The National Health Service (NHS) is a public service that belongs to the people.
Its aim is to improve our health and well-being by assisting us in staying mentally and physically fit, getting better when we are sick, and staying as healthy as possible until the end of our lives. It operates at the frontiers of science, putting the most advanced human expertise and ability to bear on saving lives and improving health. It enters our lives at times of essential human need, when compassion and care are most needed.
The NHS is built on a collection of shared beliefs and values that unite the communities and individuals it serves – including patients and the general public – as well as the people who work for it.
The NHS in England is governed by the ideals and values set out in this Constitution. It lays out the privileges that patients, the public, and employees have, as well as the pledges that the NHS is committed to achieving, as well as the duties that the public, patients, and employees owe to one another in order for the NHS to function equally and efficiently. The Secretary of State for Health, all NHS organisations, private and voluntary sector providers of NHS services, and local authorities exercising their public health functions are all bound by statute to take this Constitution into account in their decisions and acts. Local authority public health services are included in references to the NHS and NHS services in this paper, but references to NHS bodies do not include local authorities. Where there are variations in depth, the Handbook to the Constitution explains them.
Every ten years, the Constitution will be updated with input from the public, patients, and employees. It is supplemented by the Handbook to the NHS Constitution, which must be renewed at least every three years and contains existing instructions on the Constitution’s privileges, pledges, roles, and responsibilities. These renewal conditions are legally binding. They ensure that the NHS’s principles and values are reviewed and re-committed on a regular basis, and that any government seeking to change the NHS’s principles or values, or the rights, pledges, duties, and obligations set out in this Constitution, must participate in a complete and open discussion with the public, patients, and staff.
The NHS is driven by a set of principles.
The NHS is driven by seven main concepts in everything it does. They are supported by core NHS principles resulting from comprehensive consultations with staff, patients, and the general public. In the following section of this text, these principles are outlined.
- The NHS is a robust service that is open to all.
Sex, race, disability, age, sexual orientation, religion, belief, gender reassignment, pregnancy and maternity, and marital or civil partnership status are all eligible. The program is intended to help people with both physical and mental health issues improve, avoid, diagnose, and manage them. It owes a responsibility to each and every person it represents, and it must uphold their human rights. At the same time, it has a broader social responsibility to encourage equity in the services it offers, paying special attention to communities or parts of society where health and life expectancy gains are lagging behind the rest of the population.
- NHS services are free of charge, except in limited cases authorised by Parliament, and are based on clinical necessity rather than an individual’s willingness to pay.
- The National Health Service aspires to the highest levels of competence and professionalism.
It invests in the people it hires, as well as the funding, education, training, and advancement they receive; in the leadership and management of its organizations; and in its dedication to innovation and the promotion, behaviour, and use of science to enhance the population’s current and future health and care. Respect, integrity, kindness, and caring should be at the heart of how patients and staff are handled, not just because it is the right thing to do, but also because staff who are respected, encouraged, and supported enhance patient safety, experience, and outcomes.
- The NHS would put the patient at the centre of everything it does.
It should assist people in promoting and managing their own wellbeing. The interests and expectations of patients, their families, and their carers must be reflected in NHS services, which should be organized around and adapted to them. As part of this, the NHS will ensure that, in accordance with the Armed Forces Covenant, members of the armed forces, reservists, their families, and veterans have equal access to health care in their local area. Patients will be involved in and consulted on all decisions affecting their care and treatment, along with their families and carers, as needed. The NHS will actively promote, accept, and use input from the public, patients, and staff to enhance its services.
- The NHS collaborates with other organizations.
It collaborates with other organizations to benefit patients, local governments, and the general public. The NHS is a unified system of organizations and services tied together by the Constitution’s ideals and values. To provide and implement changes in health and wellbeing, the NHS is committed to collaborating with other local government services, other public sector organizations, and a wide variety of private and voluntary sector organizations.
- The NHS is dedicated to giving taxpayers the best value for their money.
It is dedicated to making the most effective, equitable, and long-term use of finite resources. Public healthcare funds will be used exclusively for the good of the people served by the NHS.
- The National Health Service is accountable to the people, neighbourhoods, and patients it represents.
The NHS is a government-funded public service that is accountable to Parliament for its operation. The government establishes the structure for the NHS and is responsible for its operation. However, the majority of decisions in the NHS, particularly those concerning individual care and detailed service organization, are made correctly by the local NHS and patients in consultation with their clinicians. The NHS’s system of decision-making responsibility and accountability should be open and clear to the public, patients, and employees. For this reason, the government would make sure that there is always a consistent and up-to-date declaration of NHS accountability.
Collaboration for the benefit of patients
In all the NHS does, the patients come first. Patients, workers, families, carers, societies, and practitioners from both within and outside the NHS are all fully involved. We prioritize the needs of patients and families over the needs of organizations. When things go wrong, we speak up.
Dignity and respect
We treat their person as an individual, respecting their goals and responsibilities in life, and seeking to understand their interests, needs, abilities, and limitations, whether they are patients, their families or carers, or staff. We listen carefully to what others have to say. We are forthright and frank about our beliefs and what we can and cannot do.
Commitment to providing high-quality care
We win your confidence by focusing on quality and working to get the fundamentals of treatment – protection, efficacy, and patient experience – right the first time. Patients, relatives, carers, employees, and the general public are encouraged to provide input. We use this information to strengthen our care and draw on our achievements.
We ensure that compassion is at the heart of the treatment we give, and we respond to each person’s pain, depression, anxiety, or need with humanity and kindness. We look for things we can do, no matter how insignificant, to provide comfort and alleviate suffering. We make time for patients, their families, and caregivers, as well as the people with whom we collaborate. Since we care, we don’t wait to be questioned.
Improving people’s lives
We work to strengthen people’s health and well-being, as well as their perceptions of the NHS. We value quality and integrity in everything we do, from daily activities that enhance people’s lives to clinical practice, service enhancements, and creativity. We recognize that we all have a role to play in improving the health of ourselves, our patients, and our communities.
Your legal rights
With the exception of a few select exceptions approved by Parliament, you have the right to free NHS services.
You are entitled to use NHS facilities. You will not be denied entry on the basis of irrational grounds.
You have the right to care and treatment that is tailored to you, meets your needs, and takes into account your desires.
You have the right to expect the NHS to identify your community’s health needs, mandate and implement programs to address such needs as needed, and, in the case of public health services provided by local governments, to take steps to improve the local community’s wellbeing.
If you meet the applicable conditions, you have the right to authorisation for planned care in the EU under the UK EU Trade and Cooperation Agreement.
If you are protected by the Withdrawal Agreement and satisfy the applicable conditions, you will have the right to authorization for planned care in the EU, Norway, Iceland, Lichtenstein, or Switzerland.
You have the right to be treated equally in the delivery of NHS services, regardless of your gender, ethnicity, disability, age, sexual orientation, faith, belief, gender reassignment, pregnancy and maternity, or marital or civil partnership status.
If this is not feasible, you have the right to access such NHS-commissioned services under maximum waiting times, or the NHS must take all appropriate steps to provide you with a choice of suitable alternative providers if this is not possible. The waiting times are detailed in the NHS Constitution Handbook.
You have the right to receive professional treatment from sufficiently trained and competent personnel in a duly licensed or registered facility that meets necessary safety and quality standards.
You have the right to be cared for in an atmosphere that is clean, healthy, comfortable, and appropriate.
To maintain good health and nutrition, you have the right to appropriate and safe food and hydration.
You have the right to expect NHS agencies to track and enhance the quality of healthcare they commission or provide on a continuous basis. This includes enhancements to service protection, efficiency, and user experience.
Confidentiality, respect, and consent
In accordance with your human rights, you have the right to be treated with dignity and respect.
You have the right to be free of violence and neglect, as well as degrading care and treatment.
You have the freedom to accept or deny care, and you cannot be subjected to a physical examination or treatment until you have given valid consent. If you lack the mental capacity to agree, consent must be sought from a legal representative or the care must be in your best interests.
You have the right to know what tests and treatments are available to you, what they entail, and what the costs and benefits are.
You have the right to inspect and correct any factual inaccuracies in your medical records.
You have the right to privacy and confidentiality, and you should trust the NHS to protect your personal details.
You have the right to know how your personal information is used.
You have the right to request that your private information not be used for anything other than your own care and treatment, to have your objections heard, and to be informed of the reasons for not being able to obey your wishes, including the legal justification.
Making an educated decision
You have the right to choose your GP practice and be accepted by that practice unless the practice has valid grounds to deny you, in which case you will be told of those grounds.
You have the right to request a specific doctor from your GP practice, and the practice must strive to accommodate your request.
You have the right to open, available, and comparative data on the efficiency of local healthcare services as well as outcomes when compared to those across the country.
You have the right to choose which services are commissioned by NHS bodies and to receive information to help you make those decisions. The choices available to you will evolve over time and will be based on your specific requirements. The Handbook to the NHS Constitution contains more details.