NHS Constitution Rights
Written in plain language for general understanding. This is educational content, not legal advice. Based on UK Acts of Parliament, statutory instruments, and official guidance.
What is this right?
The NHS Constitution sets out your legal rights and pledges when using NHS services in England. Key rights include:
- Treatment within maximum waiting times: 18 weeks from GP referral to treatment (legally binding). The government has set an ambition to reduce this further.
- Right to drugs and treatments approved by NICE: If the National Institute for Health and Care Excellence (NICE) has approved a treatment through its technology appraisal process, the NHS must fund it within 3 months of the recommendation.
- Right to choose: You can choose which hospital or clinic to be referred to for your first outpatient appointment.
- Access to NHS services free of charge — based on clinical need, not ability to pay.
Scotland, Wales, and Northern Ireland have their own NHS bodies and patient rights legislation, though the core principle of free healthcare remains.
When does it apply?
- You are ordinarily resident in England — most NHS services are free at the point of use.
- The 18-week right applies to most consultant-led treatments. Exceptions include cancer (which has its own faster pathway) and mental health.
- Cancer: You have the right to be seen by a specialist within 2 weeks of an urgent GP referral, and to begin treatment within 62 days of referral.
- If the NHS cannot treat you within the maximum waiting time, you have the right to be offered alternative providers (including private treatment funded by the NHS).
What should you do?
- If you've been waiting longer than 18 weeks, contact the hospital and ask about your wait. You can also contact the Independent Sector Treatment Centre or ask your GP about alternatives.
- If a NICE-approved treatment is refused, raise it with the clinical team and, if necessary, make a formal complaint.
- Use the NHS website (nhs.uk) to research services, check waiting times, and compare providers.
- If your rights under the NHS Constitution are not met, you can complain through the NHS complaints procedure and ultimately to the Parliamentary and Health Service Ombudsman.
What should you NOT do?
- Don't assume long waits are acceptable — the 18-week target is a legal right, not just an aspiration.
- Don't pay for treatment privately before exploring whether the NHS should be providing it — once you go private, you generally can't return to the NHS for the same episode of treatment.
- Don't confuse rights with pledges — the NHS Constitution distinguishes between legally binding rights and non-binding pledges. Know the difference.
How Wales differs from UK national law
Wales has NHS Wales, which operates independently from NHS England:
- There is no NHS Constitution in Wales. Patient rights are set out in the NHS Wales governance framework.
- NHS Wales is organised into 7 Health Boards (replacing the old trust model).
- Wales has its own waiting time targets (a 26-week referral-to-treatment target), though these are currently under review.
- The Welsh language has equal status — you have the right to receive NHS services in Welsh under the Welsh Language Standards.
Additional Steps in Wales
- Complaints escalate to the Public Services Ombudsman for Wales, not the PHSO.
- Contact the ombudsman at 0300 790 0203 or ombudsman.wales.
Relevant Law: NHS (Wales) Act 2006; Health and Social Care (Quality and Engagement) (Wales) Act 2020
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