Patient choice has some way to go before it delivers improvements in hospital quality, says The King's Fund

Patients will be able to choose where they are treated from any provider meeting Healthcare Commission standards from 1 April, but a King's Fund's briefing, Free Choice at the Point of Referral, on the latest official data finds the policy has some way to go before it is likely to drive improvements in the quality of hospital services.

One of the ambitions of free choice is to create incentives for hospitals to drive up quality standards as they compete for patients, but official data shows that:

  • use of 'Choose and Book' — the computer system designed to facilitate choice — whilst increasing still falls short of the government's target, with only 50 per cent of referrals from GP to hospital being made using the system
  • although increasing numbers of patients say they remember being offered a choice of hospital by their GP since the policy began in 2006, the proportion is still only 45 per cent
  • of those 45 per cent, only 27 per cent said their GP gave them a booklet containing comparative information on hospital performance to help them make a decision.

If the government's objective for choice to drive improved quality is to be met, at least some patients need to be choosing a hospital on the basis of quality. But existing data suggest that many more patients are picking the hospital that is easiest to get to rather than basing their choice on quality related factors, such as low infection rates.

Ruth Thorlby, King's Fund policy fellow and co-author of the briefing, said:

'Free choice is not going to result in a rapid change in the quality of hospital services. Only if more people are aware of choice, patients and GPs are willing to shop around, and information on the quality of services is available and used to inform choices, is there a potential to drive improvements.'

Read our briefing: Choice at the Point of Referral

Notes to editors: 

  1. Download the briefing Free choice at the point of referral from The King's Fund website.
  2. For further information or interviews, please contact the King’s Fund media and public relations office on 020 7307 2585, 020 7307 2632 or 020 7307 2581. An ISDN line is available for interviews on 020 7637 0185.
  3. The King's Fund is an independent charitable foundation working for better health, especially in London. We carry out research, policy analysis and development activities, working on our own, in partnerships, and through funding. We are a major resource to people working in health and social care, offering leadership development programmes; seminars and workshops; publications; information and library services; and conference and meeting facilities.