VATHLT2180 - The services of the medical and paramedical professions: opticians: how the optical trade operates

Opticians divide into the following categories:

Optometrists (previously ophthalmic optians)	These are qualified to perform sight (England, Wales and N. Ireland) and eye examinations (Scotland) and to write prescriptions. They can also treat and manage some eye conditions and in some cases can also prescribe and supply drugs for eye care conditions where they hold an additional qualification. Optometrists can therefore provide a range of medical care and can dispense both spectacles and contact lenses and their supplies of sight testing, medical care and dispensing are exempt. Optometrists have to be registered with the General Optical Council (GOC) in order to practise.
Dispensing opticians	These are not qualified to perform sight tests or examinations or to write prescriptions, but they are qualified to dispense spectacles. Some hold an additional qualification which permits them also to fit the dispense contact lenses and if necessary, modify a prescription where contact lenses are required. Such an optician can also provide certain other medical services such as a slit lamp examination as part of supplying contact lenses. Any supplies of dispensing, plus other medical services supplied in relation to contact lens medical care, are exempt. Dispensing and contact lens opticians also have to be registered with the GOC in order to practise.
Opthalmic Medical Practitioners (OMP’s)	These are registered general practitioners who have specialised in sight testing and primary eye care. OMP’s have to be registered with the General Medical Council (GMC) in order to practise.
Ophthalmologists	These are registered medical consultants who are specialists in diseases of the eye and eye surgery. Like other medical specialists they operate primarily in hospitals (although one of two may run medical ophthalmology outpatient and minor surgery clinics in the community). Like all doctors, ophthalmologists have to be registered with the General Medical Council (GMC) and also be on the Specialty List of a Medical Royal College in order to practise.
Non-registrant dispensers	These can dispense sight correcting spectacles (but not contact lenses) from a prescription, but not to children under 16 or to people registered as visually impaired or severely visually impaired (previously known as partially sighted or blind). In order to exempt their supplies, they must demonstrate that the dispensing is carried out by that registered optician or a non-registrant dispenser directly supervised for VAT purposes by a registered optician, according to the criteria set out in this guidance.
Other suppliers outside of an optical practice	In 1984, the provision of spectacles was de-regulated on the grounds that minor difficulties with reading due to age were not considered to be a disease, but rather a natural process. This meant that anyone could sell ready-made reading spectacles known as ‘ready readers’ .Ready readers are simple magnifiers with the same power in both eyes up to 4 dioptres. They must conform to the requisite British Standards and cannot be supplied to children under 16 or to the partially sighted. Therefore, these suppliers are not dispensing spectacles to meet a clinical need but simply supplying low magnifiers which are liable to VAT at the standard-rate.