Patient Rights & Advocacy

Overview

NHS Constitution

The NHS Constitution for England sets out patients’ rights, NHS pledges, NHS values, and public responsibilities. NHS bodies and NHS-funded providers must take account of it.

Your rights include:

• access to NHS services without unlawful discrimination
• safe and effective care
• dignity and respect
• clear information
• involvement in decisions
• informed consent
• confidentiality
• access to health records
• complaints and redress

Consent

Consent means agreeing to care, treatment, tests or procedures after receiving understandable information.

You should be told:

• what is proposed
• why it is recommended
• benefits and risks
• alternatives
• what may happen if you do nothing
• whether you can refuse or delay
• who to contact with questions

For children, consent depends on age, understanding, parental responsibility, risk and safeguarding. Young people may sometimes consent for themselves if they understand the decision.

Mental capacity

The Mental Capacity Act 2005 protects and empowers people aged 16+ who may lack capacity to make specific decisions. Capacity is decision-specific and should not be assumed absent because of disability, diagnosis, age or communication needs.

Key principles:

• assume capacity unless shown otherwise
• support the person to decide
• respect that people can make unwise decisions
• best-interests decisions if capacity is lacking
• choose the least restrictive option

An Independent Mental Capacity Advocate can support some people who lack capacity and have no suitable person to represent them.

Confidentiality

NHS services must protect confidential patient information. Confidentiality may be limited if there is a serious risk, safeguarding concern, legal duty, or strong public interest reason.

You can ask:

• who can see your records
• what information is shared
• why it is shared
• how to access your records
• how to request correction of inaccurate information
• how to object to information being used beyond your individual care

Accessible Information Standard

The Accessible Information Standard applies to NHS and publicly funded adult social care services. It requires services to make sure disabled people and people with impairments or sensory loss can access and understand information and receive communication support.

The updated requirements describe five steps: identify, record, flag, share, meet and review communication needs.

You can ask for:

• Easy Read
• large print
• Braille
• audio
• BSL interpreter
• spoken language interpreter
• text or email instead of phone
• longer appointments
• quiet waiting area
• communication support
• carer or advocate involvement

Equality rights

Under the Equality Act 2010, NHS services must not unlawfully discriminate and must make reasonable adjustments for disabled people.

Reasonable adjustments may include:

• accessible appointment booking
• step-free access
• longer appointments
• sensory adjustments
• interpreter support
• communication aids
• home visits where clinically appropriate
• accessible complaints process
• reasonable adjustment flag on NHS records

Advocacy services

Advocacy helps people understand options, speak up, prepare for meetings, challenge decisions and make complaints.

Types include:

• NHS complaints advocacy
• PALS support
• Care Act advocacy
• Independent Mental Capacity Advocate
• Independent Mental Health Advocate
• children’s advocacy
• SEND advocacy
• safeguarding advocacy

PALS provides confidential advice, support and information for patients, families and carers, usually through local hospitals.

Children and parents

Parents and carers can ask for:

• child-friendly explanations
• interpreter or communication support
• reasonable adjustments
• involvement in decisions
• safeguarding support
• copies of clinic letters
• advocacy where appropriate
• school or SEND evidence to be considered

Children and young people should be listened to and involved in decisions in a way that fits their age, understanding and safety.

Evidence standards

Keep:

• appointment letters
• care plans
• referral dates
• test results
• medication lists
• consent forms
• discharge summaries
• complaint letters
• emails and call notes
• names and roles of staff
• impact on health, school, work or care

Ask for:

• written decisions
• reasons for refusal
• copies of records
• complaint reference number
• review date
• reasonable adjustments in writing

Accountability and complaints

If something goes wrong:

1. Speak to the clinician, practice manager or service manager.
2. Contact PALS for hospital or NHS trust concerns.
3. Make a formal NHS complaint.
4. Ask for advocacy support if needed.
5. Escalate unresolved complaints to the Parliamentary and Health Service Ombudsman.

Official links

• NHS Constitution: https://www.gov.uk/government/publications/the-nhs-constitution-for-england
• Accessible Information Standard: https://www.england.nhs.uk/accessible-information-standard/
• Mental Capacity Act guidance: https://www.nhs.uk/social-care-and-support/making-decisions-for-someone-else/mental-capacity-act/
• Independent Mental Capacity Advocates: https://www.gov.uk/government/publications/independent-mental-capacity-advocates
• PALS: https://www.nhs.uk/nhs-services/hospitals/what-is-pals-patient-advice-and-liaison-service/
• Find PALS: https://www.nhs.uk/service-search/other-health-services/patient-advice-and-liaison-services-pals/
• NHS complaints: https://www.nhs.uk/contact-us/how-to-complain-to-the-nhs/
• Ombudsman: https://www.ombudsman.org.uk

Best rule: know your rights, ask for accessible information, keep records, request advocacy early, and escalate if care is unsafe, discriminatory or unexplained.