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Your choices in the NHS

Choosing a hospital

If you need to go to hospital to see a specialist, you have the right to choose which hospital you're referred to by your GP.

This legal right lets you choose from any hospital offering a suitable treatment that meets NHS standards and costs.

You also have the right to choose which consultant-led team, or clinically appropriate team led by a named healthcare professional, will be in charge of your treatment for your first appointment at the hospital. You will be seen by the consultant or by a doctor who works with the consultant in their team. Get tips on how to choose a consultant.

There are some healthcare services where you cannot make choices. These are set out in the box on the right. 

The hospital you choose for your first outpatient appointment is most likely the same place you'll receive treatment, should you need it. Evidence shows that if you choose a hospital where you feel comfortable and confident, you're likely to improve both the result of your treatment and your experience while you're in hospital. 

You should therefore think about any treatment that could follow on when your GP refers you. For example, if you expect to be prescribed a simple course of medication, your choice of hospital may be based largely on convenience, such as how far away the hospital is, waiting times and parking facilities.

If you're likely to need an operation, such as a hip replacement, your choice will probably be based on other factors. Clinical ratings such as infection and mortality rates may be more important, especially if results vary significantly between hospitals. You should choose your hospital according to what's most important to you.

Choosing the hospital that's best for you is a personal decision. Discuss your choice with your GP before they refer you to a specialist. If you don't wish to make a decision there and then, you can take away information about hospitals and decide later. 

 

Once I've made my choice, how do I book a hospital appointment?

If your GP refers you through the Choose and Book system, you'll be given a password and reference number that allows you to book your appointment online or over the phone. The Choose and Book appointments line is open:

  • Monday to Friday                                8am-8pm
  • Weekends and bank holidays        8am-4pm
  • Christmas Day                                   closed

Phone: 0345 608 8888 or go to Choose and Book to book your appointment online.

 

If you're not happy with your first outpatient appointment, you could ask your GP for a new referral. However, this may delay any treatment you need, as you will have to go through the 18-week waiting time period once more.

If your GP is not already using Choose and Book for your referral, you can ask them to do so. If your GP refuses to use Choose and Book, you should speak to your local Clinical Commissioning Group (CCG). Find your local CCG.

If you feel that you have not been offered a choice of hospital or consultant-led team within hospitals, discuss this with your GP first. If you are still unhappy that you have not been offered choices, you can make a complaint to your local CCG.  

If you are unhappy with the decision made by your CCG, you have the right to complain to the Parliamentary and Health Service Ombudsman. Visit www.ombudsman.org.uk or call the helpline: 0345 015 4033.

Your local Healthwatch, the consumer champion in health and social care, can also signpost you to information on local services.

How far should I travel?

How far you have to travel to the hospital may be important if you have to spend time in hospital or you need to return to the same hospital often.

This doesn't mean that you should choose a local hospital if its results are poor. But you may not want to go to a hospital hundreds of miles away if it will stop you seeing your friends and family for a long time, or if you have to travel there frequently.

On the other hand, you may want to travel further if you can be treated more quickly. For example, an amateur sportsman who needs a ligament in his knee repaired may be prepared to travel to the other end of the country if it means he can receive the best treatment quickly.

Expect to make compromises to find the right balance between convenience and clinical results. If you're thinking of choosing a hospital that's far away, talk to your friends and family to allow them to plan. 

 

Can I get help with travel costs?

You may be entitled to help with your travel costs through the Healthcare Travel Cost Scheme (HTCS) if you are referred to a specialist care appointment by a GP or another professional at a location that is different to where you were referred from and receive either Income Support, income-based Jobseeker's Allowance or Pension Credit Guarantee Credit, or if you're named on an NHS tax exemption certificate or qualify under the NHS Low Income Scheme (LIS).

For information on travel subsidies and policies in the NHS, go to the sections on Help with health costs and The NHS in England.

Comments

The 28 comments posted are personal views. Any information they give has not been checked and may not be accurate.

PuffHead said on 10 April 2014

My GP practice said that 'there is no such thing as choose and book anymore due to NHS cuts'. I live in Harringey and was told I only have two hospitals to choose from, both of which I do not wish to attend.

I am young and have complications with arthritis and wanted to be seen be a specialist in a different hospital from the two I was offered but was told my case would need to be reviewed. I asked them about the patient choice initiative and was told it comes down to cost as they have block contracts with the two hospitals.

I was made to feel like the annoying patient by exercising my right to choose what care I wanted. I despair!

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emmajane58 said on 19 March 2014

My husband has been in agony with Sciatica and discs in his back for months. He is reliant on painkillers whilst the powers that be decide how best to deal with it.
We wouldn't let animals suffer in pain why do we let humans!

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trent101 said on 22 February 2014

Choice? What choice?

GP recommended Newark Hospital.

Shock to the practice and patients to be told that Newark Hospital is so deficient in staff and facilities that its staff can't manage patients who take steroids so they can't be treated there!

That's not just steroid tablets, This applies to All types of steroid medication taken for a long time or high dose including steroid cream,sprays and tablets for all sorts of conditions.

That's one huge number of potential patients automatically excluded! Of course the Trust don't state that up front on their website so patients and their GP's will waste their time choosing and arranging a referral only to be told this shocking news afterwards.

If there are people out there on steroid meds who have had surgery at Newark we'd like to know.

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Makka said on 01 February 2014

Hi,
I have a few health problems,ne being my knees and my Doctor refered me to the mucular skeletal clinic after the scans they refered me to NTGH in Stockton without giving me a choice. I asked to be refered to another hospital because I felt at ease with their Doctors. They refused saying it is up to my own Doctor to refer me to the other hospital,he said no it's upto them,anyway each person is passing the buck they even tried to blame bookings dept. I still don't have a choice and I am dreading going to NTGH . Do have a choice or not what do I do next.

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archdeacon said on 19 December 2013

My GP has refered me for tests at a local hospital, and each time I have attended the local hospitals I have come home with an infection, and I am worried about going back to either hospital. What can I do?

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benson991 said on 14 December 2013

I really cannot believe that a official NHS website says,

"Expect to make compromises to find the right balance between convenience and clinical results"

Compromise on clinical results !!!!!!!!!!!

That should never be an option, surely we all strive for the best clinical results possible at all times. If we do not then we are failing in providing a service to patients.

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shomar said on 10 December 2013

Too much Smoke and Mirrors! Too much not wanting to take responsibility. Too much Top Heavy Administration. Not enough preventative treatment to keep healthy people healthy.

Insult to injury!? if you go one letter over the 2000 allocated here. This usless software deletes all of the text you have entered!

So, I can't find the energy to retype my full account!

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TinaNW said on 29 November 2013

I knew which hospital I wanted to be treated at (Salford Royal), but to do so I had to keep my home address at my parents' house so I could keep my GP in Salford (despite only living just over the border in Bolton).

I wasn't certain whether I'd be able to be treated at my preferred hospital if it wasn't within the area covered by a GP situated where I lived - I didn't want to take the risk.

Having read the information on this site, it seems that I would still be able to choose Salford Royal despite living in Bolton and this is very useful to know.

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Peterxrm said on 10 September 2013

Most consultants work part time outside the NHS. If you want to see a specific consultant see them as a private patient asking at that time to refer you into their NHS clinic for further treatment. The initial downside is the consultants private fee.

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lesleyW said on 14 March 2013

Isn't anyone reading these? There's a whole list of problems and 2 positive comments. And the last comment is from October 2012, 4 months ago. Seems fairly pointless. I got here from the rather odd box which pointed out I could choose my hospital - but I couldn't find any condition relating to 'tear in knee cartiledge' so I couldn't use the facility, which, from reading these posts, is pointless anyway. I'm glad I read them - it simply never occurred to me that you could choose the hospital but then not get the consultant you wanted! Spin, all spin.

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KatGan said on 02 October 2012

Three years ago I had to have an ICD Defibrillator fitted at a specialist hospital, I now have to have this checked twice a year at the hospital the Op was performed at, this involves a round trip of 140 miles.

The same service is now available at my local hospital three miles away, the hospital that I first had the OP insist that I go back there twice yearly, there is no clinical need for this nor is there any continuing trial of the ICD

Makes sense to me to have this checked locally as the time involved in travel seems unnecessary as too does the cost as I have to rely on hospital transport.

In this day of cutbacks I am only trying to help the NHS save money, what are your suggestions please

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rogcal said on 13 September 2012

You have the right to see a GP of your choice at the surgery but not so the consultant of your choice at the hospital of your choice.

The current choose and book system only gives you a choice of a hospital and appointment dates and times.

Under the previous system you could choose a consultant but not any longer. Now even your GP can no longer refer you to the consultant best suited for your problem.

What is the point in having a choice of hospital if you are going to have to take pot luck as to who you see and particularly annoying when you've got a recurrence of a problem and the consultant who previously saw you (a specialist in his field) is not available as a choice because of the changes to the booking system.

A very retrograde step in my opinion and certainly not an example of genuine patient choice!

Oh and if you dare to insist on seeing a particular consultant, just stand back and watch the shutters come down. It seems that the risk of upsetting the other consultants if you choose one instead of another is to much for many of these esteemed gentlemen and closing ranks is the only way they know how to behave in such circumstances. We can't have their protocols abused, can we!

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Julie Shrive said on 17 August 2012

I am outraged at the myths I see perpetuated by people & text books who should know better .As a results our Doctors do not have a clue.Surely an open mind & research is the answer.
I am an adult with the spina bifida that causes no problems? As a result I cannot access fair treatment & assistance as the system discriminates. Why children only ?
My spina bifida was found in my 20's relating to chronic utis & infections 3 weekly causing waits of 3 hrs + to access medication . I asked for research & got it & can attribute many other conditions to it such as poor mobility , breathing , heart feeling pain more intensely .I have encountered many poor souls on internet at wits end being pased from pillar to post.
Now I am getting temporary acute pain & partial paralysis when utis out of control & suspect only minimally invasive repair or stem cells may resolve. Does system want to know they blame me for wanting to know procedure for next time as do not know what to do? So call out security when ask for the medical person in charge.

To make matters worse PALS have left me in limbo blaming knowing I am on a boundary of 3 boroughs & GPs in too small a practice being told what to do by LA who seem to be effecting negligence with my treatment as been raising issues about the maladministration of social services. Because the outlying Whittington in Park Road [ 5 min away] being managed by a practice with a catchment area I cannot access a fair immediate service & now heart symptons are kicking in .
If I am on GP Panel & Link & cannot address these access issue what hope is there for anyone else. Even Counsellors there are rude.As for MP thinks PALS is the answer?

A lot of this is emanating from online Medical Record - Summary of Care?

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fjl said on 21 June 2012

I visited the Medical Investigation Unit at St Heliers Hospital and had very efficient, friendly and professional care from two members of staff. Keep up the good work!

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schoo said on 27 April 2012

to those expressing frustration or disappointment with this choice, don't let your GP fob you off. You don't have to argue with him/her, just be assertive and tell them that according to 'this' site, you have a legal right to choose and this is where you want to go. But take note, your right is to choose the hospital not the consultant.

You will probably be offered Choose and Book but once you have your appointment, phone the consultant's secretary and see if you can't arrange to get with the one of your choice. Doesn't always work but hey - it's worth a try!

Moral of the story is don't take no for an answer!

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jobielad said on 01 March 2012

This is so annoying. I care for my 86 year old disabled mum. Today I found out not only has her 6 monthly eye appointment been delayed by 3 months and now I am told I have to go to the hospital which is chosen for her when she does finally get to the top of the list! I had this argument years ago and refused to put her through the trauma of going to a hospital where we cannot park, have to wait hours to be seen and are allocated some random consultant instead of her regular one who is known to her. Our last visit to that particular hospital resulted in her confusion worsening, her diabetes becoming more unstable and me becoming at the age of 61 extremely stressed due to having to drop her off and leave her alone in her fragile mental state whilst I walked a mile or so back to the hospital after parking the car. When I phoned today to tell the admin staff I would not go to this same hospital I was told to either get her onto the hospital bus (she can't climb steps and I can't lift her wheelchair up on it) or order hospital transport (who won't allow me to travel with her anyway and will result in us waiting hours to get her back home) There is no patient choice take it from me.

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jeannie500 said on 23 February 2012

It is so frustrating to read on this site you have a legal right to choose your hospital when reality is you DON'T.I know which hospital I want, I know which surgeon I want but will my doctor refer me to it NO. No reason other than "we give 3 choices and yours is not it." So much for choice.Surely the NHS must work together and if GP's can't or wont offer choice then a site like this should not report that you have a legal right to choose. It is causing frustration, argument and anger.

What other organistation gets away with such crazy stuff as this.
The hospital I want is only a couple of miles away from the one allocated, so distance is not the reason.

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Boutflower1 said on 26 January 2012

I have recently been a day case patient at Sunderland Royal Hospital and can vouch for the superb care I received throughout the several hours I was in their care.
I was made to feel welcome by every member of staff I encountered. This made me feel very safe and I could easily place my trust in their hands.
I was very aware of the effort staff made to ensure my privacy throughout my time their, particularly as my surgery involved exposure and access to my gentleman's region.
I never felt any discomfort for two days after my surgery, which is a credit to the care of the doctors and nurses, who regularly assessed if I was in pain from recovery room to discharge and was supplied with an excellent combination of medication to combat this when back at home. The advice given by the day case nurses ensured I kept on top of my discomfort and could care for myself appropriately whilst my wound healed, especially washing and dressing.
Despite a busy schedule both surgeon and anaesthetist had time to see me before I was discharged from the recovery room, to check that I was ok. Despite only being in their care for a short time, I was given tea and biscuits and nurses ensured that I had eaten them, as they appreciated I had been fasted from midnight and did not feel that I should be sent home on an empty stomach. I was also given several leaflets about my condition, follow up and what to expect post operatively. A contact number was provided, should I require any further explanations regarding my condition.
In short I felt as if I had been treat as royalty, despite the short duration of my stay.

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HowardH said on 24 January 2012

This choice system is a complete waste of time and money. My three choices for a nasal problem were all at the ENT department of the Royal Liverpool. How am I supposed to know the difference between General ENT, Nurse Led Services and Rhinology?
My GP is the expert so why can't he send me to the most appropriate clinic?
Let's tick a few boxes first and worry about patient care later.

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Beam10 said on 02 December 2011

I sent an email to my doctor asking to exercise my right to choose a hospital rather than just the three that he had offered to me.

He replied that advice from the local PCT instructed practices not to send patients outside the local area and particularly not to London hospitals. This was to save costs!

That was contrary to the information given to me at first by the PCT. So I contacted them again and eventually they admitted that they advise practices verbally at regional meetings but not in writing!

So the facts are that the NHS publishes web sites like this one saying that we have a choice. But at the same time the PCTs tell doctors not to give us that choice!

Is that really honest and above board?

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glynm said on 13 November 2011

Choice seems to have a different meaning to the NHS than the OE Dictionary.

Referred by my GP I was offered 4 'choices'. The 1st - 3 miles away showed no appointments; the2nd 12 miles away - no appointments 3rd & 4th approx 20 miles away showed appointments. So much for choice! I reluctantly booked an appointment. 5 weeks later I have a letter saying that my appointment has been moved further away & 2 weks later.
If this is intended to make me get a private consultation closer to home its almost working!! I am disgusted at this treatment - just to get an appointment. The choice policy is'nt working!!!

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Beam10 said on 22 October 2011

The right to choose a hospital for your operation is very sensible! However, it does not work in practice!

I need a simple operation which is classed as general surgery and performed at all hospitals. I selected an NHS hospital about 15 miles away which has a very good reputation.

My GP was told that I would like my treatment at that hospital but he replied that he could only offer the three hospitals in their local Hospital Trust group. I did not question this at the time because I was not sure of my rights.

The local NHS Trust PALS office confirmed my right to choose a hospital and could not suggest a reason why he might have refused. I suspect it could be some kind of funding aspect but nobody can confirm this.

Now I have to enter into an argument with my GP to insist on my rights. I am happy with the GP and dont want to have to do this but his reaction has forced me to do this.

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whitemaremma said on 28 September 2011

I've been attending St James' eye clinic in Leeds quite happily since 2000.

This week I received a letter informing me of my next appointment - at Seacroft hospital, further away. No reason, no explanation.

On querying, I was told that part of the eye clinic had moved to Seacroft and that if I wanted to change consultants and stay at St. James' I would have to go to my GP and be referred again.

So much for choice!

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Akcipitrokulo said on 12 July 2011

Agreed on mental health - and from my situation, why not maternity services? I want to give birth close to my family.

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capricorn1 said on 10 July 2011

Hi stan84
The government and the NHS still discriminate against folk with mental health problems by denying us choice.

I am given to understand that this is due to a shortage of psychiatrists, many of who speak poor english, but that should not allow discrimination.

Of course having a mental health problem means we always get the short straw, anything will do, anyone will do, even when talking about childhood abuse we are allocated a male doctor, so much for a little sensitivity!

It is about time equality was introduced into mental health, I choose which GP I see at my practice and should have the same choice in mental health.

Sadly mental health Trusts cover a vast area so to go to another Trust means an extremely long journey and not much use in an emergency, again we are discriminated against!

In the modern world you would think we should all be treated as equals, we should all have the same rights. In the general sector patients get a choice of hospitals, they get a choice of consultant, they get a choice re language, interpreters are provided, they get same sex doctors if requested, in mental health we have no choice and because one Trust cover a wider area, we have no real option to go elsewhere ... and they call this equality!

Mental health has always been the Cinderella of the NHS, we always get the short straw, and if we complain ... well we have a mental health problem ... don't we!

And I bet you because my comment criticises the NHS, as always they withdraw it!

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stan84 said on 08 June 2011

Can somebody explain to me why 'choice' does not apply for mental illness? I was referred to a psychiatrist at a hospital, but was extremely upset and unhappy with the treatment I recieved from this individual. I spoke to my GP and she agreed that I could go to a different hospital, which is actually much nearer to me ( the other one took me almost 2 hours in travel time and that in itself was very difficult) however she then told me she couldnt get me an appointment there and furthermore the psychiatrist I saw, is the one that covers all patients from our area (where the gp surgery is) so I dont have an option but to see him. Im not a demanding person, im not being overly fussy, I did not push any further on the matter but I really need to have some help for my mental health problems from the NHS. So please can somebody explain why mental health is not as important as physical health, because it feels the way the NHS treats it as much less. I have had to privately fund some of my treatment, I no longer can afford to do that -its not right that I should be forced to take that option. Why cant I choose?

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User540500 said on 22 March 2011

Thank you for such a nicely written and easily understood explanation of Hospital choice history and use.Thanks in advance for your cooperation with the above conditions. I hope you find it useful.It helped me with ocean of knowledge so I really believe you will do much better in the future I appreciate everything you have added to my knowledge base.

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Worlds_gone_mad said on 10 March 2011

Really? Someone ought to tell my GP that, he's trying to make me go to a hospital thats twice as far as the one I am willing to go to, when I have MS and manic depression too and the hospital I want does what I need and I feel comfortable going there.
He won't accept that I have a choice in it and its the only GP surgery I can register with here. Just had a disagreement on the phone over it, why say its a legal right when there is no way of the patient enforcing it? I don't feel I can physically get to the hospital he wants me to go to and its 20 miles away, the one I want to go to is 12 miles away, so if he won't change it I cannot go. No offer from him to supply transport or help at all so I literally have no choice. Where's the sense in that?

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Page last reviewed: 07/03/2014

Next review due: 07/03/2016

Making your choice checklist

1. Know your choices
Discuss your options with your GP
2. Find and compare hospitals
Choose according to what matters most to you, and compare hospitals to make your choice 
3. Talk about it
Discuss your choices with family or friends
4. Book an appointment
Contact your GP practice, or access Choose and Book online or by phone on 0345 608 8888

 

Services excluded from choice

You cannot choose:

  • services where speed of access to diagnosis and treatment is particularly important, such as emergency and urgent care
  • cancer services, which are subject to a two-week maximum waiting time
  • maternity services
  • public health services commissioned by local authorities

 

Download the Choice Framework and find out where you have the legal right to choice in the NHS.

 

Disabled people in hospital

Get tips and advice on how to make arrangements if you are disabled and you need hospital treatment, including information for carers

Your outpatient appointment

Find out what happens on the day of your hospital outpatient appointment

GP referrals

This section provides information about how to request a specialist service from your GP. Also find tips on other services you may access through your GP

Preparing for hospital

A nurse describes what to pack if you're going into hospital, and what facilities inpatients and their visitors can expect.

Media last reviewed: 14/11/2013

Next review due: 14/11/2015