Choose & Book, your right to choose your hospital

The NHS e-Referral Service (e-RS), commonly still known as Choose & Book, is the system through which GPs send most non-urgent elective referrals to consultant-led hospital services. As an NHS patient in England you have a statutory entitlement, at the point of GP referral, to choose any clinically appropriate provider listed on e-RS for your specialty.

What you can choose

The Choose & Book entitlement covers: any clinically appropriate provider listed on e-RS for the specialty you need; a named consultant-led team within the provider; and, where availability allows, the appointment date and time. It does not normally cover specialised tertiary services (e.g. transplant centres, certain cancer centres), urgent or emergency care, or maternity services.

When and how to ask

The right moment is in the GP appointment when the referral is being prepared. Ask the GP to show you the e-RS provider list for your specialty — the list includes the geographically closest NHS Trusts, often other NHS Trusts within a wider radius, and (depending on specialty) private providers holding an NHS contract. You can also ask the GP to wait while you check waiting-time data at home and follow up by phone.

What signals to compare

The most useful signals at the point of choice are the procedure-specific median wait and the CQC quality rating. PlainNHS aggregates both:

• Procedure index — pick the procedure you need, sort the Trust column by median wait.
• Hospital listing — sort by RTT 18-week performance and filter by region.
• Compare page — side-by-side comparison of any two Trusts on the same procedure.

After the referral is submitted

e-RS issues you a Universal Booking Reference Number (UBRN). With this UBRN and your date of birth you can: book, change, or cancel the appointment online at www.ers.nhs.uk; check the appointment status; and ask your GP to redirect the referral if e-RS does not offer an appointment within the standard window.

If you change your mind

You can change provider after the initial referral but only once and only before the first outpatient appointment. After the first appointment any switch requires a new GP referral.

Sources

• NHS England, NHS e-Referral Service.
• NHS Constitution for England — right to choose section.
• NHS, Referrals and choosing a hospital.

Common questions

Where can I find the official documentation? Each numbered source link above takes you to the canonical NHS England, NHS Digital, NICE, or CQC publication. PlainNHS does not paraphrase these documents at length — we point you to them and explain the practical implication for patients.

How often does the underlying guidance change? NHS operational standards (RTT, A&E, cancer) have been stable for several years but performance against them is published monthly. NICE guidelines are revised every 2-3 years on a published schedule. CQC's inspection methodology was last updated in 2024 and the new framework is now in force for all inspections.

What if my situation differs from what is described here? Always speak to your GP, NHS 111, or PALS at the treating Trust. The guidance on this page covers the standard pathway; individual cases can vary on clinical grounds, locality of services, and patient preference.

How PlainNHS uses this guidance

When we present operational performance data on a Trust profile (e.g. “a Trust achieved 76% on the 18-week RTT standard”), we are referring to the same standard described on this page. Reading this guide gives you the context to interpret the numbers correctly. The PlainNHS methodology describes how we compute and verify the figures.

Related guides on PlainNHS

• The NHS 18-week RTT pathway
• The cancer 2-week-wait pathway
• How to interpret CQC ratings
• Choose & Book — your right to choose your hospital
• The A&E 4-hour target
• NHS Continuing Healthcare eligibility
• When the NHS pays for private treatment
• How to make an NHS complaint

Glossary of terms used in this guide

• NHS Trust — a statutory NHS body that runs hospitals or other healthcare services for a defined catchment.
• Integrated Care Board (ICB) — the local NHS body that commissions (purchases) healthcare for a region; succeeded Clinical Commissioning Groups in 2022.
• Multidisciplinary team (MDT) — a clinical team combining specialists from different disciplines to plan an individual patient's care.
• e-RS (e-Referral Service) — the NHS digital booking system that replaces paper referrals.
• PALS — Patient Advice and Liaison Service. Every NHS Trust has one; first point of contact for non-formal questions and complaints.

Important: This guide is general information and not medical advice. Always consult your GP, NHS 111, or a qualified healthcare professional for clinical decisions about your own care.