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Policy and guidance on improving patient choice, including how, when and where patients receive treatment, and giving the public a bigger hand in shaping local care systems.
This Government will continue to give patients more choice and control over their care. The NHS Constitution now gives patients the right to choose a provider on first referral to a consultant-led service for elective care. This document provides a summary of plans to extend patient choice over next 5 years.
Since April 2008, when a GP refers a patient to a consultant led service patients may choose any clinically appropriate secondary care provider for the first outpatient appointment with a consultant or a member of the consultants team. This choice can include any NHS provider in England, including many independent sector providers. Patients can choose the hospital their GP recommends, the hospital with the best reputation or shortest waiting times, or simply the one that is most convenient for them. (Patients may not be given a choice in some circumstances including when they are referred to mental health or maternity services, or where speed of access is important, such as suspected stroke, heart attack or cancer).
New legally binding Directions came into force on 1 April 2009. The Directions effectively legally require PCTs to ensure that patients get the choice set out in the Free Choice guidance.
Choice in primary care has always existed to large degree and what we are trying to do now is ensure that patients are aware that they have the right to choose where they receive services that best fit their lives.
For people with long-term conditions, the offer of choice is particularly pertinent, namely:
Generic choice model for long term conditions
Supporting people with long term conditions: An NHS and social care model to support local innovation and integration
The your health, your way section on www.nhs.uk, previously known as the patients' prospectus, outlines how people with a chronic or long term condition will have a choice of ‘active patient’ or ‘care at home’ options.
From April 2005, CHD choice has been extended to offer all patients, requiring a coronary artery bypass graft, angioplasty or a heart valve operation, a choice of hospital at the point of referral by the cardiologist.
“Maternity Matters: choice, access and continuity of care in a safe service” was published in 2007 for commissioners, service providers and other organisations involved in the provision of maternity services. It builds on the maternity services commitment outlined in Our Health, Our Care, Our Say and is an important step towards meeting the maternity standard set out in the Children’s NSF.
Maternity Matters highlights the Government commitment to developing a high quality, safe and accessible maternity service through the introduction of a new national choice guarantee for women. This will ensure that by the end of 2009, all women will have choice around the type of care that they receive, together with improved access to services and continuity of midwifery care and support.
The Government is committed to improving the quality of care for all people at the end of life, regardless of their condition or their location. This includes giving people more choice about the care that they receive. The first national End of Life Care Strategy (DH, 2008) sets out how these improvements in care can be delivered, and identifies a number of national actions which will support local services in implementing the Strategy. Information on how these are being taken forward can be found on the DH website and the website of the national implementation team.
End of life care was also identified as one of the eight pathways of care for which Strategic Health Authorities were required to develop local service visions as part of the NHS Next Stage Review. The end of life care visions were informed by, and informed, the development of the End of Life Care Strategy, and work programmes are now underway in each of the SHAs to implement these local visions for care at the end of life.
National consultations on choice in mental health suggest that patients have a positive perception of choice and the benefits it can offer.
Guidance on implementing cataract choice from January 2005.
NHS Choices helps you make your choices:
Explore the history of patient choice in the NHS since 1948:
