Referrals and your right to choose

If you use the NHS, in most cases, you have the right to choose the hospital where you get the care you need. Few people exercise this right – but if you do, you could cut down on how long you wait for care.

In this article, we'll help you understand your rights when choosing a healthcare provider "at the point of referral" so you can make informed choices about your NHS care. 

How can I make choices about my care?  

When a healthcare professional – like your GP – refers you for a routine health condition, in most cases, you have the right to choose which hospital or service they refer you to. 

You may also be able to choose a clinical team led by a specific consultant or healthcare professional as long as the team offers the treatment you need. 

Your healthcare professional will share at least five suitable options with you, where possible. You can decide which to choose based on factors like:  

• How far you'll need to travel to a care provider 
• The waiting times for your first outpatient appointment 
• Whether you have friends or family nearby for additional support 
• How other patients and healthcare regulators have rated a care provider 

You can choose during your appointment if you want. But if you'd rather take more time to think about your options, you can do that too.  

Where can I find information and support to help me choose? 

If you'd like to research your options, there are several places where you can get information about hospitals and services: 

• My Planned Care is updated each week with information such as waiting times. 
• You can use the NHS website to compare information about hospitals, services and consultants. 
• You can find information about NHS and independent care providers on the Care Quality Commission website, including how patients and healthcare regulators rate them. 

Once you've decided, there are a couple of ways you can confirm your choice: 

• Your referring clinician will send you a link via text or email to confirm online through the NHS e-Referral Service. 
• If you don't have internet access or would rather talk to someone, you can call the referral helpline on 0345 608 8888 (open Monday to Friday, 8 AM to 8 PM, and from 8 AM to 4 PM on weekends and bank holidays). An operator will talk you through your shortlist and support you to choose the option that will work best for you. 

If I choose a provider further away from home, will I have to travel to this hospital for follow-up appointments? 

You'll need to travel to the hospital you pick for your first outpatient appointment and any follow-up appointments, so keep this in mind when you choose a provider. 

If I choose a non-NHS provider, will this cost the NHS more? 

Integrated Care Boards (ICBs), which plan and fund NHS services, have contracts with non-NHS providers to increase NHS capacity.  

You have the right to choose any provider that has a contract with the NHS to provide the service you need. This means there won't be an additional cost to the NHS. 

If I choose a provider outside my area, am I entitled to travel or accommodation expenses? 

The NHS has a scheme called the Healthcare Travel Costs Scheme (HTCS) that lets you claim a refund for reasonable travel costs if you're eligible. 

If you're eligible for the HTCS, and the healthcare professional who refers you says it's medically necessary for someone to travel with you, that person can also claim travel costs. 

Some ICBs may accept claims for help with travel costs if you're the parent or guardian of a child under the age of 16 that you must attend an appointment with. 

Will I still be able to choose an alternative provider if I live in a rural area? 

If there is limited choice in your area, you'll be able to look at options from other areas of the country.  

What if I don't want to choose an alternative provider? 

Patient choice is a right, but it's not a requirement. Your healthcare professional can refer you to your local service if you'd like them to. 

Are there any times when I won't get a choice? 

You have a right to choose your care provider at the point of most routine referrals. However, patient choice rights don't apply where speed of access to diagnosis and treatment is essential, such as an urgent suspected cancer referral.  

There are also exceptions if you are: 

• In need of urgent or emergency treatment 
• Accessing maternity services 
• Serving in the armed forces 
• Detained under the Mental Health Act
• Detained or temporarily released from prison, an immigration removal centre or a secure children's home 
• Referred to high-security psychiatric services or drug and alcohol misuse services provided by local authorities 

Image credit: Jonathan Borba, Unsplash