Choice has re-emerged as a key theme in UK public policy. Drawing on a major empirical study of choice in NHS London, the authors report on some important policy implications. First, NHS as well as private sector providers responded to pro choice incentives. Second, the supply-side response was patchy and narrow, based on pre-existing ideas. Third, a case study of a private sector provider suggested that it was able to generate extra capacity quickly and effectively. Fourth, clinicians highlighted the threat to continuity of care, particularly in the case of chronic or complex conditions, rather than simple or elective surgery.