January 2026
Dear Practice,
It has been reported that, when patients are referred to alternative providers for CUES due to time-frame requirements, there are occasions where patients are seen for a CUES assessment and then proceed to have a sight test at the CUES provider’s practice. In some cases, patients are not offered the option to return to their usual practice for their sight test.
We would like to remind practices providing CUES that this service is not an adjunct to a sight test, but an alternative pathway for patients with recent-onset symptoms that are not suitable for a sight test. Accordingly, practices and practitioners must decide to undertake either a sight test or a CUES core assessment, based on the patient’s presentation and their best clinical judgement.
Patients may be seen for a sight test and CUES follow-up appointment simultaneously if clinically indicated. However, during an initial assessment, patients should be managed within an eye examination or be seen as a CUES only.
If clinically indicated during a CUES episode, refraction should be carried out within the episode. In a small number of cases, the CUES outcome may be to advise the patient to see their own optometrist for a sight test. However, exceptional circumstances may require a sight test on the same day as a CUES appointment – such as a patient driving when unsafe to do so. It should be extremely rare for a sight test to lead to a CUES assessment.
CUES eligibility includes the following criteria when presenting as the main reason for attendance:
- Acute visual changes
- Ocular discomfort
- Abrasions and foreign bodies
- Other presentations requiring urgent clinical investigation but not suitable for GOS & not appropriate for eye casualty
When conducting CUES episodes, practitioners should always respect the patient’s loyalty to their usual optometrist and not solicit the provision of services that fall outside the scope of the service such as regular sight tests. Practices should never add patient’s details to their reminder system to send recall letters, emails or SMS messages for regular eye exams unless the patient expressly requests this.
This approach helps uphold best practice and safeguards patient choice. Failure to obtain a patient’s consent to have their personal details added to a practice recall system does not comply with current GDPR legislation which may carry fines up to, and exceeding, £500,000. Please ensure your team are aware of these requirements and incorporate them into your daily practice procedures.
Further information may be found in the Guide for Practices and Practitioners for this service using the following link: https://help.optom-referrals.org/article/732-community-urgent-eyecare-service-cues-guide-for-practices-and-practitioners as well as the policy suite for sub-contracting with Primary Eyecare Services using the following link: https://help.optom-referrals.org/article/288-policies-and-procedures
Thank you for your continued hard work and support.
If you have any questions, please contact hello@referral.support.
Kind regards,
Primary Eyecare Services
