NHS hospital services

Hospital services fall under secondary care and, with the exception of emergency care, you will need a referral to access treatment.

In England, hospital services are commissioned by clinical commissioning groups (CCGs). Hospitals themselves are mostly managed by NHS trusts, which ensure high-quality care is provided and that money is spent efficiently.

If hospitals or trusts provide poor quality of care, then they could be put into special measures. Trusts in special measures are expected to have made improvements within 12 months. View A guide to special measures.

Is hospital care free on the NHS?

Hospital treatment is free if you are ordinarily resident in the UK. If you are visiting England, or recently moved to England, please look up the relevant information about accessing the NHS, as charges may occur.

The services and treatments listed below are free to all in NHS hospitals.

• accident and emergency services – but not emergency treatment once you've been admitted to hospital
• family planning services – but not termination of pregnancy or infertility treatment
• treatment for most infectious diseases, including sexually transmitted infections (STIs)
• treatment required for a physical or mental condition caused by torture, female genital mutilation, domestic violence or sexual violence – this does not apply if you have come to England to seek this treatment

Choosing a hospital or consultant

If you are referred for your first outpatient appointment then, in most cases, you have the right to choose which hospital in England to go to. This will include many private and NHS hospitals that provide services to the NHS.

You are also able to choose which consultant-led team will be in charge of your treatment, as long as that team provides the treatment you require.

Therefore, if you wish to be treated by a particular consultant for a procedure, you can choose to have your first outpatient appointment at the hospital where the consultant works and to be treated by that consultant's team. But this doesn't necessarily mean you will be seen by the consultant themselves.

This choice is a legal right, if you are not offered a choice at the point of referral, ask your doctor why and say that you wish to go through your options. If you are still not offered, or refused, a choice, contact your local CCG.

Note: if a GP wants to refer you for a service or treatment that they think is best for you but is not routinely offered by the NHS, then the process is different. The GP will have to submit an Individual Funding Request (IFR) to your CCG and provide details of where they want you to go. CCGs will publish information about individual funding requests on their website. You can find out who your local CCG is by using the 'Services near you' search on this site.

You do not have a legal right to choice if:

• you need urgent or emergency treatment
• you are serving in the armed forces
• you are accessing maternity services
• you are detained under the Mental Health Act
• you are detained in or on temporary release from prison, in court, an immigration removal centre or a secure children's home
• if you are referred to high-security psychiatric services, or drug and alcohol misuse services provided by local authorities

Visit GOV.UK to read more about your legal rights to choice in the NHS.

How NHS Choices can help you to choose

On this site, you can compare different hospitals according to what matters most to you, such as waiting times, patient safety, complaints or quality of food. Use the Services near you search tool to find your nearest hospital.

You can also read what other patients have said about the hospital or leave your own feedback. Simply select the 'Leave review' option provided on each hospital profile to record your experiences about the treatment you received.

In addition, you can find out how a consultant performs for a particular procedure or compare consultants from different hospitals before you make your choice for your first outpatient appointment. Use our consultant search tool to try it out.

For some specialties, you will also be able to see how many times a consultant has performed a particular procedure, including quality measures such as complication rates, adverse events and mortality rates. You will also be able to compare the information to other consultants for this particular specialty in England.

Tip: Watch the what is a consultant? video and find out more about their role.

How to book your appointment

Once you have decided on a hospital, you could book your first outpatient appointment through the NHS e-Referral Service. This can happen in the following ways:

• your GP can book it while you are at the surgery
• you can book it online using the Appointment Request letter your GP gives you
• you can phone the NHS e-Referral Service line on 0345 60 88 88 8 (open 8am to 8pm Monday to Friday, and 8am to 4pm on weekends and bank holidays)

How long do I have to wait for my appointment?

If your referral is for non-urgent care, you have the right to start treatment led by a consultant within 18 weeks of being referred, unless you want to wait longer or waiting longer is clinically right for you. For more information, read our guide to waiting times.