The NHS Constitution

About the NHS Constitution

The NHS belongs to the people – it is there to improve our health and well-being, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives. It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most.

The NHS is founded on a common set of principles and values that bind together the communities and people it serves – patients and public – and the staff who work for it.

The NHS Constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively. All NHS bodies and private and third sector providers supplying NHS services are required by law to take account of this Constitution in their decisions and actions.

The NHS Constitution was published on 21 January 2009. It was one of a number of recommendations in Lord Darzi’s report High Quality Care for All, which  set out a 10-year plan to provide the highest quality of care and service for patients in England.

The Constitution was further updated in March 2013 following a consultation that sought views on a number of proposed changes. In addition to strengthening areas of the NHS Constitution, various technical amendments were made to ensure it was up-to-date for the introduction of the new health and care system on 1 April 2013.

Furthermore, as part of the government’s initial response to the report into the failings at Mid Staffordshire NHS Foundation Trust by Robert Francis QC, the Constitution was changed to reflect that the NHS’s most important value is for patients to be at the heart of everything the NHS does. The Francis report emphasises the role of the NHS Constitution in helping to create a positive and caring culture within the NHS.

Who does the Constitution apply to?

The rights and responsibilities in the Constitution generally apply to everyone who is entitled to receive NHS services and to NHS staff.

In some other cases, there are further specific rules that apply. In particular, there are different rules for children, people who lack mental capacity, and patients detained under mental health legislation.

Where does the Constitution apply?

The core principles of the NHS are shared across all parts of the United Kingdom. However, the NHS Constitution applies only to the NHS in England. The devolved administrations in Scotland, Wales and Northern Ireland are responsible for developing their own health policies.

Rights and pledges

One of the primary aims of the Constitution is to set out clearly what patients, the public and staff can expect from the NHS and what the NHS expects from them in return. The Constitution distinguishes between:

Your rights

A right is a legal entitlement protected by law. The Constitution sets out a number of rights, which include rights conferred explicitly by law and rights derived from legal obligations imposed on NHS bodies and other healthcare providers. The Constitution brings together these rights in one place but it does not create or replace them.

Pledges

This Constitution also contains pledges which the NHS is committed to achieve, supported by its management and regulatory systems. The pledges are not legally binding and cannot be guaranteed for everyone all of the time, because they express an ambition to improve, going above and beyond legal rights.

Some of the pledges, such as those relating to waiting times for treatment, are long-standing commitments on which the NHS already has a track record of success and strong mechanisms in place to ensure delivery. In other areas, the pledges refer to relatively new commitments that the NHS is working towards achieving.

Responsibilities

The Constitution sets out expectations of how patients, the public and staff can help the NHS work effectively and ensure that finite resources are used fairly.

What to do if your expectations are not met

The NHS welcomes and encourages feedback (both positive and negative) from patients, the public and NHS staff. This is a vital source of information and will help the NHS to improve. Please contact our customer services team to give us your feedback.

Where can I read the Constitution?

You can view the Constitution, alongside the handbook and other documents, on the Government’s website.

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Page last updated on April 5th, 2013