Possible explanations for the fall in satisfaction 1

One straightforward explanation for the fall in satisfaction is that NHS services deteriorated between 2010 and 2011 to the extent that this was noticed or felt by at least some of the public and to the extent that this reduced satisfaction.

An actual reduction in the quality?

There is no evidence of a real decline in service quality or performance, however. At national level, key measures of performance such as waiting times and health care acquired infection rates have not noticeably deteriorated – remaining relatively stable in the case of most measures of waiting times or, in the case of methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C difficile), reducing (Appleby et al 2012).

Other surveys – such as those carried out nationally by the NHS, for example, patient experience surveys of inpatients (Care Quality Commission 2012a), outpatients (Care Quality Commission 2012b) and the GP Patient Survey (Department of Health 2012) also show little or no significant reduction in general measures of the quality of the experience patients report. For example, 43 per cent of respondents to the 2011 NHS inpatient survey rated the care they received as 'excellent', 35 per cent as 'very good', 14 per cent as 'good', 6 per cent as 'fair', and 3 per cent as 'poor'. The only change since 2010 was a slight decrease in the proportion rating their care as 'good' (though the difference was so small it was lost in the rounding of the results).

Similarly, Ipsos MORI's regular issues survey investigating current concerns among the public shows an association with the British Social Attitudes survey satisfaction results, particularly from 2001 onwards (see graph below, Ipsos MORI 2012b). A similar 'concerns' tracker poll by YouGov suggests the NHS fell back slightly as one of the most important issues facing the country between 2010 and 2011 (YouGov 2012a). It should be noted that both this and the Ipsos MORI issues polls ask an implicitly relative question; concern about the NHS, for example, will in part be influenced by the strength of concern about other issues – such as the economy or education.

It is worth noting that while national performance measures – such as waiting times – have been relatively stable over the last few years, key national figures will mask local variations, with some hospitals failing to meet national performance standards. However, there is little evidence that this variation changed substantially between 2010 and 2011.

Figure 5

Figure 5: Ipsos MORI ‘Issues facing Britain’ survey vs British Social Attitudes survey dissatisfaction with the NHS (1983-2011)

Possible explanations for the fall in satisfaction - other data in this section

Public satisfaction with the NHS and its services - other sections