Patient choice

Patient choice is at the heart of the NHS. There are a range of choices that patients should expect to be offered in the NHS services they use.

The Choice Framework, published by the Department of Health, sets out the nine main types of choices that should be available to patients in the NHS. Some of these choices are legal rights, while some are subject to specific exceptions.

Survey evidence shows (2015 Choice Survey) that progress towards achieving meaningful choice for NHS patients has stalled over recent years. NHS England is therefore committed to a major programme of work to realise the NHS’ longstanding promise to give patients choice over where and how they receive care, as highlighted in the NHS Five Year Forward View.

Patient choice programme

NHS England’s goal is to significantly improve patient choice by 2020. To achieve this, a major programme of work has been launched to achieve a radical step-up in the offer, awareness, uptake and operation of patient choice across the NHS. This work is being led by a dedicated team called the Patient Choice Unit.

Our vision for patient choice by 2020 is that:

  • All patients are aware of the choices available to them, particularly where these are legal rights and have the information they need to make meaningful choices,
  • All GPs/referrers discuss the different treatment options available to patients, include them in shared decision making, and offer choice to patients,
  • All providers make good quality, up to date information about their services available and accept all appropriate patient referrals in line with the NHS Standard Contract,
  • All commissioners assess how well choice is working within their CCG and put improvement plans in place to address areas that need strengthening,
  • All opportunities to extend the operation of choice beyond existing standards are explored and implemented.

Clinical commissioning groups (CCGs) have a duty to enable patients to make choices, and to promote their involvement in decisions related to their care or treatment. NHS England will work alongside CCGs to help them meet their legal responsibilities and build on their offer of choice to patients, to ensure that choices are meaningful and deliver positive improvements to patient outcomes including patient experience of the services they access and use.

The initial priorities of this programme of work are:

Further advice

The Choice Framework, published by the Department of Health, includes information for patients about how to complain if they are not offered choice.

As a patient, healthcare provider, commissioner, patient group, or representative body, you may contact NHS Improvement for informal advice, or to make a formal complaint. Further information is available on NHS Improvement’s website.

If you are a patient or member of the public who would like more information on choice then please visit the NHS website.

You can also contact us at for guidance, advice or information, or if you have any concerns about how well choice is working for patients.