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What does the NHS Constitution say about patients' rights

This advice applies to England

The NHS Constitution sets out the principles and values of the NHS, together with your legal rights. It also contains pledges that the NHS are committed to achieving.

The NHS Constitution sets out:

  • the principles and values of the NHS
  • rights, pledges and responsibilities for patients and staff in the NHS.

Patients’ legal rights are rights protected by law.

NHS pledges are commitments that the NHS aims to achieve but which aren’t legally binding. They can’t be guaranteed for everyone all of the time, because they express an ambition to improve, going above and beyond your legal rights.

The following are examples of organisations that have a legal duty to 'have regard to' the NHS Constitution:

  • hospitals
  • GPs surgeries
  • clinical commissioning groups (CCGs)
  • independent organisations providing NHS care
  • local authorities carrying out public health functions.

This means that they must take account of the NHS Constitution in their decisions and actions.

The Handbook to the NHS Constitution gives information about the NHS Constitution and what it means in practice. It also outlines the legal sources of patients' rights.

Examples of values

Here are some examples of values set out in the NHS Constitution:

  • patients come first in everything we do. We fully involve patients, staff, families and carers. We speak up when things go wrong
  • we treat everyone with respect and dignity. We take what others have to say seriously. We are honest and open about our point of view and what we can and cannot do
  • we are committed to quality of care  - safety, effectiveness and patient experience
  • we encourage and welcome feedback from patients, families, carers, staff and the public. We use this to improve the care we provide
  • we ensure that compassion is central to the care we provide and we respond with humanity and kindness to each person’s pain, distress, anxiety or need. We search for the things we can do, however small, to give comfort and relieve suffering. We find time for patients, their families and carers. We do not wait to be asked, because we care.

What happens if they don’t keep to these values?

In practice, mistakes are sometimes made and it’s not always possible for NHS staff to keep to these values. If you have a problem with your healthcare, for example, you experience unsafe practices or there’s been a failure to respond with kindness to your needs, and you want to complain about it, you could refer back to these values and quote them in your complaint.

Here are some examples of your legal rights set out in the NHS Constitution:

  • you have the right to receive NHS services free of charge, apart from certain limited exceptions. You won’t be refused access to these services on unreasonable grounds
  • you have the right to be treated with a professional standard of care, by appropriately qualified and experienced staff, in a properly approved or registered organisation that meets required levels of safety and quality
  • you have the right not to be unlawfully discriminated against when receiving NHS services
  • you have the right to access certain services commissioned by NHS bodies within maximum waiting times, or for the NHS to take all reasonable steps to offer you a range of suitable alternative providers if this isn’t possible
  • you have the right to drugs and treatments that have been recommended by the National Institute for Health and Care Excellance (NICE) if your doctor says they are clinically appropriate for you. You have the right to expect local decisions on funding of other drugs and treatments to be made rationally, following proper consideration of the evidence. The Handbook to the NHS Constitution explains that NHS commissioners are allowed to have a policy not to fund a particular treatment but they must consider requests for funding in exceptional individual cases
  • you have the right to accept or refuse treatment that is offered to you. You mustn’t be given any physical examination or treatment unless you've given valid consent. If you aren’t capable of giving valid consent, consent must be obtained from someone one who is legally able to act on your behalf, or the treatment must be in your best interests.

For a full list of your legal rights, go to the Constitution

If one of your legal rights has been broken, as a first step it is usually best to try to sort any problems directly with the NHS. However, in some situations you might have to court to get the problem sorted out.

There are different types of court action, depending on the problem you face. For example, you might want to go to court to challenge how a decision was made (this is called judicial review). Or you may have a claim for clinical negligence or unlawful discrimination. You should get legal advice if you’re considering court action.

Legal action isn’t part of the NHS complaints procedure.

Examples of pledges

Here are some examples of NHS pledges set out in the NHS Constitution:

  • if you’re admitted to hospital, you shouldn't have to share sleeping accommodation with patients of the opposite sex, except where appropriate. Details are set out in the Handbook to the NHS Constitution
  • people involved in your care and treatment will have access to your health information so they can care for you safely and effectively
  • any information collected during your treatment will be used anonymously in support of research to improve care for others. Where identifiable information has to be used, you’ll be given the chance to object wherever possible
  • when mistakes happen or if you’re harmed when receiving healthcare, you’ll get an appropriate explanation and apology, delivered with sensitivity and recognition of the trauma you’ve experienced.

For a full list of pledges, go to the NHS Constitution

What can you do if a pledge is broken?

If a pledge isn’t delivered, you can make a complaint using the NHS complaints procedure.

If a pledge isn't delivered, this in itself doesn't give you the legal right to challenge it in the courts. However, in some cases, you might have the right to take legal action if one of your legal rights was breached when the pledge was broken. For example, you might have a claim for unlawful discrimination.You will need specialist advice about taking a discrimination case.

Get help

Your local Healthwatch can give you more information about the NHS Constitution.

Next steps


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