This Choice Statement is a guide to choices that patients are entitled to and can make about their personal healthcare and the treatment they receive.  It is firmly written into the NHS constitution that ‘patients will be at the heart of everything the NHS does’, thus every patient has a right to make informed choices about their healthcare and be offered the opportunity to compare and make choice decisions based on their individual needs.

NHS Shropshire, Telford and Wrekin adheres to the aim of ensuring patients are as informed and involved in their care planning as possible and given as much choice as possible when they need to access NHS services.  Patient choice is currently underpinned by two separate sets of regulations. These are:

• The National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) Regulations 2012 (“the Standing Rules”); and
• The National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013 (“the PPCCRs”).

Many statutory responsibilities and patient rights around choice are already in place, underpinned by the Department of Health and Social Care National Patient Choice Framework.  This includes guidance, rights and responsibilities in terms of patients being able to:

• Choose their doctor
• Choose where to go for tests
• Choose the hospital and team for treatment
• Changing the hospital you are with
• Choosing community services
• Choosing where to have a baby
• Taking part in health research.

The legal rights to choice of provider and team only apply when the:

• Patient has an elective referral for a first outpatient appointment.
• Patient is referred by a GP, Dentist or Optometrist. Patients cannot self-refer.
• Referral is clinically appropriate (as determined by the referrer).
• Provider service and team are led by a consultant (physical and mental health) or a mental healthcare professional (mental health only).
• Provider has a commissioning contract with any ICB or NHS England for the required service.

The rights to choice do not apply if the patient:

• Is already receiving care following an elective referral for the same condition.
• Has been referred to a service that is commissioned by a local authority (not part of joint commissioning arrangement) or delivered through primary care.
• Accessing urgent or emergency (crisis) care.
• Serving as a member of the armed forces.
• Is a prisoner; on temporary release from prison; detained in hospital under Mental Health Act 1983 or another secure service.

Over a decade ago patients had very little choice, with hospital appointments made on their behalf, usually with no prior discussion. We have come a long way since then on the journey towards greater patient involvement in their own healthcare.  Not least, that Shropshire, Telford and Wrekin patients now have the right to choose when, where and who they go to for their first outpatient appointment when needing consultant-led care. We believe that patients should be involved at every stage of their pathway of care. It is a fundamental right, for patients to have the opportunity to make a reasonable choice and to receive the information and support they need to make an informed choice. Effective patient and public engagement forms a golden thread throughout all of our work to review, redesign and develop our healthcare services and processes. Having high quality patient and public engagement, supported by clear, easy-to-understand information is the key to unlocking many benefits for good patient experience, better value for healthcare resources and trusted relationships in the community.

NHS Shropshire, Telford and Wrekin already prides itself on continuing to provide informed patient choice and ensure that the choices we offer to our patients are fair, effective and sustainable.  In addition to this however, much work has been undertaken nationally by NHS England in the latter half of 2023, to review and refresh National Patient Choice Guidance, including a new approach where patients currently on longer waiting lists with extended waiting times and meet other qualifying criteria, are proactively contacted by the hospital team they are currently with, to offer them the chance to transfer their care to an alternative hospital or provider where there is a shorter waiting time.  This proactive contacting of patients is in addition to the existing right for patients to be able to change provider if waiting longer than the national standard for their appointment.

The access the Choice Statement, please click here.