GPs support patient choice – but NHS systems are making it difficult to deliver, new report finds

GPs overwhelmingly support the principle of giving patients a choice of where they receive their NHS treatment, but NHS referral systems and administrative barriers are making it difficult to deliver consistently in practice, according to a new report from the Independent Healthcare Providers Network (IHPN).

The report, based on polling of more than 800 GPs, found that while a majority of family doctors believe offering patients a choice of provider is an important part of delivering good care, only around one third (36%) say they “always” or “often” discuss or offer patients a choice of provider when making a referral.

The findings come despite NHS rules giving most patients a legal right to choose where they receive their treatment. Previous IHPN research found that patients could cut more than two and a half months off their wait for care by choosing an alternative provider, while travelling on average less than 13 miles.

The survey found that GPs face a range of practical barriers when trying to facilitate patient choice, including:

• 68% citing Single Points of Access (SPOAs) and referral management systems as barriers to offering choice.
• 67% saying limited consultation time makes it difficult to discuss different provider options with patients.
• 66% identifying the complexity of referral pathways as a significant challenge.
• 64% reporting a lack of clear and accessible information on providers and waiting times.
• Almost seven in ten (68%) saying expectations around patient choice are unclear.

Just 3% of GPs say they experience no significant barriers to discussing patient choice, while only 10% believe the current system works well in practice.

The report argues that while patient choice remains a key part of Government plans for NHS reform and reducing waiting lists, it will only be effective if GPs are properly supported to help patients understand and exercise their rights.

To address these issues, IHPN is calling for a renewed focus on embedding patient choice throughout the NHS, including:

• Publishing the Patient Choice Charter promised in the NHS 10 Year Plan, clearly setting out what patients can expect and how their rights will be protected.
• Ensuring patient choice is embedded in Single Points of Access, referral management systems and new NHS Online pathways, rather than being lost through triage processes.
• Protecting patient choice as services move out of hospitals and into community settings, ensuring patients continue to have a choice of provider unless there is a clear clinical reason not to do so.
• Introducing new questions into the annual GP Patient Survey to measure whether patients recall being offered a choice of provider, alongside clear national improvement targets.
• Providing GPs with clearer guidance, better information on provider options and waiting times, and simpler referral processes.

Danielle Henry, Director of Policy at IHPN, said:

“Patient choice is one of the NHS’s most established rights and can make a real difference to patients by helping them access treatment more quickly and in a setting that best meets their needs.

“Our research shows that GPs support the principle of patient choice, but too often face practical barriers that make it difficult to deliver consistently. The challenge is not whether GPs believe in choice, but whether the system makes it easy for them to offer it.

“If the Government wants patient choice to play a bigger role in reducing waiting lists and giving people greater control over their care, it needs to move beyond policy commitments and make choice a routine part of every patient pathway.”

Rachel Power, Chief Executive of the Patients Association, said:

“Patients tell us that having a meaningful choice about where they receive care can make a real difference to their experience, by helping them feel informed, involved and able to access treatment in a way that works for them.

“This report shows that many GPs value patient choice, but that NHS systems do not always make it easy to deliver consistently in practice. As efforts continue to improve access and reduce waiting times, patients and clinicians need clear information and straightforward processes so that choice becomes a meaningful part of care, rather than something that is difficult to exercise.”