The government's reimbursement policy, whereby local councils face fines if a patient cannot be discharged from hospital because they are waiting for an assessment etc, introduced new pressures into a system that was already fraught. One of the policy's aims is to allow people to exercise ‘genuine choice’ as regards their ongoing and longer‐term care. Based on their research into the policy however, Michelle Cornes et al investigate whether choice really can be exercised when lying in a hospital bed.