Patient Choice Charter

The Patient Choice Charter is also known as the NHS Patient Choice Framework and is a guideline which outlines your legal rights as a service user of the NHS. The purpose is to allow you to actively participate in your healthcare journey, whether that’s with your GP, in specific medical situations or when seeking healthcare abroad. 

Not only does it outline what you’re allowed to ask for but it also outlines the standard of care that you should receive across multiple areas of your medical journey. 

The Patient Choice Charter was only recently formalised, being outlined in the ‘Fit for the future: 10 Year Health Plan for England’ by the UK Government in July 2025. The NHS Choice Framework is part of a wider plan to restore the NHS and meet the demand on an already stretched health service.

‘Choice’ is just one of six principles outlined in the Comprehensive Model of Personalised Care by NHS England which is focused on making people feel as though their care is deeply individual.

The NHS Constitution for England sets out that “You have the right to make choices about the services commissioned by NHS bodies and to information to support these choices.”

The Constitution also covers a pledge by the NHS to provide accessible, relevant and reliable information to “enable you to participate fully in your own healthcare decisions and to support you in making choices.”

The NHS Choice Framework includes nationally set choices for patients in the following areas: 

• Choosing your GP and GP practice
• Choosing where to go for your first outpatient appointment
• Changing healthcare provider if you’re left waiting longer than the maximum wait time
• Choosing maternity services
• Taking part in health research
• Having a personal health budget
• Accessing treatment plans in EU member states and beyond

Many of these choices are legal rights and the Patient Choice Charter also sets out eligibility for making these decisions. 

Each section of the Patient Choice Framework outlines what choices you are able to make, whether it’s a legal right and any instances where you do not have a choice. The framework also includes where you can get more information to help you make the right choice and how to raise a complaint if you are not offered a choice when you feel that you should have been.

Under the NHS Patient Choice Charter, you can decide which GP practice you register with and ask to see a particular healthcare professional at your GP practice.

Your GP practice must make every effort to accommodate your choice but can refuse on reasonable grounds due to: 

• Being at capacity and not taking new patients
• Not accepting patients who live outside the practice boundary
• It not being appropriate for you to register for a GP outside of the area you live due to safety, clinical need or your personal circumstances

Outside of these grounds, having a choice on your GP practice and seeing a specific GP, nurse or other healthcare professional at the practice is a legal right. 

This is particularly useful if transport links make it easier for you to access a GP further from your house but which is more easily accessible. 

Outpatient appointments apply to mental health or physical health at the point of referral from your GP, dentist or optometrist. The Patient Choice Charter states that you have a choice around which provider you would like to receive care from as an outpatient and which clinical team will be in charge of your care within that organisation.

Making a choice about your outpatient care is a legal right, though there are some instances where you may not be eligible to make your own decision, for example if you require any urgent care or if you are already receiving treatment which you have been referred for.

The maximum time that you can expect to wait before an assessment or treatment is 18 weeks for all healthcare, except for diagnosis or cancer-related treatment. For these two scenarios, you can expect to wait up to 28 days.

If you have waited more than 18 weeks to start a treatment or an assessment in a non-urgent referral and in a service led by a consultant, you may ask to be referred to a different NHS service provider.

If your care provider is also not confident that you will receive a diagnosis or cancer-related update after an urgent referral within 28 days, you can also ask to change NHS provider. 

This is a legal right with some exceptions. For example, you may not be legally entitled to ask to change your NHS provider if you chose to wait longer for your treatment to start, failed to attend appointments, declined appointments or if your treatment is no longer necessary. The NHS Choice Framework outlines the full list of exceptions.

While pregnant, you can book an appointment with any NHS maternity service or ask your GP to refer you. You can also choose who you receive antenatal care from and where you want to give birth. You can change your mind at any point during your pregnancy.

Where possible, choice is given about NHS maternity services when you find out that you are pregnant. However, you are not legally entitled to choose any service you’d like. It depends which services are available to you and how many choices you are able to select from. 

That said, there is plenty of advice and support available online through the NHS Patient Choice Charter or given to you by your midwife or maternity health team.

You may take part in health research, such as clinical trials, to improve the NHS’ understanding of people’s health and develop new ways for treating disease. It is not your legal right to take part in these studies, and you aren’t able to be a participant if you do not meet the study requirements or if the study is already at capacity.

A personal health budget is an allocation of money to financially support your health and care needs. It’s especially useful for those who have their care jointly funded by the NHS and social care, have a learning disability, require mental health support, end-of-life services and more.

It is your legal right to choose a personal health budget as long as you are eligible. More information on personal health budgets can be found by contacting your integrated care board.

Via the S2 funding route, you may be entitled to NHS funding to receive free planned state healthcare in an EU country, Norway, Iceland, Liechtenstein or Switzerland. You need to apply for funding before your treatment and if you’re accepted, you will receive the treatment under the same conditions as if you were a resident of that country. 

Each country has different rules where the state may cover more or less of the treatment costs. More information about the S2 funding route is available on the NHS website.

If you feel as though your legal rights have not been met regarding your healthcare choices, the NHS Choice Framework sets out guidance on how you can log a complaint. 

For choices around GPs and GP practices, your best bet is to speak directly with the GP practice. If they are unable to resolve the issue, you can log a complaint directly with NHS England. 

For anything related to outpatient choices, you can speak directly to your GP, dentist or optometrist and can find out more information on the NHS services page of the NHS website. 

For anything related to maximum wait times, you may speak to the organisation that was handing your case and if you don’t feel as though they have taken reasonable steps to accommodate your choices, you can raise a complaint with your integrated care board.

For maternity services, your midwife is responsible for explaining the choices available to you. If you have spoken to your midwife and still feel dissatisfied, you can reach out to your integrated care board.

For choices related to healthcare research, you can speak to your healthcare professional or integrated care board. If you feel like you have been prevented from taking part in research without reasonable grounds, you can make a complaint with NHS England.

For choices around your personal health budget, you can speak to your integrated care board who is responsible for making sure you’re offered a personal health budget if it’s appropriate.

The Patient Choice Charter is just one part of the NHS Constitution for England, which also sets out rights and NHS pledges around receiving access to free health care, being treated with a high standard of professional care and being able to access medication recommended for use in the NHS.

The Patient Choice Charter deals specifically with your rights around choice and control throughout your medical journey and for your health. It provides clear communication about what you’re entitled to in order to promote shared decision-making, equity and fairness.

Understanding your rights and what you can expect from the NHS when it comes to making decisions about your health is important. It ensures that you receive the best possible outcomes for your care and that you remain informed at all times.

The NHS Choice Framework consistently outlines that choices around your GP, your GP practice, outpatient appointments and wait times are your legal right. Even in the cases where you are not legally entitled to request care, like through maternity services, the NHS and your healthcare professionals provide plenty of help to ensure that you are informed and receive the best care.

For that reason, you should not feel afraid to ask about your options when you’re receiving care through the NHS. Informed choice is the purpose of the Patient Choice Charter and, more broadly, it is the cornerstone of modern and patient-centred care.