Who is satisfied with the NHS in 2014?

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 5 of 8 of our full report.

Explaining changes in satisfaction with the NHS and its services from year to year can be difficult. While these changes can in part be taken at face value – as actual shifts in satisfaction – in general, there are a number of potential reasons for change. For example, satisfaction with the NHS will be partly dependent on what the public expects from it, actual or perceived changes in the quality of NHS care and so on. People’s attitudes are also likely to be influenced by their views about the government and its policies on the NHS, by media reporting and by attitudes to the NHS as an institution.

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

Recent contact with the NHS

As Figures 6 and 7 show, 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 by those who had not (defined as no contact personally or by friends or family members in the past 12 months).

For many years since 1998 there has been a gap in satisfaction between these two groups; people with recent contact 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. By 2011 this gap had disappeared, but in 2012 it opened up again and in 2013 the gap was 10 percentage points.

The latest year’s data shows the gap narrowing to just 3 percentage points. This was due to an 11 percentage point jump in satisfaction among those who had no recent contact with the health service. This overshadowed the 4 percentage point increase among those with recent personal contact.

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) but also perhaps elements of gratitude and appreciation for care received felt by those with recent contact.

During the period that the survey was in the field (August to September 2014), there were a number of high-profile negative media stories about the NHS – perhaps making the jump in satisfaction among those without recent contact surprising. Of course, the increase could reflect positive reports of NHS care from people they know, or reactions to some of the more positive media coverage of NHS services.

However, given the much publicised financial pressures and difficulties in meeting waiting times targets in 2014, an alternative interpretation would be that the positive views reflect a desire to stand up for the service or express solidarity for it during a difficult time.

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 those identifying themselves as supporters of the party in government to express greater levels of satisfaction with the NHS overall than non-supporters (see Figure 8). However, in 2014, satisfaction levels among supporters of the three main political parties converged; 67 per cent of Conservative supporters, 68 per cent of Liberal Democrats, and 69 per cent of Labour supporters reported being satisfied with the NHS.

This contrasts with a year earlier, when satisfaction levels among Labour supporters were 8 percentage points lower than among Conservatives. The gap was closed by an 11 percentage point increase in satisfaction levels among Labour supporters in 2014.

This increase in satisfaction among Labour supporters could be a straightforward reflection of an improvement in satisfaction. More likely – as with the explanation for the large increase in satisfaction among those with no recent contact with the NHS – this change could reflect more generalised support for the NHS as an institution at a time when some see it as under threat.

Satisfaction among supporters of the UK Independence Party – the third largest political group in the 2014 survey – was lower than the other main political parties at 57 per cent.

Country of residence

It is interesting to see how satisfaction rates vary across the different nations of Britain, particularly given changes in the governance of the NHS since devolution in Scotland and Wales and the degree of divergence in policy paths across these countries over the past decade or so. Another factor to consider is the political events, debates and media stories surrounding the Scottish independence referendum last year.

Bearing in mind the statistical caveat that the sub-sample for Scottish respondents has not been designed to be necessarily representative of the Scottish population as a whole, in 2014, satisfaction with the NHS in Scotland was 75 per cent, the highest ever recorded. This was significantly higher than satisfaction levels reported in England (65 per cent) and Wales (51 per cent). The gap in satisfaction between Scotland and the other two countries is now one of the largest since 1983.

The field work for this survey was conducted in the months running up to the referendum vote on Scottish independence in September 2014. The historically high levels of satisfaction reported in Scotland may in part reflect the sense of nationalism and pride evoked during the campaign.

On the other hand, in Wales, media reports of failures in the NHS and lengthening waiting times may explain the lower satisfaction levels.

Next: Conclusion

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