GOS Fees Confirmed at £24.13 — and the GOC Has Opened a Review Into Commercial Pressure on Patient Care

Two developments from late 2025 that, taken together, still define exactly where independent practice sits heading into the rest of 2026.

The first: in December 2025, NHS England confirmed a 2.5% increase to the GOS1 sight test fee for 2025–2026. The fee was set at £24.13, backdated to 1 April 2025. All other payments and grants remained frozen at 2024–25 levels. NHS voucher values, frozen earlier in the year, stayed frozen.

The Optometric Fees Negotiating Committee described the outcome as "very disheartening." OFNC chair Paul Carroll made the profession's position plain: the OFNC had made what it called a "very credible case" for a fee of at least £25. NHS England rejected it on grounds of affordability — in a year when the NHS budget grew and GP pay rose by nearly 30%.

For a practice running a high NHS volume, £24.13 doesn't cover the cost of delivering a modern sight test. Chair time, clinical equipment, overheads, National Insurance increases, business rates, rising energy costs. The maths doesn't work. It hasn't worked for years. This settlement makes it worse.

The independent practices best placed to absorb this are those who have already reduced their dependence on NHS income — practices with a developed private offer, a clear fee structure, and patients who understand what they're paying for and why it's worth it. That is not a criticism of NHS-heavy practices. It is a structural reality they didn't create and that their professional bodies have failed to adequately fight.

The GOC Is Coming for Commercial Practices. That Is Not Bad News for Independents.

The second development is in some ways more significant for the long term.

At its September 2025 Council meeting, the General Optical Council approved a business case for a thematic review into commercial practices and patient safety. The GOC cited growing concern among registrants and stakeholders about the influence of commercial pressures on safe patient care.

The GOC's own documentation names specific practices under review: overbooking and ghost clinics, where double-booking to manage non-attendance results in rushed or reduced appointment times; commercial targets and incentives that push products patients may not clinically need; lack of transparency around costs and NHS eligibility; and the refusal to treat young children, in part for commercial reasons.

None of those practices describe how a well-run independent practice operates. Every one of them describes systemic pressures that are more prevalent in corporate and multiple settings, where volume targets and commercial KPIs shape clinical behaviour.

The GOC review is not directed at independents. But its findings — whatever they are — will land in a market where patients are increasingly aware of what they're buying and from whom. An independent practice that already offers unhurried appointments, transparent pricing, and genuinely patient-centred care doesn't need to change anything. It just needs to make sure its patients know what they already have.

The Independence Angle Is Not Theoretical Right Now

Put these two things together. NHS fees that don't cover costs. A regulator scrutinising corporate commercial behaviour. A patient population that is — slowly, imperfectly — waking up to the difference between the cheapest option and the right one.

This is not a comfortable moment for independent practice. The financial pressure is real and it is not going away. But it is a moment where the case for what you offer is easier to make than it has been in years — and where the structural problems with the alternative are becoming harder to ignore.

The practices that will look back on this period as an opportunity are the ones building their private offer now. Not abandoning NHS patients. Not pretending the fee crisis isn't happening. But making sure that when a patient sits down across from them, there is something of unmistakable value being exchanged.

£24.13 says everything about what the NHS values optometry at. The patients in your chair are the evidence that the NHS is wrong.

If you're an independent practice owner thinking about what diversifying your revenue actually looks like in practice, Grow Independent is the starting point.