Concerns have been raised over the future of choice as a major Department of Health policy document has yet to see the light of day.
Members of a reference group commissioned by the DoH to draw up a framework on the future of choice told HSJ they had expected the document to be out by now and were frustrated by the lack of progress.
With a relatively new ministerial team at Richmond House there is now uncertainty over the future of choice, they warned.
The group has made recommendations to the DoH on how choice should be offered beyond elective care to people with health needs that include cancer, mental health and long-term conditions.
The group's draft framework urges greater choice over the type of care provided rather than just over the provider.
It finished its work in May but the framework has still not been published.
A DoH spokesman said further meetings would be held this autumn in an effort to 'influence strategic thinking about extending choice'.
Chief executive of the Picker Institute think tank Angela Coulter, who also sat on the group, said members wanted assurances that the delay did not signal a change in direction.
'There is that concern. We have had little idea about the way ministers and the department are going,' she said.
On the framework's content Ms Coulter said: 'We are looking at trying to broaden choice beyond the narrow option of choice of provider and much more into the important realm of patients having a say in their own care.
'There is a great need to get this on the agenda.'
The reference group, announced last May by then health minister Andy Burnham, was co-chaired by chief executive of the Long-term Medical Conditions Alliance David Pink and chair of the council at the Royal College of General Practitioners Mayur Lakhani.
Mr Pink said: 'I'm not aware of any signals from the new health secretary or his team that says the kind of things in the draft framework are no longer wanted.
'But then again I'm not aware of any ringing endorsements from them so it seems to be a bit in the doldrums.'
'It does concern us. We are now many months beyond when we expected it to come out,' he said.
Reference group member Joe Farrington-Douglas, senior research fellow at the Institute for Public Policy Research think tank, said the delay was 'bad news for patients who are currently not having enough say in decisions about their care'.
The DoH was 'considering how best to extend choice' following the publication of the Commissioning Framework for Health and Well-being in March, its spokesman said.
He said: 'We will be using discussions with patient groups and clinical stakeholders this autumn, to influence strategic thinking about extending choice.'