Right to Choose
You have the legal right to choose your NHS hospital
When your GP, dentist or optometrist refers you for a first outpatient appointment with a consultant-led service, or to a mental health professional, you have a legal right to choose which provider you go to, from those with an NHS contract for the service you need. There are exceptions, set out below. Healthwatch England says few people exercise this right.
This legal right applies in England only — Scotland, Wales and Northern Ireland run different systems. For Scotland, see our Scottish waiting times by health board.
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 provider in England that holds an NHS contract for the service you need and that the person referring you judges clinically appropriate
- This includes NHS Foundation Trusts, NHS Trusts, and Independent Sector providers with NHS contracts
- The choice is made when you are referred. Normally the provider you choose for your first appointment also provides the rest of your treatment
- NHS guidance asks referrers to shortlist on average 5 choices “where this is practicable, clinically appropriate and preferred by the patient”. That is guidance, not a legal requirement
Source: NHS Choice Framework, section 3 (Department of Health and Social Care), and the law it describes, regulation 39 of the NHS Standing Rules Regulations 2012.
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 whether that ISP holds an NHS Standard Contract for your procedure at the location you want. The contract does not have to be with your own area's ICB: NHS England's guidance says patients “can be referred to services outside of their local ICB geography” when the service meets the criteria. If it does, 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 band below 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. A separate right does: after an urgent referral for suspected cancer, you can ask to be referred to a different provider if your current one cannot give you a diagnosis or ruling out of cancer within 28 days (see NHS Choice Framework, section 4, which lists the conditions).
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]."
Where the right applies and your GP agrees the referral is clinically appropriate, they should refer you to that hospital. They may need to use the NHS e-Referral Service to do it.
Since April 2026 your GP may first send an Advice & Guidance request to a specialist rather than referring straight away — that isn't a rejection, and your Right to Choose still applies at the point a referral is made.
Step 3: If your GP says no
Where the right applies, your choice is between providers that the person referring you judges clinically appropriate. The regulations define a clinically appropriate provider as one that, “in the opinion of the person making the referral”, offers services that are clinically appropriate for you. NHS England's guidance adds that the referrer “is not required to make a referral to a provider or team if they do not believe this would be clinically appropriate”. The right also does not apply in the situations listed in the table below.
If you think you have not been offered a choice you were entitled to, the NHS Choice Framework says to speak to your GP first. After that you can complain to your local integrated care board (ICB), which “must ensure that choice is offered to you”, and you can raise it with NHS England. Other places to go:
- Ask the practice manager to explain why
- Complain to your local integrated care board (ICB)
- 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
More on Right to Choose
If you're already on a waiting list
The legal right to choose your provider applies when you are referred. The NHS Choice Framework says these choices “only apply at the point of referral”, and that you do not have that right if you are “already receiving care and treatment for the condition for which you’re being referred and this is an onward referral”.
Once you are waiting, a different right applies. You can ask to be referred to a different provider if “you have to wait, or have already waited, more than 18 weeks before starting treatment or assessment for a physical or mental health condition, as long as your referral is not urgent and the service you require is led by a consultant” (NHS Choice Framework, section 4).
- Who to ask. The Handbook to the NHS Constitution says “You will need to contact either the provider you have been referred to or your local ICB before alternatives can be investigated for you”. The ICB or NHS England then “must take all reasonable steps to offer a suitable alternative provider” that can see or treat you more quickly.
- It is a right to ask, not a guaranteed move. The Choice Framework says “It may not always be possible to change your provider”, and the right does not apply if, for example, no service can start your treatment sooner, the service is not consultant-led, you chose to wait longer, delaying is in your best clinical interests, you missed appointments you had chosen, you declined treatment, a doctor has decided to monitor you without treatment for now, the treatment is no longer needed, you are on the national transplant list, or you are using maternity services.
- How your wait is counted depends on the route. When your care transfers from one provider to another, NHS England's RTT recording guidance says “the referring provider must ensure that the patient's initial RTT clock start date forms part of the onward referral information”. A brand-new referral is different: waiting times start “from the day your referral is made”. Ask the new provider which start date it has recorded for you.
- A switch is only worth it if 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.
- You may not need to go back to your GP. In the Choice Framework's own example, the patient contacts the service providing his treatment, chooses an alternative, and “his transfer is sent to them by the hospital that he had originally chosen. He does not need to go back to his GP for this transfer”.
- Different rules apply to 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 ✓ |
| Mental health services (since 2014) | Yes ✓ |
| Maternity services | No — separate maternity choices apply |
| Follow-up appointment at the same trust | No |
| Onward referral for a condition you are already receiving care and treatment for | No |
| Self-referral, or a referral from one consultant to another | No |
| Already on a waiting list | A separate right to ask for another provider if you have waited, or will wait, more than 18 weeks — see above |
| Emergency, urgent or crisis care | No |
| Cancer on the Faster Diagnosis Standard pathway | No |
| Detained under the Mental Health Act, in prison, or serving in the armed forces | No |
| Diagnostic tests (MRI, CT, etc.) | Limited — depends on referral pathway |
| Inpatient admission following outpatient | Usually at the same trust |
Source: NHS England — Patient choice guidance. The guidance states that the obligation to offer choice does not apply where urgent, emergency or crisis care is needed, nor to cancer services on the Faster Diagnosis Standard, maternity services, or services commissioned by local authorities; and that it does not apply to patients detained under the Mental Health Act 1983, in prison or on temporary release, or serving in the armed forces. It also says the rights “do not apply to self-referrals or consultant to consultant referrals”, nor to “any person already receiving care and treatment for the condition they are being referred for (although it does apply for new episodes of care regardless of whether a patient has been seen for a condition previously)”. The government's NHS Choice Framework sets out the exceptions for patients in section 3.
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.
Choosing mental-health support? For anxiety and depression you can go one step further — refer yourself to NHS Talking Therapies directly, no GP referral needed.
This 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.