Explaining the results

Apart from the increase in satisfaction with A&E services between 2011 and 2012, there has been little change in levels of satisfaction with NHS services. Why is this?

Latest public satisfaction survey

View the most recent results: British Social Attitudes survey 2015.

Trends in satisfaction with the NHS by recent contact with inpatients and outpatients

Explaining changes in satisfaction with the NHS and its services from year to year can be difficult; rarely is there a single factor at play. In general, there are a number of potential reasons for change, or, in the case of the 2012 result for satisfaction with the NHS overall, effectively no change. For example, satisfaction with the NHS will be partly dependent on the public’s expectations of the NHS, actual or perceived changes in the quality of NHS care and so on. In addition, people’s attitudes towards the NHS are likely to be influenced by their view about other things, in particular about the government and its policies concerning the NHS.

Why has satisfaction with the NHS and most of its services remained essentially unchanged from 2011?

The key result from the 2012 survey is that satisfaction with the NHS and most of its services remain essentially unchanged following the big fall in 2011. As we note, part of the explanation for this could be that the actual or perceived quality of NHS care has remained unchanged. Indeed, key measures of performance likely to have been noticed by the public – for example, waiting times either in A&E departments or for outpatients and inpatients, and for health care-acquired infections – have not significantly changed from 2011 to 2012 (as seen in our September 2012 quarterly monitoring report); furthermore, there is no significant change in satisfaction for respondents who have had recent contact with the NHS.

As Figures 6 and 7 show, there is essentially no difference in satisfaction with the NHS overall between respondents who had recent experience of inpatient or outpatient services (defined as personal contact in the last 12 months, or contact via a close family member/friend, or both personal contact and via close family member/friend) and those who did not, and effectively no difference between 2011 and 2012 levels of satisfaction for both groups.

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Either satisfaction or contact questions not asked in: 1983–1986, 1988, 1991, 1992 and 1997
* Very satisfied + quite satisfied
** 'Contact’ is defined as: ‘Just me’ + ‘Not me, but a close family member/friend’ + ‘Both me and a close
family member/friend’. 1987–1996, contact within last two years; 1997–2012, contact within last year
NB: As there was no question asked about contact with NHS services in 2010, an estimate for the contact and
no contact groups’ satisfaction with the NHS overall in that year has been imputed based on the known
satisfaction figure for 2010 for the NHS overall from the whole survey group. The estimate is based on the
statistical relationship between the trend for this whole sample and trends for satisfaction with the NHS overall
for the contact and no contact groups in other years between 1987 and 2012.
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Trends in satisfaction with the NHS by party identification

Another reason for satisfaction remaining broadly unchanged may be that views about the NHS expressed by some or all respondents are based on their views about something else – in particular about the government and/or its policies concerning the NHS. Previous analyses of British Social Attitudes survey satisfaction results have noted a tendency for levels of satisfaction with the NHS overall to correlate with the party in government, with those identifying themselves as supporters of the party in power expressing greater satisfaction than non-supporters (see Figure 8).

What does satisfaction by party identification look like in 2012?

But as Figure 8 shows, while this association appears broadly true over time, it is less true of the results for 2012. In 2012 there is little difference in levels of satisfaction by party identification: 64 per cent of both Conservative and Labour supporters are satisfied with the NHS overall, as are 63 per cent of Liberal Democrat supporters. For Liberal Democrats, this continues a decline from a high of 74 per cent satisfied in 2010. For Labour supporters, on the other hand, satisfaction has risen since 2011 by 7 percentage points – a statistically significant increase following the large fall between 2010 and 2011 of more than 17 percentage points. For Conservative supporters, satisfaction in effect remains flat at 64 per cent (lower than a high of 70 per cent in 2010).

These changes would suggest that the general association between respondents’ party identification, the party in power and satisfaction with the NHS does not, for now, hold true. Equally, however, the fact that Liberal Democrat and Conservative party supporters’ satisfaction has at best remained flat (and down on their 2010 views) may reflect some ambivalence about the coalition government’s performance and policies among its supporters.

The (statistically significant) increase in satisfaction among Labour supporters is also difficult to explain on the basis of the historic association between the party in power and the attitudes expressed by respondents according to party identification. In part, it may simply reflect an inevitable recovery following a very large fall. In part, too, there may be some reaction to what Labour supporters may have perceived as general ‘negativity’ towards the NHS. In other words, their attitudes may reflect a general vote of support for the NHS at a time when they may have thought it was under attack, rather than specific satisfaction with the NHS.

Either satisfaction or party identification questions not asked in: 1985, 1988, 1991 and 1992
NB: The whole survey satisfaction data includes people who identified themselves with other or no
political parties. This latter group tended to be less satisfied than supporters of the three main parties.

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More from the British Social Attitudes survey 2012