Intended for healthcare professionals


A constitution for the NHS

BMJ 2009; 338 doi: (Published 28 January 2009) Cite this as: BMJ 2009;338:b330
  1. Jennifer Dixon, director
  1. 1Nuffield Trust, London W1G 7LP
  1. jennifer.dixon{at}

    A helpful summary, but what next?

    Today’s NHS is shaped by a mass of laws and regulations that are old, new, and often obscure. Until now, no one has clarified in one document what the NHS is now, what it offers, and the level of service it aspires to.

    The NHS constitution, published on 21 January, does just that. It is a “declaratory document” that sets out the rights and responsibilities of patients, staff, and groups providing NHS funded services in a 12 page constitution and accompanying 140 page handbook.1 The constitution was developed as part of the NHS next stage review led by Lord Darzi,2 and it has been drawn up after extensive consultation. It applies to people entitled to receive NHS care in England and to staff providing NHS funded services in England.

    For patients it sets out 25 rights, which are legally binding, plus pledges and responsibilities, which are not. For example, patients have the right to receive NHS services free of charge (apart from limited exceptions sanctioned by parliament); to access …

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