Patient choice

Most patients in England who are referred by their GP for non-urgent specialist treatment now have the right to choose which hospital they go to.

This national system follows pilot projects that offered choice for patients in certain areas and for particular types of treatment, such as hip replacements.

Under the early schemes, people were offered a choice of at least four hospitals or 'secondary care providers' meeting NHS standards and costs.

This has now been extended, so most patients referred for non-urgent treatment can opt for any hospital or treatment centre ('provider') in England that meets government standards.

Usually you will be offered a choice of three local hospitals but you may express a preference for a hospital further away. Exceptions may include:

• Emergency and urgent services
• Cancer
• Maternity services
• Mental health services

Your choices

All providers with an NHS contract are listed on the electronic Choose and Book system. This can be used by GPs and patients to arrange hospital appointments and can be done in the surgery, during a consultation, or later by phone or on the internet.

Providers include:

• NHS hospitals
• Foundation trusts (NHS hospitals with greater freedom to manage themselves)
• Private hospitals
• Independent sector treatment centres (ISTCs)

What this means

So, if you need an operation to remove varicose veins and you live in London, you're no longer restricted to your local area. For example, if you want to be treated in Liverpool to be near family, your GP will be able to refer you to your preferred hospital in Liverpool (as long as it has an NHS contract and your GP believes it can meet your clinical needs).

In these circumstances, your primary care trust - the organisation that funds your NHS care with money provided by the government - will not be able to refuse your request.

If you're referred by your GP on the NHS under the patient choice initiative, your treatment will be funded by the NHS even if you choose a private hospital or ISTC.

And if you're eligible for free transport to and from hospital, your journey will be funded by the NHS. If your GP decides that medically you need transport, you may be entitled to help with your travel costs through the Healthcare Travel Cost Scheme (HTCS) if you're under the care of a consultant and receive either:

• Income Support
• Income-based Jobseeker's Allowance
• Pension Credit Guarantee Credit
• If you're named on an NHS tax exemption certificate or qualify under the NHS low-income scheme

Selecting a hospital

You may be able to decide quickly which hospital you want to use. One hospital may be able to see you more quickly, for example, or a family member or friend may make a recommendation. There may also be practical reasons, such as better transport links, why one hospital or treatment centre suits you better than another.

You can, of course, still choose to be treated at your local NHS hospital.

If you don't immediately know which hospital you'd like to attend, the government has a website, NHS Choices, that can help you to decide.

Type in the treatment you need and it will set out your options. You can also access details of all the hospitals listed and information comparing hospital waiting lists and cleanliness.

Another source of information is Patient Opinion, an independent website that allows people to share their experiences - good and bad - of NHS care.

The Healthcare Commission also provides information about hospitals' performance and Choose and Book has a patient section.

Patient choice leaflets should be available in your GP surgery and local library.

Exceptions

In some circumstances patients won't have this level of choice. Two exceptions are when you need to be seen at a rapid access clinics, such as a chest pain clinic or acute respiratory clinic, or by a cancer specialist within the two-week maximum waiting time.

The extension of patient choice also doesn't currently cover maternity or mental health services. And the location of emergency care or treatment after an accident might not be your choice - for example, an ambulance crew may decide this for you.

Sometimes, even when it isn't an emergency, your GP may choose for you if you need specialist attention quickly.

Scotland, Wales and Northern Ireland

The new arrangements only apply to England. For information about how the health service and referrals work in the other UK countries, visit:

• NHS Wales
• NHS Scotland
• Health and Social Care in Northern Ireland