Right to Choose
You have the legal right to choose your NHS hospital
Under the NHS Constitution, every patient in England can pick the hospital for their first outpatient appointment. Most patients don't know this right exists.
Written and reviewed by Mustafa Ghafouri (MBChB, MSc) ·
What it means
This means:
- You do not have to go to your nearest hospital
- You can choose any NHS hospital in England that provides the treatment you need
- This includes NHS Foundation Trusts, NHS Trusts, and Independent Sector providers with NHS contracts
- Your GP must offer you a choice of at least 5 providers
Why this matters
Waits vary a lot between hospitals. For the same specialty, one hospital might have a 12-week wait. Another 20 miles away might have a 38-week wait.
Pick the hospital with the shorter wait and you could be treated months sooner.
Right to Choose at independent providers
Right to Choose also covers some private hospitals — known as Independent Sector Providers (ISPs). These are groups like Nuffield Health, SpaMedica, Optegra, and Practice Plus. They must hold a special NHS deal — an NHS Standard Contract — for the exact procedure you need.
If they do, the NHS pays the bill. You pay nothing.
Most patients (and many GPs) get this wrong in two ways:
- Some assume all private hospitals are off-limits. Not true. Many hold NHS contracts and accept NHS referrals every day, often with much shorter waits than the local NHS hospital.
- Others assume any private hospital will do. Also not true. The deal only covers specific procedures in specific areas. An ISP might hold an NHS contract for cataract surgery but not hip replacement. Or hold one in Greater Manchester but not Devon.
How to check: ask your GP if your area covers NHS referral to that ISP for your procedure. If yes, the GP can refer you through the NHS e-Referral Service (e-RS) — the same system used for any NHS provider. There is no separate process.
On HospitalWaits, we list ISPs with NHS contracts in a separate bandbelow the NHS hospital list. They carry the “Independent — NHS contract” label. This makes the difference clear without hiding good options.
For cancer-suspicion searches, we still show routine surgery waits. People already diagnosed need this to compare hospitals. But we add a clear banner at the top to explain that the 2-week-wait (2WW) / Faster Diagnosis Standard (FDS) pathway is the separate urgent route for new symptoms. Right to Choose does not apply to the cancer pathway itself.
How to exercise your right
Step 1: Search
Use HospitalWaits to find which hospitals near you have the shortest wait for your specialty.
Step 2: Ask your GP
At your GP appointment, say:
"I'd like to exercise my right to choose where I'm referred. I've looked at the waiting times and I'd prefer to be referred to [Hospital Name], which has a shorter wait for [specialty]."
Your GP should refer you to that hospital. They may need to use the NHS e-Referral Service to do it.
Step 3: If your GP says no
Your GP cannot refuse your right to choose for a first outpatient appointment. The only exceptions are genuine emergencies, or when the service is not clinically right for you.
If you feel your choice is not being respected:
- Ask the practice manager to explain why
- Contact NHS England's Customer Contact Centre: 0300 311 22 33
- Contact your local Healthwatch: healthwatch.co.uk
- Contact the Patient Advice and Liaison Service (PALS) at your local hospital
If you're already on a waiting list
Good news: Right to Choose still applies if you want to switch hospitals. But the rules around the switch matter.
- Switching restarts your wait at the new hospital. You do not carry the time you have already waited with you. The new hospital treats you as a fresh referral from the day your GP refers you in.
- A switch is only worth itif the new hospital's typical wait is much shorter than your remaining wait at your current one. Use this site to compare. If the gap is small (a few weeks), staying put is usually the better call.
- Real-life friction matters too. Referrals sometimes get lost in admin. You may need to repeat tests the new hospital has not seen. Delays in communication can add weeks. Factor this in when the wait gap is borderline.
- Tell your current hospital you are switching so they can release your slot. They cannot refuse the switch. But it is polite to let them know.
- Different rules applyto cancer pathways, urgent referrals, and follow-up care. See “When does Right to Choose apply?” below for the full breakdown.
Compare your current hospital's wait to other options near you →
When does the right to choose apply?
| Situation | Right to choose? |
|---|---|
| First outpatient appointment (new referral) | Yes ✓ |
| Maternity services | Yes ✓ |
| Mental health services (from April 2023) | Yes ✓ |
| Follow-up appointment at the same trust | No |
| Emergency admission | No |
| Diagnostic tests (MRI, CT, etc.) | Limited — depends on referral pathway |
| Inpatient admission following outpatient | Usually at the same trust |
What about travelling further?
A hospital further away means a longer journey. But it could mean a much shorter wait. Things to think about:
- How much shorter is the wait? Saving 6 months may be worth a longer journey.
- Can you get there? Check public transport and parking.
- You may be able to claim back travel costs from the NHS if you receive certain benefits. Ask the hospital.
Official NHS guidance
Ready to act
Find a faster NHS hospital near you
Search by postcode and specialty to compare every NHS hospital in England. Then print a GP letter with your chosen hospital already filled in.
Search by postcodeThis page gives general information about NHS patient choice. It is not legal advice. For questions about your own referral, speak to your GP or contact NHS England.