Patient choice has been central to the government’s recent NHS reforms, along with a new payment system that rewards hospitals that are attractive to patients. But will these reforms make services more responsive? In the treatment of HIV and AIDS, patients have always had a choice of which hospital to go to. This paper explores the impact of patient choice on services in this area by presenting interviews with staff and patients from five HIV/AIDS units. Senior staff believed that their patients’ freedom to move services had had an effect on the way that some of their services were designed. However, although most patients valued their right to choose, few had chosen to travel or change their hospital.