Choice
Choice is one of the six components of the Comprehensive Model of Personalised Care.
The NHS in England has offered patients choices on where they receive healthcare services since it was established, and these choices have been extended over time in legislation. Choice is also highlighted as a key consideration in other priorities for the NHS, including in the NHS Long Term Plan and as part of elective care recovery within the Delivery Plan For Tackling the COVID-19 Backlog of Elective Care.
The NHS Constitution for England sets out the principles and values of the NHS. In relation to patient choice, it says:
“You have the right to make choices about the services commissioned by NHS bodies and to information, and support to make these choices. The options available to you will develop over time and depend on your individual needs.”
The Handbook to the NHS Constitution describes in more detail the rights in relation to informed patient choice.
The Department of Health and Social Care NHS Choice Framework sets out some of the nationally determined choices available to patients.
It explains:
- when you have choices about your healthcare
- where to get more information to help you choose
- how to complain if you are not offered a choice
Some of the choices which are described in the framework are legal rights and others will depend on what services are available in your local area. The legal rights covered in the NHS Choice Framework are:
- Choosing GP and GP Practice
- Choosing where to go for a first appointment as an outpatient
- Asking to change healthcare provider if maximum waiting times are exceeded
- Choosing to have a Personal Health Budget.
Further guidance on when choice should be offered in the NHS can be found in:
- Securing meaningful choice for patients: CCG planning and improvement guide
- Choice in mental health care
On 1 July 2022 clinical commissioning groups (CCGS) were replaced with integrated care boards (ICBs), Monitor has been abolished and NHS England has taken on most of Monitor’s functions. Under transitional arrangements NHS England has become responsible for oversight of the patient choice requirements.
It is intended that the patient choice provisions in the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 will be amended, and new guidance will be issued. In the interim, the existing choice regulations will continue to have effect. Therefore, the Securing meaningful choice for patients: CCG planning and improvement guide and Choice in mental health care addressed to CCGs and NHS England, should be read during the interim period as referring to ICBs and NHS England (in its role as a commissioner).
Making a decision that is right for you
When you need to find information on where to go for your care and treatment, or want to choose your GP and GP practice, there are a number of places you can find information to help you make a decision.
You can compare information about hospitals, services and consultants on the NHS website. This website includes information about the quality of care, waiting times, parking and travel. You can find information about:
- choice of GP
- choosing a hospital or consultant
- choosing a mental health service
- choices in end of life care
There are a number of useful resources available to help prepare you for appointments where you may be asked to make a decision about where to go for an appointment. This patient leaflet provides helpful information on how you can make the best choices for you when you have a choice as part of a Shared Decision Making conversation with your health professional.
If you need to go for a hospital appointment, the My Planned Care webpage provides information on how long patients usually have to wait on average to see different services, at different hospitals.
NHS England
NHS England leads on the policy development and operational delivery of patient choice within systems. It can provide advice and guidance to patients, the public, commissioners and providers (NHS and Independent sector).
In addition NHS England also has oversight responsibilities to make sure that providers and local health organisations offer patients the choices they are entitled to. The organisation is also responsible for responding to and investigating complaints about patient choice.
One element of this relates to complaints from providers about the qualification of providers by integrated care boards (ICBs), for services where the legal rights to choice and related obligations apply under the Procurement patient choice and competition regulations (PPCCRs).
To strengthen existing processes a choice provider qualification complaints panel has been established to pro-actively review and support the timely resolution of these types of complaints which is described here: NHS England » Standard operating procedure: Choice provider qualification complaints process.
A pro forma has been produced which allows providers to summarise their complaint to NHS England, and this can be accessed here. The pro forma needs to be completed to submit a complaint to NHS England about the qualification of providers by ICBs.
Further information about the application of the procurement patient choice and competition regulations is available here: NHS England » Procurement, patient choice and competition regulations.
If you have questions about patient choice or the application of the Procurement patient Choice and Competition Regulations, you can contact the NHS England Choice team by email at england.choice@nhs.net.