Many people in England are unaware they now have more choice over where they can get NHS treatment, a poll suggests.
Each year 9.4m referrals for non-emergency treatment are made
As of 1 January, patients can choose between at least four hospitals or clinics for non-emergency treatment.
A poll of 1,276 over-40s found 80% knew little about the changes - though many would travel to get treatment faster.
Ministers hope the reforms will cut waits and raise standards. But some healthcare professionals fear the vulnerable will miss out.
The survey, conducted on behalf of the Department of Health, asked what people knew about the government's flagship NHS reform.
Some 41% said they knew "nothing at all" about the policy, while 39% said they knew "just a little". Only 4% said they knew a great deal.
Health Secretary Patricia Hewitt said increasing patient choice represented a "revolution" in healthcare and would help give people "better and faster care".
HOW FAR WOULD PEOPLE TRAVEL?
No further than local NHS hospital: 6%
Within strategic health authority area: 68%
Any UK NHS hospital: 14%
To Europe: 11%
"Every survey shows people want more choice and control over healthcare. We found the majority welcome being offered a choice and use that choice."
Ms Hewitt said millions of leaflets would be sent to GP surgeries explaining the new system.
She added that the survey also showed more than 50% of people had "some awareness" of the change.
Most of those questioned said they would be prepared to travel within their health authority area if it could deliver treatment in half the time of their nearest NHS provider.
Only 6% said they were not prepared to travel further than their local NHS hospital under any circumstance.
Some 14% would be willing to travel to any NHS hospital in the UK for treatment and 11% would travel to Europe.
But many were willing to wait longer for treatment at their local hospital rather than travel to a private hospital.
The director of nursing at the Royal College of Nursing, Alison Kitson, said nurses advocated the principle of choice but in reality GPs had insufficient time to research the information required for patients.
The reforms could in fact "effectively erode choice for patients", she said, as popular hospitals became overwhelmed, while unpopular ones could face closure.
"Fewer hospitals mean less choice for patients - and it is the most vulnerable members of society, such as the elderly, who will suffer the most if they cannot access hospital services on their doorstep, leaving them with no real choice at all," she said.
'Lack of capacity'
Some GPs have also expressed concerns.
George Rae, a GP near Newcastle, told BBC Radio Five Live "everyone" welcomed the idea of choice but its benefits should not be overstated because there was still a lack of resources.
"There's always been choice and a very important thing to say is that choice implies that there is spare capacity," he said.
"At the present time we're still, to be honest, pretty short of doctors, nurses and other health professionals to run a high quality 21st Century health service."
Patients' groups support the reform in principle but say it risks being undermined by delays in upgrading the NHS IT system to link GP practices to hospitals.
The government plans to extend the choice initiative to give patients a choice of "any hospital or provider which meets NHS standards at NHS costs" by 2008.
This is part of a wider plan to extend choice across the NHS, including to GP surgeries.
A White Paper setting out these proposals is expected later in January.