The doctor will see you... two weeks ago

Nearly a quarter (23%) of people who used the NHS in the past 12 months received an appointment invitation after the appointment had already happened, an increase of 3 percentage points on the previous year, according to new analysis from The King’s Fund, Healthwatch England and National Voices.   

New polling conducted by Ipsos in December 2025, repeating research from December 2024, found that two thirds of patients and carers (66%) experienced at least one NHS administrative problem in the past year. These included not being kept informed about waiting times, having to chase test results, not being told who to contact while waiting for care, or being given incorrect information. 

Perhaps most disturbingly the report finds the 4 out of 10 (41%) of patients said these experiences made them less likely to seek care in the future. Worryingly, none of these figures have improved since the same survey was carried out a year earlier. 

While the number of people experiencing these issues has remained unchanged, what has shifted is wider public awareness: administrative failings are increasingly recognised as a frequent and persistent problem across the NHS. 

Stories shared with the organisations by people navigating the NHS lay bare just how damaging poor admin can be. Patients describe taking time off work only to discover on arrival that their clinic appointment has been cancelled without warning, losing income as they repeatedly juggle work commitments due to rescheduled consultations and feeling unsure which messages to trust as communication channels contradict one another. Others shared the experience of receiving communications about cancer surgery before actually receiving biopsy results or a diagnosis, and highlighted the stress of managing their care across phone calls, text messages and multiple apps including the main NHS app. 

The organisations warn that the burden of poor NHS admin is not shared equally. People more likely to suffer the consequences include those with long-term conditions, people from ethnic minority backgrounds and those struggling financially. Strikingly, over 4 in 5 (81%) patients and carers who report they are struggling financially have experienced an issue with NHS admin, compared with 3 in 5 (63%) of those who are comfortable financially. 

Despite some signs of a growing political focus on patient experience – including work to create a new minimum patient experience standard for those on the elective care waiting list – the report concludes that no progress has been made since last year’s findings. Long-standing issues persist, from patients chasing test results to not knowing who to contact for care. 

These failures are not only delaying diagnosis and treatment but also undermining staff morale and public confidence. Over half of people (57%) say poor admin makes them believe the NHS wastes valuable staff time.   

Dan Wellings, Senior Fellow at The King’s Fund and co-author of the report said: 

‘These results show that for many people navigating the NHS still too often feels like being set adrift without a compass. Two thirds of patients experiencing problems with NHS administration is not a minor systems issue – it is a day‑to‑day reality for millions of people. People are left chasing basic information and struggling to manage the care they need at moments when they are already anxious about their own health or that of someone they love, and that is completely unacceptable in a 21st century health system.  

‘These findings should be a real cause for concern for government and NHS leaders. Not only has there been no improvement in patients’ experiences of these issues over the past year, but wider public awareness of these administrative failings is growing. Once negative perceptions take hold, they are difficult to reverse. Recent gains in public satisfaction with the NHS may be short‑lived unless rapid action is taken to tackle this problem. 

‘Reducing waiting times matters. But when policy focuses too heavily on hitting numerical targets, it risks missing what patients value most while they wait: clear, timely and reliable communication.’  

Jacob Lant, Chief Executive of National Voices, said: 

‘The government’s shift to prevention is the right move for creating a healthier country and a more sustainable NHS. But any efforts to move in that direction will be totally undermined unless the NHS takes immediate action on admin failures. It’s absolutely staggering to think that for 2 in 5 people who tried to access care, the admin doom loop has got so bad that they are less likely to seek help in future as a result. That is not the way to create communities that are engaged in their health and feel supported to proactively manage any conditions they might have. 

‘After last year’s report we saw very senior leaders across the NHS pick up our mantra on the importance of getting the basics right, but acknowledging the problem is only half the battle. The government needs to take admin seriously. From the upcoming workforce plan to the national quality strategy, fixing the basics needs to be top of the to-do list.’ 

William Pett, Head of Policy, Public Affairs and Research, Healthwatch England, said: 

‘NHS administration failures cause a three-fold problem for the health service. First, they frustrate patients, leaving people feeling forgotten during waits for care and damaging confidence in services. Second, admin errors, such as incorrect medical records, can have serious implications for patient safety. And third, poor admin affects the efficiency of the NHS, for example when clinicians’ time is wasted with patient no-shows caused by wrong or delayed appointment letters. 

‘Worryingly, our research shows that admin problems fall hardest on the people facing the biggest challenges, such as those dealing with long-term conditions or struggling financially. We know that government is introducing new measures to help “get the basics right” but these can’t come soon enough for the patients across the country who simply cannot navigate the NHS.’ 

The three organisations are calling for NHS admin to be made a national priority, supported by clear standards that ensure processes work better for patients. Digital tools, including the NHS App, should be intuitive, accessible, and designed to work together so people aren’t left confused navigating a labyrinth of different platforms. 

They also urge the NHS to routinely collect and act on patient feedback about admin, co‑producing improvements with patients and service users. Crucially, they emphasise the need to support and value the NHS admin workforce through proper planning, training and development. 

Notes to editors  

1. Ipsos interviewed a representative sample of 1,908 online adults aged 16–75 across England between 29 November and 1 December 2025. Data are weighted to match the profile of the population. The full set of polling results, conducted by Ipsos, can be found here.

2. The King’s Fund, National Voices and Healthwatch England will publish their analysis on Thursday 16 April exploring the polling findings, alongside a briefing titled 10 actions the government and NHS leaders can take on NHS admin. 

For further information, or to request an interview, please contact the Media and External Engagement team on 020 7307 2585 or email [email protected]  

The King's Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible health and care is available to all.  

Healthwatch England is your health and social care champion. If you use GPs and hospitals, dentists, pharmacies, care homes or other support services, we want to hear about your experiences. As an independent statutory body, we have the power to make sure NHS leaders and other decision makers listen to your feedback and improve standards of care. We can also help you to find reliable and trustworthy information and advice. Last year, we helped nearly two million people like you to have your say and get the support you need. 

National Voices is the leading coalition of health and social care charities in England. We have more than 200 members covering a diverse range of health conditions and communities, connecting us with the experiences of millions of people. We work together to strengthen the voice of people: patients, service users, carers, their families, and the voluntary organisations that work for them.