What is NHS Right to Choose and how does it work?

Did you know you can often choose which hospital and consultant-led team treat you, even when you receive NHS care? Making informed choices about your healthcare can make the process less stressful and help achieve better results. We examine how the scheme works and what your options are.

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What is NHS Right to Choose?

Right to choose lets you decide where to have your NHS treatment to give you more control over your care. In most cases, it gives you a legal right to choose, although there are some exceptions. You can also choose a private hospital if it has an NHS contract to provide the service you need, in which case the NHS pays for your care.

The NHS right to choose scheme applies to physical and mental health treatment, and you can usually book appointments using the NHS e-Referral Service. You can learn more about your options in the NHS Choice framework.

What is the NHS Choice framework looking to achieve?

NHS England believes that people are experts in their own health, meaning involving them in decisions about their treatment and which healthcare provider to use will improve outcomes. Studies have shown that outcomes tend to improve when patients can speak freely with their doctors and understand the information given to them. It also lowers the stress associated with being ill. Being able to choose a healthcare professional you get on with can be a positive first step.

NHS England aims to allow patients to discuss their needs with their GP and choose an appropriate healthcare provider. It also wants to ensure that GPs give patients enough information to make an informed choice.

What choices are available?

Within reason, you can choose a healthcare provider for many aspects of your care. For example, you can choose which GP surgery you register with, but your location and other factors often limit this. It can become a priority if your existing GP surgery closes.

Key findings - What choices are available

Who to see for your first consultant appointment
Switching to a different consultant or hospital
You can choose a private hospital that provides NHS services
How Right to Choose applies to mental health services

You can choose a healthcare provider or ask to switch to a new one in the situations below. Here are your main options.

1. Who to see for your first consultant appointment

If your GP refers you to a consultant or for mental health treatment, you have the right to choose who you see. This applies to outpatient care; you can choose an organisation and team. For example, you might go to a particular hospital with several consultants, each leading a team of healthcare professionals. You can decide which one you want to see for your first outpatient appointment. If you need treatment for a mental health condition, you can choose a mental healthcare team offering treatment in your area.

2. Switching to a different consultant or hospital

NHS waiting times remain a challenge: at the end of August 2026, in 65.2% of cases the patient had been waiting up to 18 weeks, against the 92% standard. However, waiting lists are still measured against NHS England standards for maximum waiting times. You have a right to ask to switch to a different healthcare provider if your current one can't start your care within those guidelines. For suspected cancer, you should receive a diagnosis or have cancer ruled out within 28 days. Otherwise, the maximum wait to start treatment is usually 18 weeks. On 31 October 2023, patients who had waited more than 40 weeks for a first outpatient appointment were asked by their provider whether they wanted to change, but you can ask to move if you have waited, or are likely to wait, more than 18 weeks. Your waiting time starts when the hospital or service receives your referral letter, or when you book your first appointment through the NHS e-Referral Service.

3. You can choose a private hospital that provides NHS services

It's worth remembering that you can choose a private provider if it holds an NHS contract for the service you need. Many consultants practise privately and in the NHS. NHS commissioners also contract with private hospitals, where consultants can carry out treatment paid for by the NHS. You don't pay for that care, and a private hospital with no NHS contract for the service you need isn't part of this choice.

If you've already seen a consultant for your first outpatient appointment and need surgery, they may offer you the opportunity to go to a private hospital for your operation. Colin received treatment from an ENT consultant and said this about his care:

"I saw my consultant at an NHS hospital, and then they contacted me to offer me an appointment for surgery at a local private hospital much closer to home."

4. How Right to Choose applies to mental health services

Right to choose applies to mental health services just as to physical treatment. You can decide where to be treated and which team provides your care. You can also choose private services if they hold an NHS contract for that care.

The right to choose also applies to assessments for conditions such as ADHD. If your GP agrees an assessment is appropriate, they can refer you to any provider with an NHS contract to carry out ADHD assessments, including private providers, and the NHS pays. You can't refer yourself, and some providers only assess and diagnose, so ask what follow-up care yours offers. It's worth remembering that even private services face increased demand, meaning you may still need to wait for treatment.

Are there circumstances where you may not have a choice?

There are some circumstances where the right to choose doesn't apply, so you must understand your legal rights.

Generally, prisoners or anyone detained in young offender institutions, immigration removal centres, secure training centres or living in a secure children's home don't have the right to choose. This also applies to members of the armed forces or anyone sectioned under the Mental Health Act. Other restrictions also apply depending on your situation.

First appointment

You have a legal right to choose who you see for your first outpatient appointment, but there are exceptions. If you've already seen a consultant for treatment and they refer you to another healthcare professional for additional care, you don't have the right to choose who that is.

There can also be some restrictions on maternity services. While you can book with a hospital of your choice and make decisions about who looks after you and the type of birth you have, these aren't a legal right, as your care will vary depending on your risk profile.

Changing consultant/hospital

The right to choose scheme lets you switch to a new provider if you must wait for more than the maximum time for treatment. You don't have a legal right to a second opinion, but you can ask for one.

However, the right to switch doesn't apply if no one else can see you within the time limit, if a consultant doesn't lead the care you need, or if you choose to wait longer. In some circumstances, a delay might give you a better outcome. For example, some treatments have a better chance of success if you lose weight or give up smoking before you start.

You also won't have a right to choose a new provider if you've declined treatment or haven't attended appointments.

Emergencies

If you need urgent or emergency treatment, such as at A&E, you won't have the right to choose who treats you. This can apply if you need an urgent appointment, for example, for suspected cancer. However, your GP will usually offer you a choice if it's practical.

Clinical reasons for not offering a choice

There may be medical reasons that mean you don't have a right to choose who treats you. For example, you may need treatment only available at a specialist centre or from one consultant-led clinical team in your area. You won't have a right to choose in those circumstances, as your GP will make your referral based on clinical need.

What are your options if you’re stuck on a waiting list?

Millions of people are waiting for treatment in the UK and looking for options. In this article, we look at what some of those options are.

What is a GP referral and how can you get one (UK)?

Read how to get a GP referral in the UK and what to expect from the process, as well as other options available to you.

What’s happening with NHS waiting lists?

In this article, we look at the current situation in the NHS when it comes to waiting lists.

How do choices work in practice?

Once your GP has referred you, you can book your appointment at your chosen hospital or clinic online through the NHS e-Referral Service or the NHS App, using the booking reference number and password from your referral, or ask your GP to book the appointment. You'll need a GP referral, and your GP should offer you a shortlist of providers to choose from. It's a good idea to discuss your options with your GP before they make the referral so they know what your priorities are or if you have a particular consultant in mind.

If you have waited, or are likely to wait, longer than 18 weeks to start treatment, you can contact the hospital treating you or your local integrated care board (ICB) and ask to switch. They have to look into it and offer you a range of suitable alternative hospitals or clinics that could see you sooner.

What can you do if you aren't offered a choice?

If your GP has referred you for treatment but has not offered a choice, you should contact them initially to discuss this. If that doesn't resolve things, you can complain to your local Integrated Care Board (ICB). ICBs are responsible for commissioning and managing healthcare services in your area, including ensuring GPs offer patients their right to choose. You can take it further if necessary; there's guidance in the NHS Framework document on the next steps and other organisations that can help you.

Reasonable adjustments

Reasonable adjustments are separate from your right to choose and are a legal right under the Equality Act 2010. However, you may need to consider any reasonable adjustments and discuss these with your GP when they make your referral. Your chosen provider must take reasonable steps to avoid putting you at a disadvantage because of your disability, which can mean making adjustments.

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Reasonable adjustment

A reasonable adjustment is a change or adjustment to services to support patients with a disability or impairment that affects their ability to access services.

Comparing healthcare providers

Having the right to choose is great, but how can you make an informed choice?

Check your priorities

When you need medical care, your first priority is likely to be to feel better. However, think about the type of care you need. Do you want a hospital close to home? Is there a consultant or clinical team specialising in the treatment you need? You might need a larger hospital offering a broad range of support services.

Talk to your GP

Your GP can offer helpful insights during the conversation about your referral.

GP insights

In many cases, GPs coordinate follow-up care after surgery and receive updates on how consultant-led treatment is going. These updates let them offer insights into the standard of care each consultant provides.

Private consultants

Many consultants work privately and in the NHS. If a private hospital has an NHS contract for the service you need, you may be able to be seen there with the NHS paying. Ask your GP whether this is a possibility.

Friends and family

If your friends or relatives have had similar treatment, ask them for recommendations. NHS England also publishes the results of the 'friends and family' test every month, and you can look up treatment provider listings on the NHS website.

Private Healthcare Information Network (PHIN)

PHIN publishes information on the safety, quality and costs of private healthcare. However, as many consultants also practise in the NHS, their website can be a valuable source of information.

What is PHIN?

PHIN is a government-mandated, independent organisation that helps patients make informed choices about private treatment.

What does PHIN do?

Hospitals and consultants who offer private treatment must submit data to PHIN, which publishes information based on performance measures, including patient experience and how successful treatments have been.

Using PHIN to find a consultant

PHIN's website has a search facility where you can find providers by name, type of service, or postcode.

Google individual practitioners

Many consultants have websites advertising their private services and including details about their background and patient reviews. If you have a consultant in mind, Google can provide links to these and other review sites.

Patient review sites

There are many patient review sites where you can discover the positives and negatives of different consultants and services. Always check whether reviews are verified to ensure you hear from actual patients. You can find out more in our guide to finding a private medical consultant.

Search the GMC register

Every doctor in the UK must register with the General Medical Council (GMC). The GMC records training and is responsible for investigating complaints. You can search for your chosen consultant on their website to find out about their training and whether there have been any issues in the past.

Check the Care Quality Commission website

The Care Quality Commission (CQC) inspects hospitals in England and produces regular reports detailing evidence of good clinical practice and areas of concern. You can search their website to help you decide which hospital to choose.

Get in touch

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