Choice is one of the six components of the Comprehensive model of personalised Ccare.

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.

Patient choice guidance

Patient choice guidance outlines how commissioners, providers and primary care referrers can meet the statutory, contractual and policy obligations which enable patients’ rights to choice as set out in the NHS Constitution for England.

This guidance replaces existing publications produced by NHS England and NHS Improvement in relation to patient choice and aims to:

  • Provide an overview of the choices available to patients in the NHS and the rules that underpin patients’ rights
  • Enable consistency in the application of these rights
  • Explain how commissioners can fulfil their duties in relation to patient choice and meet their statutory obligations
  • Provide guidance on how NHS England will manage enquiries and complaints related to patient choice.

Specific guidance on how NHS England will exercise its enforcement powers in relation to patient choice is set out in NHS England’s Enforcement guidance.

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:

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 NHS Standing Rules.

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 in NHS England’s Patient Choice guidance.

If you have questions about patient choice or the application of the NHS Standing Rules, you can contact the NHS England Choice team by email at