Who is satisfied with the NHS?

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 2013 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.

Because the British Social Attitudes survey also collects information on the particular characteristics of survey respondents – their party political identification, where they live and so on – we can explore the satisfaction data in more depth.

Latest public satisfaction survey

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

Recent contact with the NHS

As Figures 6 and 7 show, for example, there is a gap between the satisfaction levels reported by respondents who had recent experience of inpatient or outpatient services (defined as personal contact in the last 12 months) and those who did not. For many years since 1998 there has been a gap in satisfaction between these two groups; people with recent contact with either inpatient or outpatient services tend to report slightly higher levels of satisfaction than those with no recent contact.

This difference has varied over time. For example, for inpatients it has been as large as 18 percentage points (in 2001) in favour of those with recent contact. In 2010 and 2011 this gap disappeared, but in 2012 it opened up again and the latest results show it widening to +10 percentage points in favour of those with recent contact. For those with recent contact with outpatient services there is a similar pattern although the 2013 results show the largest gap (+13 percentage points) in the past 15 years.

In general the differences in satisfaction between those with recent experience and those without are likely in part to reflect negative media reporting about the NHS (influencing the views of those with no recent contact with the NHS) but also perhaps elements of gratitude and appreciation for care received which colour views on satisfaction for those with recent contact.

Party political identity

Another factor affecting satisfaction levels may be that views about the NHS expressed by 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). Following a year in which satisfaction with the NHS among supporters of the three main political parties converged, 2013 saw views diverge once again. Between 2012 and 2013, satisfaction increased slightly among Conservative supporters (up 3 percentage points), remained the same for Liberal Democrats, and dropped slightly among supporters of the Labour party (down 4 percentage points). To an extent the opposing changes in the satisfaction levels of Conservative and Labour supporters will have cancelled each other out, helping to maintain the steady trend overall.

Trends in satisfaction with the NHS by political party identification – percent very or quite satisfied

Country of residence

Given changes in the governance of the NHS across Britain since devolution in Scotland and Wales and the apparent divergence in policy paths across these countries over the past decade or so, it is interesting to see whether such differences are reflected in satisfaction rates. Because of relatively small sample sizes for Wales and Scotland since 2011, the differences between countries each year since then are not statistically significant.

However, we can combine Scottish and Welsh responses. In general, there has been no significant difference in satisfaction rates between countries since the turn of the century – apart from 2011, when satisfaction in England was 58 per cent and in Scotland and Wales combined, 52 per cent. On this basis it would seem that the public appear unmoved in their attitudes towards the NHS regardless of any policy differences there have been and that remain between England and the rest of Britain, or differences in other factors likely to influence satisfaction (such as performance on waiting times).

More from the British Social Attitudes survey 2013