Choice in key NHS change programmes

End of Life Care

NHS England is dedicated to improving choice in End of Life Care (EoLC), including ensuring that more people are able to achieve their preferred place of care and death.

The Government commissioned an independent review in to choice in End of Life care. This review, What’s important to me: A review in End of Life Care was published in February 2015. The vision it set out was for a transformation of EoLC towards an ever more personalised service for dying people underpinned by quality improvements in all settings.

The need to increase personalisation of care and the ability for people to exercise choice and control over their care and treatment has been widely discussed, and the government will be publishing its response to the independent choice review on EoLC in 2016; this publication will set out the government’s plans for improving EoLC throughout this Parliament.

The Patient Choice Unit will be working alongside key partners to deliver on these plans.

For more information email


Our work is enhancing the choices available in maternity services, including through a programme of Pioneers, in order to develop and test ways of improving choice in maternity services for national replication.

In March 2016, CCGs were invited to express their interest in working with neighbouring CCGs to become Maternity Choice and Personalisation Pioneers. This programme marks the first phase in the implementation of the recommendations from the National Maternity Review which was published in February 2016.

The seven Pioneer sites are now live and we are working with them to co-develop and test ways of improving choice and personalisation in maternity services.

See further information about the programme. If you would like to find out more about this programme of work, please email

New Care Models

Giving individuals real control to personalise their care and make meaningful choices across the NHS is central to empowering patients and delivering the vision set out in the Five Year Forward View (FYFV).

The development of new care models (NCM) is also a priority set of the FYFV, which is being championed through the New Care Models (vanguards) Programme. The vanguard sites are bringing services together and combining funding streams to enable providers to improve demand management, allocate resources more effectively and enable a greater focus on population health.

Two vanguards models established to redesign out-of-hospital care are multi-speciality community provider (MCPs) and primary and acute care system (PACS). These models will both see redesign of funding, contracting and delivery models.

The establishment of MCPs and PACS will transform the disparate community, acute and mental health provider delivery models into new singular bodies (local monopolies) which will provide better integrated models of care. Whilst these models will deliver benefits to patients, consideration needs to be given to legislation designed to safeguard and expand the range of choices available to patients.

The Patient Choice Unit is working with the with the New Care Models Programme to provide expert advice and guidance into the development of guiding principles for vanguards, as well as delivering a direct support offer to specific vanguard sites to help them ensure that meaningful choice is still available to their patients.

This will include:

  • Supporting vanguard sites to navigate through the legal and regulatory issues and using the framework to help them achieve their aims of improving services for patients.
  • Supporting vanguard sites and the wider commissioner landscape to adopt compliant approaches that enable innovation and service redesign and secure better outcomes for patients.

For more information please contact the Patient Choice Unit