The aim of this article is to explore how people with learning disabilities can be supported to make choices about their treatment and care in primary and acute healthcare settings. The article describes the policy and legislative framework designed to promote choice and discusses how this can be implemented in contemporary healthcare settings. The legislative framework described applies to England and Wales. Scotland and Northern Ireland have different arrangements. The responsibilities of healthcare professionals in respecting and upholding the rights of all patients are also emphasised. After reading this article and completing the time out activities you should be able to: Understand the need for current legislation and policy aimed at promoting choice for people with learning disabilities. Explain the key features of the concept of choice. Describe the factors that inhibit or promote decision making for people with learning disabilities in healthcare environments. Identify the roles and responsibilities of healthcare staff in promoting choice for people with learning disabilities.