The strategic health authority found that over-60s were significantly less likely to opt for an alternative provider than younger patients.
GPs interviewed during the project raised concerns that insufficient signposting and advocacy services are hampering the ability of older patients to make informed choices.
The findings surprised report author Chris Joseph, who said: 'We expected it to be minority ethnic groups who were facing inequity, but that wasn't the case at all.
'There didn't seem to be any real difference in uptake for people from different ethnicities, social backgrounds, gender or area.
'But for older people the role of their GP is important, and many need more time to discuss and absorb the information before straying from their local hospital.'
A telephone survey found that up to 34 per cent of patients over 60 declined to take up the offer of an alternative provider. Among the 30-44 age group, this figure was 16 per cent and for those aged 17-29 it was 20 per cent.
The views of a wide range of health professionals were also canvassed, including GPs, health economists, consultants, managers, and voluntary sector representatives.
This revealed strong support for improved choice, in addition to fears that patients with more complex needs could be missing out. Most professionals questioned felt better advocacy services were needed, but that they should be mainstream as opposed to add-ons, to avoid stigmatising people.
Supporting Patient Choice: learning from stakeholders found:
- nearly two-thirds of patients were pleased to be offered a choice of provider;
- 59 per cent preferred to receive information face-to-face;
- of those who accepted the offer of an alternative provider, three-quarters did so to be treated sooner;
- transport was an important factor for 43 per cent of respondents;
- 45 per cent of those who declined the offer said they had experience of a particular provider they wished to use again;
- a significant minority of patients with needs such as culture, language and disability may require more information to feel comfortable about making their choice.