Patient choice Patients in England are being offered more choice about where they want to be treated, but what does this mean in practice?

In this article

Your choices What this means

Selecting a hospital Exceptions

Scotland, Wales and Northern Ireland

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.

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)

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.

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.

In some circumstances patients won't have this level of choice. Two exceptions are when you need to be seen at a rapid access chest pain 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.

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 or Health and Social Care in Northern Ireland.

This article was last revised in March 2008