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Press release

Public satisfaction with the NHS rose sharply in 2019

New analysis published today by The King’s Fund and the Nuffield Trust shows public satisfaction with the NHS jumped to 60 per cent across the UK in 2019, up 7 percentage points from the year before.

The increase marks a turnaround from declines in 2017 and 2018 which saw public satisfaction with the health service drop to 53 per cent, the lowest level in a decade. With NHS waiting times worsening throughout 2019, the authors conclude the improvement is likely to be linked to high profile announcements of more funding for the service before and while the survey was carried out.

Questions commissioned by the two think tanks were put to the public by the National Centre for Social Research (NatCen) as part of their gold standard British Social Attitudes Survey. The annual survey was carried out between July and October last year, several months before the start of the Covid-19 pandemic which has seen health and care services placed under unprecedented pressure.

The main reason people gave for being dissatisfied with the NHS overall was not enough staff. This has jumped to 62 per cent – an increase of 10 percentage points since 2018 – suggesting that concern about staff shortages in the NHS has made a significant impression on the public. This was followed by waiting times for GP appointments and hospital treatment (57 per cent) and a view that the government doesn’t spend enough money on the NHS (49 per cent).

As in previous years, the public still overwhelmingly believes that the NHS faces a major or severe funding problem, however, the proportion who say this has fallen over the past two years from 86 per cent to 80 per cent. The report authors warn that higher satisfaction may not endure unless waiting times and staffing shortages are addressed.

The authors note that responses show rising satisfaction across supporters of all major political parties. The increase is also seen across 'leavers' and 'remainers', and different age groups – although as in previous years older people and Conservative supporters are the happiest with services.

The public remains pessimistic about the health service’s future, with 42 per cent thinking the standard of care will get worse and only 29 per cent thinking it will get better. However, this is a marked improvement from the previous year when 51 per cent expected care to deteriorate. The way that services respond to the Covid-19 pandemic is likely to influence results of future surveys.

Results from other questions commissioned by the Nuffield Trust and The King’s Fund and published today include:

  • satisfaction with GP services was 68 per cent in 2019 – a significant 5 percentage point increase over the previous year

  • the majority (54 per cent) of people surveyed said that if extra funding were needed for the NHS they would prefer it to come from either general taxation, or specially earmarked taxes

  • satisfaction with social care services remains much worse with 37 per cent dissatisfied and 29 per cent satisfied. There has been no significant change here

Report author John Appleby, Chief Economist at the Nuffield Trust said:

'This survey was carried out in 2019 when the NHS was struggling with severe staffing shortages and consistently missing waiting time targets. So at first glance, it may seem surprising to see a jump in public satisfaction. But since the summer of 2018 and in the first months after Boris Johnson became Prime Minister, the public has heard a lot about plans for substantial extra spending on the NHS. That may have sparked a sense of optimism. The question is how long it will last unless we see those promises being delivered soon.'

Report author Dan Wellings, Senior Fellow at The King’s Fund said:

'The Covid-19 outbreak will put health and care services under extraordinary strain over the coming months and this will undoubtedly have a longer-term impact on public attitudes to the NHS. Seeing health and care staff pushed to their limits in the current crisis may only reinforce the public’s long-term support, trust and admiration for the NHS and their willingness to pay for it. Just possibly some of that concern and appreciation may also start to extend to social care as well.'

Notes to editors

  1. Since 1983, the National Centre for Social Research’s (NatCen) BSA survey has asked members of the public across England, Scotland, and Wales about their views on the NHS and health and care issues generally. The latest survey was carried out between July and October 2019 and asked a nationally representative sample of 3,224 people about their satisfaction with the NHS overall, and 1075 people about their satisfaction with individual NHS and social care services. The King’s Fund and The Nuffield Trust sponsor these health questions and summarise the headline results.

  2. We publish at a time of unprecedented crisis facing the health services, the economy and society in the form of the Covid-19 pandemic. The timing of the survey means it is important to bear in mind that the results reflect attitudes before the emergence of coronavirus. How this pandemic unfolds over the coming months and the way the NHS and care organisations respond are factors likely to influence results from future BSA surveys.

  3. The main question asked was ‘All in all, how satisfied or dissatisfied would you say you are with the way in which the National Health Service runs nowadays?’ and the response options were ‘very satisfied’, ‘quite satisfied’, ‘neither satisfied nor dissatisfied’, ‘quite dissatisfied’ and ‘very dissatisfied’. Satisfaction as reported here aggregates those who answer 'very' and 'quite' satisfied. The survey methodology is based on a randomly selected sample of the British public and is conducted via a face-to-face interview with multiple follow up requests to non-responders. It includes those who had recent contact with the NHS and those who had not. The order in which topics are covered in the survey, and the order in which questions on the NHS are asked, have not changed in recent years.

  4. For the first time, the 2019 BSA survey also measures whether there are differences in satisfaction between users and non-users of a range of health and care services. In addition, we include survey questions relating to funding of the NHS, which were previously published separately.

  5. The analysis of the BSA health results was carried out by John Appleby, Nina Hemmings, David Maguire, Jessica Morris, Laura Schlepper, Dan Wellings. It will be published on both the Nuffield Trust and King’s Fund websites at 00.01 on Friday 3 April 2020, with a link to the report from the NatCen website. Previous survey reports can be viewed here:

  6. The Nuffield Trust is an independent think tank aiming to improve the quality of health care in the UK by providing evidence-based research and policy analysis.

  7. The King’s Fund is an independent charity working to improve health and care in England.

  8. The National Centre for Social Research, Britain’s largest independent social research organisation, helps government and charities make the right decisions by listening to the public and making sure their voice is heard. By really understanding the complexity of people’s lives and attitudes, it aims to give the public a powerful role in shaping decisions and services that make a difference to everyone.

For further information, or to request an interview with Professor John Appleby or Dan Wellings, please contact the Nuffield Trust press office:
Fiona Johnson: [email protected], 07825 510527 or Meilir Jones: [email protected], 07795410433.