King's Fund - British public’s satisfaction with the NHS at lowest level in over a decade
Public satisfaction with the NHS has fallen to its lowest level since 2007, according to analysis of the 2018 British Social Attitudes (BSA) survey published last week by The King’s Fund and the Nuffield Trust.
The survey , carried out by the National Centre for Social Research (NatCen), is seen as a gold standard measure of public attitudes. It finds that, following a sharp drop in 2017, public satisfaction  with the health service fell by a further 3 percentage points in 2018 to 53 per cent, its lowest level in over a decade and 16 percentage points below its historical peak of 70 per cent in 2010. The continued fall in satisfaction came despite Prime Minister Theresa May’s announcement last June – just before the interviews for the survey were undertaken – of a £20bn long-term funding boost for the health service.
The think tanks’ analysis also reveals that public satisfaction with general practice has declined over the past decade. In 2018, it remained at its lowest level since the survey began in 1983 (63 per cent),  while dissatisfaction with general practice remained at its highest level since the survey began. Almost a quarter (24 per cent) of respondents reported being dissatisfied with their GP service – double the level of dissatisfaction in 2009.
The founding principle of the NHS, that it is free at the point of use, remains one of the primary reasons people are satisfied with the NHS (selected by 62 per cent of satisfied respondents). The survey also reported an increase over the past three years in the proportion of people who cited quality of NHS care as a reason for their satisfaction (71 per cent). Concerns over waiting times, NHS staff shortages and inadequate funding remained the top three reasons people gave for being dissatisfied with the NHS in 2018.
Other key findings from the survey, which was carried out by NatCen between July and October 2018, include:
- Satisfaction with hospital services has fluctuated in recent years, but in 2018 an 8 percentage point increase in satisfaction with inpatient services takes it to its highest level since 1993 (63 per cent) and a 5 percentage point increase in satisfaction with outpatient services takes it to the highest level since the survey began (70 per cent).
- Satisfaction with both inpatient and outpatient hospital services was higher among those who have used those services recently or have friends or family members who have done so than among those who had no contact with inpatient services by either themselves or their friends and family.
- Satisfaction with NHS dentistry, accident and emergency departments and social care did not change significantly between 2017 and 2018. Satisfaction with social care provided by local authorities remains far lower than satisfaction with NHS services.
- Overall satisfaction with the NHS was higher among people aged 65 years or older (61 per cent) than among adults under 65 (51 per cent).
- There is a divergence of views between supporters of the two main political parties: 58 per cent of supporters of the Conservative party were satisfied compared to 51 per cent of supporters of the Labour Party.
Ruth Robertson, Senior Fellow at The King’s Fund said: ‘Despite the outpouring of public affection around the NHS’s 70th birthday and the Prime Minister’s “gift” of a funding boost, public satisfaction with how the NHS is run now stands at its lowest level in over a decade. In the short term at least, the promise of more money doesn’t appear to buy satisfaction. The public identified long-standing issues such as staff shortages and waiting times amongst the main reasons for their dissatisfaction and cash alone will not solve these.’
Professor John Appleby, Director of Research and Chief Economist at The Nuffield Trust, said: ‘Satisfaction with general practice – historically the service people were most satisfied with – has been falling for the past decade and is now at its lowest since the BSA survey began over 30 years ago. This may reflect continued strain on general practice, with mounting workloads and staff shortages and the evidence shows that people are finding it harder to get appointments than before. The NHS long-term plan expects even more of general practice – these problems will need to be addressed quickly if that vision is to be made possible.’
Notes to editors
- Since 1983, the National Centre for Social Research’s (NatCen) BSA survey has asked members of the public across England, Scotland, and Wales about their views on the NHS and health and care issues generally. The latest survey was carried out between July and October 2018 and asked a nationally representative sample of 2,926 people about their satisfaction with the NHS overall, and 973 people about their satisfaction with individual NHS and social care services. The King’s Fund and The Nuffield Trust sponsor these health questions and summarise the headline results. The King’s Fund will publish further results of the health questions in the coming weeks and NatCen will publish further results from BSA in the summer.
- The main question asked was ‘All in all, how satisfied or dissatisfied would you say you are with the way in which the National Health Service runs nowadays?’ and the response options were ‘very satisfied’, ‘quite satisfied’, ‘neither satisfied nor dissatisfied’, ‘quite dissatisfied’ and ‘very dissatisfied’. Satisfaction as reported here aggregates those who answer 'very' and 'quite' satisfied. The survey methodology is based on a randomly selected sample of the British public and is conducted via a face-to-face interview with multiple follow up requests to non-responders. It includes those who had recent contact with the NHS and those who had not. The order in which topics are covered in the survey, and the order in which questions on the NHS are asked, have not changed in recent years.
- Satisfaction with GP services in 2018 was 63 per cent. The change in satisfaction from the previous year (down by 2 per cent) was not statistically significant and satisfaction remains at its lowest level since the survey began in 1983. The GP satisfaction measure is the closest the survey gets to a measure based on direct personal experience, as most people will have visited their GP in the past year for either themselves or a family member.
- The analysis of the BSA health results was carried out by Ruth Robertson, John Appleby, Harry Evans and Nina Hemmings. It will be published on both The King’s Fund and the Nuffield Trust websites at 00:01 on 7 March 2019, with a link to the report from the NatCen website. Previous survey reports can be viewed here: kingsfund.org.uk/projects/public-satisfaction-nhs
- The King’s Fund is an independent charity working to improve health and care in England.
- The Nuffield Trust is an independent think tank aiming to improve the quality of health care in the UK by providing evidence-based research and policy analysis.
- The National Centre for Social Research, Britain’s largest independent social research organisation, helps government and charities make the right decisions by listening to the public and making sure their voice is heard.
For further information, or to request an interview with Professor John Appleby or Ruth Robertson, please contact Gemma Umali at The King’s Fund on 020 7307 3583 (07584 146 035 if calling out of hours) or email firstname.lastname@example.org
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