The NHS Choice Framework exists so that you — as a patient in England — can have more say and control over your health care. It explains what decisions you may be able to make, when those decisions are a legal right, and when they depend on what’s available locally.

It also tells you where you can find information to help make those choices — and what you can do if you feel a choice you should have been offered wasn’t given.

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🩺 What choices you might have

Here are the main areas where you may be able to choose — whether you’re registering with a GP, being referred for specialist care, or receiving support for a long-term condition.

Choosing your GP (family doctor) or GP practice

• You can choose which GP practice you register with — and within that practice, you can ask to be seen by a particular doctor, nurse or other healthcare professional.

• The practice should do its best to meet your wishes — though sometimes they might be full, or unable to meet your request (for example if the practitioner is unavailable, or because of where you live).

Choosing where you go for your first specialist / outpatient appointment

• If your GP (or dentist, or optometrist) refers you for consultant-led treatment (physical or mental health), you usually have the right to pick which provider (hospital/clinic) you go to — including providers outside your local area, as long as they hold an NHS contract.

• You can also choose which clinical team (consultant or specialist) will oversee your care.

However — there are situations where you do not have a choice. For instance: if you already have ongoing care for the same condition (onward referral), or if you need urgent or emergency treatment (e.g. in a crisis).

Asking to switch provider if waiting times are long

• If you’re waiting for non-urgent consultant-led treatment and the wait is longer than the maximum standard (usually 18 weeks), you can ask to be referred to a different provider.

• Also, for suspected cancer cases under the updated rules: if after an urgent referral you’re not diagnosed or ruled out within 28 days, you may request another provider who might be faster.

If there’s more than one alternative, you should be given a choice of where to go.

Maternity services (for those who are pregnant or planning for a baby)

• You can often choose where to receive maternity care — for example, whether to use a midwife-led service, a hospital obstetric unit, a birth centre, or even have a home birth (if local services allow).

• You can choose care even outside your local area, if you prefer — but whether all options are available depends on what services are commissioned in your region.

• After birth, you may have a say in where you get postnatal care: e.g. at home, at a community centre, or at a hospital.

Because maternity services vary by area, this isn’t always a guaranteed legal right — but the NHS aims to offer choice where possible.

Choosing to take part in health research (clinical studies, trials)

• If there is a suitable study and you meet its criteria, you can choose whether or not to participate — and you can change your mind later.

Personal health budgets (for those with ongoing needs)

• If you are eligible (for example, you receive continuing healthcare, need a wheelchair service, have a learning disability or long-term mental health needs), you might be offered a “personal health budget.” This gives some flexibility over how your care is arranged — including how the budget is managed (by you, by a third party, or by the responsible board).

• Not everyone eligible will be able to manage the budget directly — sometimes a professional will need to handle it, depending on capacity or clinical need.

• There are limitations: a personal health budget doesn’t cover urgent or emergency care, GP appointments, medications, or some other excluded items.

Accessing planned treatment abroad (certain European states + some additional countries)

• Under certain conditions, you may be able to access planned treatment in EU countries or certain other European countries (e.g. Norway, Iceland, Liechtenstein, Switzerland), in line with recent changes.

ℹ️ Getting helpful information & asking for support

• The NHS promises to give you clear, easy-to-understand information to help you make these decisions — including online tools, quality ratings of providers, waiting-time data, and more.

• If you have a disability or additional support needs, you have the right to receive reasonable adjustments. That means care and information should be offered in a way that works for you (e.g. accessible formats, communication support, etc.).

• If you feel you were not offered choices you believe you should have, there are steps you can take: you can speak to your GP or the service provider; or, if needed, contact organisations such as Healthwatch, Patient Advice and Liaison Service (PALS), your local Integrated Care Board (ICB), or ultimately Parliamentary and Health Service Ombudsman.

💡 What’s helpful to know

• Sometimes you have a legal right to choose — for example choosing your GP, many first outpatient appointments, or using a personal health budget (if eligible).

• Other times, the choice depends on what services are available locally: if that option isn’t available where you live, your wish may not be possible — but you should be given an explanation.

• It’s okay to ask questions and express your preferences — you deserve to be involved in decisions about your care. The NHS aims to support you to make informed choices that reflect what matters to you.

You can find out more from gov.uk here NHS Choice Framework