Patient Choice and Quality

Patient Choice is a key part of the government’s reform programme to improve the quality and efficiency of the NHS in England. In 2002 Delivering the NHS Plan (Department of Health 2002) first outlined plans to offer patients, already on waiting lists, opportunities to choose alternative hospital providers with shorter waiting times. This idea was tested in a series of pilots and has since developed and expanded. Since April 2008, all patients in England being referred to a non-urgent hospital appointment by their GP can choose to be treated at any hospital listed in a national directory of services, which includes NHS acute trusts, foundation trusts and independent sector providers. The government plans to enshrine a patient’s right to choose in the NHS Constitution and believes that giving patients a choice of hospital will put pressure on providers to improve their services and make them more responsive to users’ needs.

The King’s Fund is working with the Picker Institute, City University and RAND Europe on a research project funded by the Department of Health’s Policy Research Programme. This study aims to examine the implementation of the patient choice policy and its impact on the quality of services. It aims to answer the following questions:  

  • How do patients experience choice?
  • What factors are important to patients when choosing between health care providers in practice?
  • How do GPs support choice?
  • What is the response of providers to choice?

Four local health economies have been selected as case study sites for this research. In each site, there are a number of components to the research:  

  • Interviews with senior staff in NHS trusts: to understand how their organisations are responding to patient choice policy.
  • A survey of patients referred to hospital: to understand whether and how they chose a hospital for treatment and explore how they would choose a hospital in hypothetical situations (using a discrete choice experiment methodology).
  • Interviews with GPs: to understand whether and how they offer patients a choice of provider and what support they provide to aid that choice. 

This research began in autumn 2008 and is due to be completed in spring 2010. Results of the research findings will be published during 2009 and 2010.

For more information on this project please contact Ruth Robertson.