The Patient Charter: Your rights, NHS pledges and responsibilities

Access to NHS services

Your rights include:

• Care free at the point of use - with some exceptions such as prescriptions in England, dentistry and eye care.

• Treatment that meets your needs, reflects your preferences, and is not refused without good reason.

• Equal access regardless of age, disability, race, religion, sex, sexual orientation, gender reassignment, pregnancy, or marital status.

• Waiting time standards and alternatives if those standards aren’t met.

Access is one of the most powerful promises in the NHS Constitution. For patients, it means you should not face barriers to care because of who you are, where you live, or how much money you have. In practice, waiting lists remain one of the biggest frustrations. The Charter doesn’t guarantee instant care, but it gives you the right to expect an explanation and an alternative if standards slip. That transparency matters as it means you are not left in the dark and can hold the system to account.

It’s also worth noting that access isn’t just about the individual. The NHS must look at the health needs of entire communities and plan services to meet them. That’s why public health programmes, such as smoking cessation support or local vaccination drives, exist. They’re part of your right to a service that looks at the bigger picture as well as the individual patient.

Quality of care and environment

Your rights include:

• Being treated by qualified, professional staff in safe, regulated settings.

• Clean, safe hospitals, GP surgeries, and clinics.

• Nutritious food and hydration in hospital.

• Continuous monitoring and improvement of the safety, effectiveness, and experience of care.

For many people, quality and safety are assumed. You expect hospitals to be clean, staff to be properly trained, and equipment to be up to standard. But history shows that this cannot be taken for granted. Scandals such as Mid Staffordshire highlighted what can happen when standards slip. By making quality and safety legal rights, the NHS is making it clear: these are not optional extras, they are the foundation of healthcare.

It also puts a duty on NHS organisations to improve continuously, not just meet a minimum bar. That’s why inspection bodies like the Care Quality Commission (CQC) exist to measure quality against these rights. For patients, it’s reassurance that you have a benchmark to point to if you feel care falls short.

Medicines, treatments and programmes

Your rights include:

• Access to medicines and treatments recommended by the National Institute for Health and Care Excellence (NICE) - if your doctor thinks they are right for you.

• Fair and evidence-based local decisions about other drugs and treatments.

• Routine vaccinations as part of the national immunisation schedule.

This is about fairness and avoiding a postcode lottery. If NICE says a treatment should be available, it should be available wherever you live provided your clinician agrees it’s suitable. If local NHS bodies decide not to fund a treatment, they must explain their reasoning.

This protects patients from being left wondering why someone in another part of the country could access a drug while they cannot. It doesn’t mean every treatment is available to everyone, but it does mean decisions must be rational, evidence-based and explained. That’s a powerful safeguard in a world of expensive new medicines and limited NHS budgets.

Respect, consent and confidentiality

Your rights include:

• To be treated with dignity and respect.

• To refuse or accept treatment, and to give valid consent.

• To receive clear information about risks and benefits of care.

• To see and correct your records.

• To have your information kept private and secure.

These rights place patients at the centre of care. In the past, medicine could be paternalistic - decisions made for patients, not with them. The Charter makes clear that your body and your information belong to you.

This is also about trust. You should feel confident that your personal health information will not be shared inappropriately, and that your privacy will be respected in hospitals and clinics. The right to consent ensures that healthcare is something done with you, not to you. For many patients, that reassurance is just as important as the treatment itself.

Choice and involvement

Your rights include:

• To choose your GP practice and request a preferred doctor.

• To access clear information comparing local and national services.

• To be involved in decisions about your treatment, including end-of-life care.

• To be told openly if something goes wrong, with facts, an apology, and support.

Choice can feel limited in a pressured system, but it remains central to the NHS vision. Being able to request a particular GP, to switch practices, or to ask for more information about your options, gives patients agency.

The “duty of candour” - your right to be told openly if something goes wrong - is also hugely important. It means mistakes cannot be brushed under the carpet. Patients should expect honesty, transparency, and support when things don’t go as planned. This builds trust, even when care falls short.

Complaints and redress

Your rights include:

• To have complaints acknowledged quickly and investigated properly.

• To escalate complaints to the Ombudsman if needed.

• To seek judicial review of unlawful NHS decisions.

• To receive compensation for harm caused by negligence.

Nobody wants to complain, but knowing you can and that it won’t affect your future care is vital. Complaints are not about blame, but about learning and improving.

For patients, this is about voice and accountability. If you feel ignored or mistreated, you have a structured pathway to raise concerns and expect a meaningful response. For the NHS, it’s about listening and learning, not defending or deflecting.

Your responsibilities

You are asked to:

• Look after your own health where possible.

• Register with a GP.

• Treat NHS staff and other patients with respect.

• Keep or cancel appointments responsibly.

• Provide accurate health information.

• Follow treatment plans, or discuss difficulties.

• Take part in vaccination and screening programmes.

• Share your wishes about organ donation.

• Give feedback to help services improve.

The NHS is a partnership. While you have rights and protections, the service can only survive if patients play their part. Every missed appointment, every late prescription request, and every abusive exchange with staff makes it harder for others to get the care they need.

This isn’t about shifting blame onto patients but about recognising that a fair system depends on everyone contributing. By respecting staff, keeping appointments, and making healthy choices, you’re protecting the NHS not just for yourself, but for your family, friends and community.

Why the Patient Charter matters

The Patient Charter is more than just words. It is a social contract between the public and the NHS. It says:

• You have rights - safe, timely, fair and respectful care.

• You have pledges - commitments from the NHS to go further than the minimum.

• You have responsibilities - to use the service fairly, and to treat others with respect.

At a time when the NHS faces long waiting lists, staff shortages and financial pressures, the Charter reminds us of the balance between what we can expect, and what we can give back.

For patients, it is a tool of empowerment - you are not powerless, you have rights and choices. For staff, it is a framework for fairness and respect. For society, it is a reminder that the NHS is not just a service - it is a partnership, built on trust and shared responsibility.

Read the full NHS Constitution at nhs.uk/constitution.