Right to choose

What is it?

If you are registered with a GP in England and they refer you to a consultant or specialist doctor, you have the legal right to choose your provider.

  • Right to Choose (RTC) is not currently available in Scotland, Wales or Northern Ireland. If you move out of England during your treatment, you will no longer be eligible for RTC. 
  • The organisation you choose must be a ‘qualified provider’. 

In the current climate it is understandable that some patients are exercising their ‘right to choose’ and requesting referral to independent providers who hold an NHS contract with ICB’s.  Some providers are advertising NHS assessment and shorter waiting times.

Patients choosing such services should be mindful that some services will only diagnose and will not prescribe or provide the secondary care part of a shared care arrangement. This should be taken into account by the patient when making their decision of whether it is appropriate to refer to those providers only making a diagnosis in terms of what the patient is hoping for as an outcome.

Patients should check before they decide to exercise their Right to choose, that their GP will enter into a shared care agreement with the provider.

GP providers may be hesitant to enter into shared care agreements with private providers for several reasons:

  1. Capacity Issues: Many NHS GP surgeries face capacity challenges, making it difficult to take on additional responsibilities associated with shared care arrangements.
  2. Safety Concerns: Without a formal shared care agreement, there may be concerns about the safety and continuity of care, as well as the ability to ensure that all necessary clinical information is shared and acted upon appropriately.
  3. Lack of Support: GPs may feel that there is insufficient support when expert help is needed, particularly if the private provider does not have established protocols for collaboration.
  4. Governance and Quality Assurance: Shared care arrangements require clear governance and quality assurance processes. Without these, there may be concerns about accountability and the standard of care provided.
  5. Health Inequalities: Engaging in shared care with private providers could potentially promote health inequalities, as not all patients may have access to or be able to afford private care.
  6. NHS Constitution Principles: The NHS constitution emphasises keeping NHS and private care as separate as possible to ensure that NHS resources are used appropriately and that patients are not charged for NHS services.
  7. Complexity of Care Coordination: Coordinating care between NHS and private providers can be complex, potentially leading to gaps in care or communication issues.

For these reasons, GPs typically prefer to work within established shared care frameworks when collaborating with private providers. This ensures that patient care is managed effectively and ethically.

Nettleham Medical Practice does not enter shared care agreements with third party providers that are not NHS services.