The NHS elective care waiting list remains a critical challenge across England. While the NHS operates under a target known as the Referral to Treatment (RTT) standard—which states that 95% of non-urgent, consultant-led treatments should begin within 18 weeks—high demand and systemic pressures mean actual waiting times frequently exceed this standard.
Understanding how the system works and exercising your statutory legal options can help you navigate delays more effectively.
What is NHS ‘Right to Choose’?
Under the NHS Constitution and the Health and Social Care Act, patients registered with a GP in England have a legal right to choose where they receive their NHS elective (non-urgent) outpatient care.
If your local hospital or service has a long waiting list, Right to Choose (RTC) allows you to request a referral to any qualified independent or NHS-contracted provider in England at no cost to you.
Key Benefits of Right to Choose:
- Shorter Wait Times: Private clinics or alternative NHS trusts holding NHS contracts often have significantly shorter queues.
- 100% NHS Funded: Treatment, diagnostic scans, and consultations are fully covered under NHS commissioning.
- Choice of Location & Provider: You can opt for remote/telehealth appointments or choose a hospital/clinic outside your immediate region.
Where Does Right to Choose Apply?
Commonly Used Pathways:
- Neurodiversity & Mental Health: ADHD and Autism (ASD) assessments and titration/treatment services (e.g., via specialized contracted providers like Psychiatry-UK, Clinical Partners, 360 Wellness, etc.).
- Elective Surgeries & Orthopedics: Hip and knee replacements, cataract removals, and hernia repairs at private healthcare hospitals that deliver NHS care.
- Diagnostic Testing: Specialized MRI, CT, or ultrasound scans.
Exceptions & Restrictions:
- Location: Right to Choose specifically applies to patients registered with an NHS GP in England. (Scotland, Wales, and Northern Ireland operate under separate healthcare framework agreements).
- Service Exclusions: RTC does not apply to urgent/emergency care (A&E), maternity services, cancer services, or inpatient mental health services.
- Local ICB Caps & Shared Care: Local Integrated Care Boards (ICBs) and GPs may require specific Shared Care Agreements (SCAs) before taking over routine prescriptions post-diagnosis.
1.Check Eligibility & Research Qualified Providers:Verify provider contracts before booking.
Ensure you are registered with an NHS GP practice in England. Research approved providers that hold an NHS England contract for your specific service. Check their current waiting times and confirm if your GP will require a Shared Care Agreement for ongoing prescriptions.
2.Download the Provider Referral Pack:Saves administrative time for your doctor.
Most RTC providers (e.g., Psychiatry-UK, Clinical Partners, Practice Plus Group) offer a Right to Choose referral letter template and self-assessment symptom forms on their website. Fill out the patient sections in advance.
3.Book a GP Appointment:Frame the conversation clinically.
Schedule an appointment with your GP. State clearly that you wish to exercise your legal Right to Choose under the NHS Patient Choice guidance. Present your completed referral pack and explain why your current wait time or symptoms justify an alternative referral.
4.Track Your Referral Status:Follow up with the chosen clinic.
Once your GP submits the paperwork, contact the receiving provider to confirm they have processed your intake form. You will be added to their waiting list or invited to book an initial assessment.
Action Plan Checklist
Use this checklist to track your setup process from GP contact through to referral acceptance: