The comparison below sets out the Health and Social Care Bill's initial proposals as regards choice, what has now changed and some key questions that remain unanswered.

The original proposals in the Health and Social Care Bill

  • Choice to be extended beyond elective care to most NHS-funded services by 2013/14.
  • Duties on the NHS Commissioning Board and commissioning consortia to promote patient choice and involve patients and their carers in decisions about their care.
  • Patients to be able to choose their GP, regardless of where they live.

What has changed in the proposed reforms?

  • A 'choice mandate' to be included in the NHS Commissioning Board's mandate from the Secretary of State.
  • Duties to involve patients and their carers in decisions about their care strengthened to better reflect the 'no decision about me without me' principle.
  • Personal health budgets to be extended through a mandate to the NHS Commissioning Board, with a right to a personal budget to be introduced over time.

What is still unanswered?

  • How will the government make a reality of shared decision-making in clinical practice?
  • How will the NHS Commissioning Board be held accountable for delivering on the 'choice mandate'?
  • How will decisions be made about extending personal budgets to more conditions?

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