Survey reveals more needs to be done on choice for patients

More than half of patients (51 per cent) were aware of their legal right to choose a hospital or clinic for an outpatient appointment, and a similar proportion (53 per cent) referred for an outpatient appointment first had a discussion with their GP about where to receive treatment.

Fewer than two fifths of patients, however, said they were offered a choice of hospital by their GP when being referred for an outpatient appointment.

These are some of the findings of a survey being published today of over 2,700 patients conducted for NHS England and the health regulator Monitor, which looked at the number of patients being offered a choice by their GPs.

It is important that, in consultation with their GPs, patients are offered their legal right to choose as set out in the NHS Constitution, particularly given the differences between hospitals on such things as waiting times.

The survey also found that:

  • people from black and minority ethnic groups were more likely to have discussed choice with their GP (66 per cent compared with 52 per cent of white patients) although less likely to be aware of their legal right beforehand (42 per cent compared with 51 per cent of white patients)
  • people not currently working, including retired people, were more likely to be aware of their right to choose (55 per cent compared with 46 per cent of those who are working)
  • people in rural areas were more likely both to be aware of their right and to have been offered a choice of provider for their care and treatment (45 per cent compared with 36 per cent of those in urban areas)

Most of those who were offered a choice felt that they had enough information to choose (89 per cent), and were able to go to their preferred hospital or clinic (92 per cent).

Ian Dodge, NHS England’s National Director for Commissioning Strategy said: “While patient choice of first outpatient appointment is a reality for some patients in England, the challenge now is to ensure that everyone enjoys their legal right, for example to choose hospitals or clinics with shorter waiting times, if that’s what they want, in both mental health and physical health services.”

Catherine Davies, Co-operation and Competition Director at Monitor said: “This survey gives us some helpful insight into how patients have experienced choice in England. Some of these results are encouraging, and suggest that many GPs are having helpful conversations with patients about decisions that affect their care. But it also suggests the NHS needs to do more to make sure patients are aware they have a choice and are offered that choice. We will continue in our efforts to make sure this happens, and to help patients feel involved and in control of their health care.”

The survey results summary can be seen here, while the survey’s results tables are here. The survey was carried out by Populus on behalf of NHS England and Monitor, and interviewed 7,038 adults online. It included 2,706 interviews with respondents who had been referred for an outpatient appointment by their GP within the last 12 months.

Legal rights to choice are set out in the NHS Constitution and the NHS Choice Framework. These legal rights include the right for patients to start consultant-led non-emergency treatment within a maximum of 18 weeks of a GP referral and for the NHS to take all reasonable steps to offer a range of alternatives if this is not possible.


  1. Dr A Hubbard says:

    The choose and book system is not working.Referrals are increasingly being made where it is the GP administrative staff who choose the appointment without consultation with the patient, who is unaware of the time and place until an appoitment letter is recieved from the Trust.Increasingly we are finding that our patients have “chosen” appointments during periods they were on holiday.

  2. Elizabeth Muir says:

    My mother (83) has recently been asked to find a GP in her own area as her GP (of many years and as upset as my mother) can no longer look after her, the trigger for this appears to be the fact that she is on warfarin and the hospital that manages her blood tests will not do so going forward!
    Where is the ‘choice’ in this?
    It sounds like the CCG in that area is closing its doors to people who are just outside their area!

    • kate says:

      Hi this is a little confusing- the GP may not be trained to manage warfarin (although lots of CCGs offer enhanced services to train practices so if that was the case she could be monitored in practice). If the GP isnt trained warfarin management will usually be in the anti-coag dept. of the hospital. Your mother has a choice where to be referred for this. you need to check that your mother’s warfarin is managed by a copmetent professional so your GP may not feel/may not be train or allowed to do this (i.e the practice has no service). Therefore the gP needs to refer your mother to a hospital for this management; again this will be based on where offers an anti-coagulant monitoring service.i woudl suggest the GP in question contacts their local CCG before requesting your mother moves practices (which makes no sense in any way!)