided by the ‘Eye Health Policy’ and GOS regulations. 

There are three outcomes as a result of PPV. These are: 

  • all claims verified with no observations to feedback to the contractor 

  • claims verified and contractors advised on best practice due to observations made 

  • claims not verified and case escalated ​​​​​​ 

Evidence to supply 

For each GOS claim, we ask that you provide evidence that confirms the validity of that claim. 

View our guide which explains how we’ll be reviewing each type of GOS form (Word: 405KB). It contains some suggestions of the evidence you might submit. 

Suggested evidence 

You should submit a copy of the pre-visit notification if you have retained it.  

You should also submit appropriate extracts from your sight test records for the patient, which should show as a minimum: 

  • patient name 

  • history and symptoms 

  • reason for the sight test (if it has been conducted earlier than the memorandum of understanding on minimum sight test intervals) 

  • date of last sight test 

Submitting evidence 

There are a number of ways for you to submit evidence to us. 

All evidence submitted must be legible. 

If you have access to a secure NHSmail account, you can send us your evidence by email. 

This can include sending screenshots of your practice management system or photographs / scanned copies of paper forms. 

To submit evidence by email, save the electronic document with the filename: 

{your practice name}_{PPV reference for the sample}_{date submitted} 

Send this to: nhsbsa.ophthalmicproviderassurance@nhs.net.   

If you do not have access to a secure NHSmail you will need to send your evidence via post. 

Send copies of requested evidence, along with a completed cover form, which is included in Appendix B, to: 

Provider assurance (Ophthalmic) 
NHS Business Services Authority 
Bridge House, 2nd floor 
152 Pilgrim Street 
Newcastle upon Tyne 
NE1 6SN 

If you have any questions, or you are unable to provide evidence via email or post, contact us by email: nhsbsa.ophthalmicproviderassurance@nhs.net

PPV documents

Ophthalmic provider assurance national briefing (PDF: 317KB)Contractors perspective process map (PDF: 119KB)Ophthalmic provider assurance Wessex area briefing (PDF: 283KB)Ophthalmic provider assurance West Yorkshire and Harrogate area briefing (PDF: 283KB)

PPV No Patient Signature

To evaluate the effectiveness of optical responses to the pandemic, the NHS Business Services Authority Provider Assurance Ophthalmic Services (NHSBSA PAOS) team will be undertaking PPV on a limited number of contractors across the country around GOS 1 claims undertaken between June and December 2020. Read the National Briefing (Word:249KB).

Requesting patient information in line with GDPR 

A full privacy impact assessment was carried out before the go-live of this service. All aspects of the transfer of data have been assessed in line with the impact of GDPR. 

There's a patient declaration on each type of GOS form. This states: 

“I confirm I am entitled to an NHS funded sight test and I consent to the disclosure of relevant information for the purposes of checking this and in relation to the prevention and detection of fraud.” 

Patients are consenting to their information being shared with NHS England and NHS Improvement and authorised organisations when they are signing the GOS form. 

We have been authorised by NHS England and NHS Improvement to deliver PPV through a memorandum of understanding between the two organisations.