British Social Attitudes survey 2014: conclusion

Since 1983, the National Centre for Social Research’s British Social Attitudes survey has asked the public – rather than simply patients – about their views on and feelings towards the NHS and health care issues generally. The latest survey was carried out between August and September 2014. Here we present the top-line results and trends from the survey. This is page 6 of 8 of our full report.

The results of the 2014 British Social Attitudes survey show an increase in the public’s level of satisfaction with the NHS between 2013 and 2014. This may represent a genuine feeling among the public that the health service improved in 2014.

Official measures of performance tell a different story: NHS funding has been under increasing pressure since 2010 and there have been well-publicised performance problems with high-profile targets such as the 4-hour A&E waiting time standard and the 18-week maximum wait from referral to treatment. At the same time, the media has featured negative stories about the financial position of NHS hospitals and the need for additional investment in the service.

Growing public concern about the NHS can be seen in the results of a monthly survey conducted by Ipsos MORI. This shows that the public now considers the NHS as neck-and-neck with the economy as one of the top three issues facing Britain today (Figure 10).

Media coverage of the NHS: August and September 2014

Three main stories dominated media coverage about the NHS before and during the time the field work for the survey was conducted.

The first was deteriorating NHS finances and the growing number of NHS trusts that were running up deficits.

Second was the debate about funding and calls for more investment in the NHS, which culminated in pledges to increase funding from all the main parties at their party conferences.

Third were pressures on services and the impact of this on waiting times – in particular, waiting times for cancer treatment which were widely reported as having been missed while the field work was being conducted.

But the biggest story during this period centred on the Scottish referendum. For a short time in the run-up to the referendum, the NHS dominated the headlines as the two campaigns traded blows about the implications of independence for the NHS in Scotland.

This context suggests a possible alternative explanation for the increase in satisfaction in 2014. We know that what drives changes in satisfaction is not straightforward – and almost certainly is never simply satisfaction with the NHS per se, for all respondents to the survey. Political beliefs, attitudes towards the government of the day, media stories and expectations of the NHS will shape people’s satisfaction.

One interpretation of the increase in overall satisfaction for the NHS is that it is likely to reflect a vote of support for the NHS as an institution in difficult times. A lack of objective improvement in NHS services and the fact that improvements in satisfaction appear to have been driven by an 11 percentage point increase in satisfaction among Labour supporters and those without recent contact with the service, may lend weight to this analysis. This may especially be the case given that some see the NHS as currently under threat, for example from privatisation, and some feel ministers and others have been too critical of the NHS and its staff.

In the run-up to the 2015 general election, indicators like the British Social Attitudes survey will be increasingly drawn on to help the media and the public judge the government’s performance in running the NHS. However, the results of the latest survey should be interpreted carefully. As our analysis shows, public satisfaction reflects a multitude of factors other than actual satisfaction with the NHS.

So, while satisfaction improved in 2014, this is not necessarily synonymous with an improvement in the actual performance of the NHS, nor does it simply reflect an actual improvement in satisfaction. Nevertheless, it is clear that public satisfaction with the NHS and support for it as an institution remains high.

Next: About the British Social Attitudes survey

Explore the full report

  1. Key findings and summary
  2. Introduction
  3. Satisfaction with the NHS overall
  4. Satisfaction with NHS and social care services 
  5. Who is satisfied with the NHS? 
  6. Conclusion
  7. About the British Social Attitudes survey
  8. References and acknowledgements