Your Rights as an NHS Patient

The NHS Constitution, last updated in 2023, sets out seven core principles and a range of specific rights for patients in England. These are legal rights, not just aspirations, and the NHS must act in accordance with them.

Key legal rights include:

• The right to receive NHS services free of charge (apart from permitted charges such as prescription fees and dental charges)
• The right to be treated with dignity and respect, free from unlawful discrimination
• The right to accept or refuse treatment and to be given information about alternative options
• The right to confidentiality of personal health information
• The right to access your own health records

The Constitution also sets out pledges — commitments the NHS aims to fulfil — covering areas such as waiting times and continuity of care. Pledges are not strictly enforceable as rights but are strong statements of intent.

Patients in England have a legal right to choose in several key areas of care:

• GP practice: You can register with any GP practice in England that has capacity, regardless of where you live. The practice cannot refuse you on the grounds of your postcode alone.
• Outpatient referral: When your GP refers you to a specialist, you have the right to choose from at least five providers — including NHS trusts, foundation trusts, and sometimes independent sector providers — using the NHS e-Referral Service (NHS eRS).
• Secondary care hospital: For most elective care you can choose which hospital treats you, and your GP must provide information to support this choice.

If your right to choice is not being upheld, contact PALS at your local NHS trust or raise a formal complaint. NHS England also has a Choice Framework that explains these rights in detail.

Every adult with mental capacity has the absolute right to refuse any medical treatment, even if that refusal might result in serious harm or death. Healthcare professionals must respect this decision. Consent must be:

• Voluntary — given freely without pressure or coercion
• Informed — you must be given enough information about the treatment, its risks, benefits, and alternatives to make a meaningful decision
• Capacity-based — you must have the mental capacity to make the decision at that time

If you lack capacity (for example due to unconsciousness or a cognitive condition), decisions must be made in your best interests under the Mental Capacity Act 2005. An Advance Decision (living will) allows you to refuse specific treatments in advance if you later lose capacity — this is legally binding if it meets the correct requirements.

If you are unhappy with NHS treatment or care, you have a right to complain. The NHS complaints procedure has two stages:

1. Local resolution: Complain directly to the organisation providing the service (e.g., your GP practice, NHS trust, or dentist). They must acknowledge your complaint within three working days and provide a full written response within 25 working days.
2. Parliamentary and Health Service Ombudsman (PHSO): If you are not satisfied with the local response, you can escalate to the PHSO, which is an independent organisation that investigates NHS complaints in England.

PALS (Patient Advice and Liaison Service), available at every NHS trust, can provide informal support and help resolve concerns without a formal complaint. Contact your local hospital to find your PALS team.