NHS Patient Choice Policy in England: What Mapping the Private Healthcare Market for NHS Patients Can Tell Us

Abstract This article examines how the private healthcare market supports successive governments’ commitment in the English National Health Service (NHS) to patient choice of NHS or private provider. The Labour government’s NHS Ten Year Health Plan in July 2025 reaffirms commitment to patient choice, and to working with the private healthcare market to improve healthcare access for NHS patients, alongside a focus on localism with the shaping of a “Neighbourhood Health Service”. The article outlines the broader NHS-private healthcare interaction against the backdrop of concerns about a “two-tier” healthcare system. The legal and policy framework governing patient choice developed since New Labour is examined to identify where further attention is needed, not least on how and where differences may arise in implementing patient choice. A case study analyses publicly-available NHS referral data to map the private healthcare market for NHS patients across the various NHS commissioning regions of England. This yields unique insight into how NHS patients in different areas of England may have more or less choice of private provider, given that London is typically seen as the centre of the private healthcare market. With this country-wide perspective, combined with law and policy analysis, it becomes possible to start to identify aspects which can help enable patient choice, such as access to transport and the NHS App. It further identifies the need for further reforms, and raise questions about the roles which the Department of Health and Social Care and the Competition and Markets Authority may play.