NHS Scotland has redrawn how frontline eye problems are handled in community clinics. Regulations made on 5 November, laid at Holyrood on 7 November and taking effect on 1 January 2026, create a named specialist tier within general ophthalmic services for common anterior eye conditions.

The statutory instrument – the National Health Service (General Ophthalmic Services) (Scotland) Amendment Regulations 2025 (SSI 2025/337), published on legislation.gov.uk – amends the 2006 rules that govern NHS eye care. Health Boards will be able to enter formal arrangements with individual clinicians who, once contracted, are treated in law as either a specialist ophthalmic medical practitioner or a specialist optometrist independent prescriber for the specified conditions in that Board area.

The referral pathway is tightened. Where a patient shows signs of an anterior eye condition, the clinician can only refer to a specialist ophthalmic medical practitioner or a specialist optometrist independent prescriber, and only when that specialist has agreed to take the case. Acceptance is permitted where the specialist reasonably expects they, or another specialist working at the same practice premises, can carry out any necessary examination.

There is also a clear nod to locality. In making a referral, the referring practitioner or optician must take account of where the patient normally lives. For rural towns, islands and remote communities, that matters: the rules point services towards being arranged closer to home rather than sending people long distances for assessment.

What counts as an anterior eye condition is now defined on the face of the regulations. The list includes anterior uveitis, blepharitis, a corneal foreign body, episcleritis, herpes simplex keratitis, herpes zoster ophthalmicus, infective conjunctivitis, marginal keratitis, ocular allergy and ocular rosacea. In short, the everyday but sometimes urgent problems that fill same‑day optometry slots.

Contracting is formalised too. A Board may only enter an arrangement with a clinician who is already on the Board’s list, and the agreement has to be completed on a form supplied by the Agency. The conditions covered must be specified in the contract, giving Boards scope to set local priorities while keeping the job titles and responsibilities consistent across Scotland.

For practices, this means clarity about who handles what. Boards will need to agree their roster of specialists, and practices will need tight referral and acceptance protocols so that patients can be booked in quickly with a named specialist rather than bounced around the system.

In practical terms, this sets clearer routes for managing red‑eye, pain and superficial injuries in high‑street clinics. Boards can commission for the particular conditions they want covered, but patients should notice a simpler experience: assessment and treatment arranged promptly at a local practice that is contracted to provide that care.

Along the border, readers should note this is a Scotland‑only change. Pathways in NHS England remain under local commissioning. English residents in Northumberland and Cumbria will continue to follow their local services, while Scottish residents in the Borders can expect more care to be delivered through community optometry under the new arrangements. When in doubt, check with your registered optician or GP practice.

The legal mechanics sit in schedule 1 of the 2006 Regulations. New sub‑paragraphs 14(4A) to (4C) set the referral rules; a new paragraph 14A gives Boards the contracting power for specified anterior eye conditions. The instrument was signed at St Andrew’s House, Edinburgh, on 5 November 2025 by Jenni Minto, authorised to sign for the Scottish Ministers. With a start date of 1 January 2026, Boards and providers have a short window to finalise specialist lists, referral processes and patient communications.