In England, when your GP refers you for a first outpatient appointment, you have a legal right to choose which provider you're referred to — any hospital or clinic holding an NHS contract for that service, including private hospitals doing NHS work, at no cost to you. It applies at the point of referral, not once you're already in a queue.
- ✓The right applies at first GP referral to consultant-led care in England — ask before the referral is sent.
- ✓Private hospitals with NHS contracts count, and cost you nothing — you're an NHS patient there.
- ✓It doesn't apply to emergencies, and Scotland, Wales and NI have no equivalent legal right.
What the right actually is
Since 2024 the NHS constitution and standing rules have been clear: when you need a referral for a first outpatient appointment with a consultant-led service in England, you can choose which provider the referral goes to. Not just which local hospital — any provider in England that holds an NHS contract for that service. That includes NHS trusts across the country and independent (private) hospitals that treat NHS patients.
The key point people miss: choosing a private hospital under this right doesn't cost you anything. You're an NHS patient throughout — the NHS pays the private hospital the standard NHS price. You're not buying anything, and you don't need insurance. What you're choosing is the queue you join and the building you're treated in.
Why it matters: queues differ enormously
With 7.3 million treatments on the waiting list and a median wait of 12.4 weeks (May 2026), the national figures hide huge local variation. One trust's orthopaedic queue can be several times another's, and independent-sector providers doing NHS work — which run high volumes of routine surgery like hips, knees and cataracts — often have materially shorter waits than the local general hospital.
The best-known use of the right is ADHD and autism assessment, where choosing a specialist provider has cut multi-year waits to months for many patients — we cover that route separately. But the right is general: it applies just as well to a cataract, a hernia or a knee. Check waits before choosing via the My Planned Care website or NHS England's trust-level data, and see our guide to reading waiting-time stats.
How to actually ask
The right is exercised at the GP appointment, when the referral is created. In practice:
- Do five minutes of homework first. Look up waits for your specialty at nearby providers on My Planned Care, and note one or two you'd prefer — including independent hospitals if they offer the service on the NHS.
- Say it explicitly at the appointment: 'I'd like to use my right to choose my provider for this referral — can we look at the options in the e-Referral system?'
- Look at the list together. The NHS e-Referral Service shows the providers accepting referrals for that service, often with indicative waits. You can usually take a shortlist away and book online with the reference number you're given.
- If you're told no without a reason, push politely. GP practices are required to offer choice; 'we always refer to the local trust' is a habit, not a rule. Ask for the choice to be recorded, or contact the practice manager or your integrated care board.
If you're already on a waiting list, the formal right to choose has passed — but if you've waited over 18 weeks you can request a transfer to a faster provider under the 18-week rules, and patients waiting long periods are increasingly offered alternatives proactively.
Want days, not weeks — and your choice of consultant?
Where it applies — and where it doesn't
| Situation | Right to choose? |
|---|---|
| GP referral, first outpatient appointment, consultant-led | Yes — any provider with an NHS contract for the service |
| Mental health services (consultant or team-led) | Yes — same basis |
| Private hospital doing NHS work | Yes — at NHS expense |
| Emergency and urgent care | No — you're treated where you're taken |
| Suspected cancer two-week-wait referrals | Limited — speed protocols take priority |
| Maternity, military health, prison healthcare | No — separate arrangements |
| Already on a waiting list | No — but 18-week rules may help |
| Scotland, Wales, Northern Ireland | No legal equivalent — England only |
The England-only point is worth underlining: the legal right comes from NHS England's standing rules. Scotland, Wales and Northern Ireland run their own systems where boards or trusts assign providers — you can ask, and clinicians have discretion, but there's no enforceable right to choose.
Right to Choose vs going private
The Right to Choose is free, and for routine surgery at an independent hospital it can feel remarkably close to the private experience — same building, sometimes the same consultants. What it doesn't give you: you're on an NHS pathway, so you wait whatever that provider's NHS queue is (shorter, usually, but not days), you don't pick the named consultant, and NHS treatment criteria still apply — including thresholds some areas set for procedures like hip surgery.
Private routes — insurance or self-pay — buy speed and choice: consultation typically within days, routine surgery in 2–6 weeks, and your pick of consultant. The honest framing is that the Right to Choose is the best free lever in the system, and worth pulling before you spend anything; private cover is for when the remaining wait, or the loss of choice, still isn't acceptable.
Frequently asked questions
What is the NHS Right to Choose?
A legal right in England to choose which provider your GP refers you to for a first outpatient appointment with a consultant-led service. You can pick any hospital or clinic in England holding an NHS contract for that service — including private hospitals treating NHS patients — at no cost to you.
Can I choose a private hospital under the NHS Right to Choose?
Yes, if the private hospital holds an NHS contract for the service you need. You remain an NHS patient — the NHS pays the hospital the standard NHS price, and you pay nothing. Independent hospitals run high volumes of routine NHS surgery like hips, knees and cataracts, often with shorter queues.
How do I use my Right to Choose at a GP appointment?
Ask explicitly when the referral is being made: 'I'd like to choose my provider — can we look at the options in the e-Referral system?' The system lists providers accepting referrals for that service, often with indicative waits. Come prepared with one or two preferred providers from the My Planned Care website.
Can my GP refuse to refer me to the provider I choose?
For a standard consultant-led referral in England, practices are required to offer choice — 'we always use the local trust' is habit, not a rule. A GP can decline a clinically inappropriate choice, but not simply because it isn't local. If refused without reason, ask the practice manager or your integrated care board to intervene.
Does the NHS Right to Choose apply to mental health services?
Yes — the right covers referrals to consultant-led or mental health team-led services, and choosing a specialist provider is one of its best-known uses. ADHD and autism assessments through named providers have cut multi-year waits to months for many patients; we cover that specific route in a separate guide.
Where does the NHS Right to Choose not apply?
Emergency and urgent care, suspected-cancer two-week-wait referrals (where speed protocols take priority), maternity services, military and prison healthcare, and situations where you're already on a waiting list. It also only exists in England — Scotland, Wales and Northern Ireland have no equivalent legal right.
Does the Right to Choose exist in Scotland or Wales?
No — the legal right comes from NHS England's standing rules and applies in England only. Scotland, Wales and Northern Ireland assign providers through their own boards and trusts. You can always ask, and clinicians have some discretion, but there is no enforceable patient right to choose a provider.
Can I use the Right to Choose if I'm already on a waiting list?
The formal right applies at the point of referral, so once you're on a list it has technically passed. But if you've waited over 18 weeks you can ask your hospital or integrated care board to offer a faster alternative provider, and long waiters are increasingly offered transfers proactively.
Is choosing a provider under Right to Choose the same as going private?
No. You're an NHS patient on an NHS pathway: you join that provider's NHS queue, you don't choose the named consultant, and NHS treatment criteria apply. Going private buys speed and choice — consultation within days, surgery typically in 2–6 weeks, your pick of consultant — but costs money or requires insurance.
Will choosing a different provider cost me anything or affect my NHS care?
No. The NHS pays your chosen provider the standard NHS price, your GP practice is unaffected, and you keep full access to NHS care as normal. The realistic downsides are practical: travel to a more distant provider for appointments and follow-ups, and the chance its queue turns out no shorter.