Public satisfaction with the NHS and social care in 2024 (BSA)

Summary

Just 1 in 5 people (21%) in 2024 said they were satisfied with the way the NHS runs.

6 in 10 people (59%) said they were ‘very’ or ‘quite’ dissatisfied with the NHS in 2024, a sharp rise from 52% in 2023. This is the highest level of dissatisfaction with the health service since the British Social Attitudes (BSA) survey began in 1983.

The British Social Attitudes survey offers a unique look at how the British public are feeling about their health service. Carried out every year since 1983 by the National Centre for Social Research, it provides a barometer for understanding not only how people feel the NHS runs nowadays, but also what is driving their satisfaction (or, rather more accurately in recent years, dissatisfaction); how they rate individual services; and what they make of social care.

The King’s Fund and the Nuffield Trust jointly sponsor questions each year to measure and track public views about health and care.

The 2024 survey was carried out in September and October 2024. It documents the lowest levels of satisfaction with the NHS on record, provides context to a health service facing profound challenges and offers a clear baseline from which we can understand how the public are feeling at the start of a new government.

We highlight the key findings below.

Satisfaction with the NHS 

• In 2024, just one in five British adults (21%) were ‘very’ or ‘quite’ satisfied with the way in which the NHS runs. This is the lowest level of satisfaction recorded since the survey began in 1983 and shows a steep decline of 39 percentage points since 2019. Only 2% of respondents were ‘very’ satisfied with the NHS, down from 4% in 2023.

• The percentage of people who were ‘very’ or ‘quite’ dissatisfied with the NHS rose to 59% in 2024, from 52% in 2023. This represents a statistically significant 7-percentage-point increase from the year before, which already had the highest dissatisfaction seen in 40 years of the British Social Attitudes survey.

• A higher proportion of people in Wales (72%) were dissatisfied with the NHS compared to the survey average and compared to people in England (59%).

• Supporters of the Reform party were less likely to be satisfied (13%) than the survey average and this was significant after controlling for other variables like age and income.

• There is a divide between generations, with satisfaction lower and falling in younger age groups. While the proportion of people who were satisfied rose slightly for those aged 65 and over, from 25% to 27%, among those under 65 it fell significantly, from 24% to 19%.

Satisfaction with social care 

• In 2024, only 13% of respondents said they were ‘very’ or ‘quite’ satisfied with social care (the same figure as 2023). 53% of respondents were ‘very’ or ‘quite’ dissatisfied.

• Respondents in Wales (69%) were again significantly more likely to be dissatisfied than the survey average.

  

Satisfaction with different NHS services 

• Public satisfaction with A&E services has fallen sharply, from 31% to just 19%, and dissatisfaction has risen from 37% to 52%. These are the worst figures on record by a large margin and make A&E the service with lowest satisfaction levels for the first time.

  

• Satisfaction with NHS dentistry has continued to collapse. As recently as 2019 this was at 60%, but it has now fallen to a record low of 20%. Dissatisfaction levels (55%) are the highest for any specific NHS service asked about.

  

• Satisfaction with GP services continued to fall, mirroring the trend over the last few years. 31% of respondents said they were satisfied with GP services, compared with 34% in 2023.

  

• Inpatient and outpatient hospital care is the part of the NHS with the highest levels of satisfaction, with 32% saying they were satisfied and only 28% dissatisfied.

  

Attitudes to standards of care, staffing and efficiency 

• The majority of the public (51%) said they were satisfied with the quality of NHS care. People aged 65 and over were more likely to be satisfied (68%) with the quality of NHS care than those under 65 (47%).

• Dissatisfaction with waiting times and the ability to get an appointment is widespread, and is consistent across respondents from all ages and UK countries:

  • 62% of all respondents were dissatisfied with the time it takes to get a GP appointment. 23% were satisfied.

  • 65% of respondents said they were dissatisfied with the length of time it takes to get hospital care. 14% said they were dissatisfied.

  • Dissatisfaction levels are highest regarding the length of time it takes to be seen in A&E. 69% of respondents said they were dissatisfied, while just 12% said they were satisfied.

• Only 11% agreed that ‘there are enough staff in the NHS these days’. 72% disagreed.

NHS funding, principles and priorities 

• 8% of respondents said that the government spent too much or far too much money on the NHS; 21% said that it spent about the right amount, and 69% said that it spent too little or far too little.

• When asked about government choices on tax and spending on the NHS, the public would narrowly choose increasing taxes and raising NHS spend (46%) over keeping them the same (41%). Only 8% would prefer tax reductions and lower NHS spending.

• Only 14% of respondents agreed that ‘the NHS spends the money it has efficiently’. 51% disagreed with this statement.

• Respondents felt the most important priorities for the NHS should be making it easier to get a GP appointment (51%) and improving A&E waiting times (49%), with increases in staff (48%) and better hospital waiting times close behind (also 48%). A&E has now slightly overtaken staffing as a priority, reflecting the sharp fall in satisfaction described above. People under 65 were more likely to prioritise improving mental health services (34%) than those aged 65 and over (21%).

• As in previous years, a strong majority of respondents agreed that the founding principles of the NHS should ‘definitely’ or ‘probably’ apply in 2024: that the NHS should be free of charge when you need to use it (90%); the NHS should primarily be funded through taxes (80%); and the NHS should be available to everyone (77%).

• The percentage of people saying that the NHS should ‘definitely’ be available to everyone decreased from 67% in 2023 to 56% in 2024. This is the only statistically significant change year-on-year across all three principles. Supporters of the Reform party (20%) were significantly less likely to say that the NHS should ‘definitely’ be available to everyone than the survey average.

Conclusion

This year’s results show that the startling collapse in public satisfaction with both the NHS and social care has continued. Satisfaction with the health service is now 39 percentage points lower than it was before the Covid-19 pandemic in 2019. Dissatisfaction with the NHS has climbed further to 59%, a record level never seen before in this survey’s 41-year history. Meanwhile, satisfaction with social care appears to have plateaued at a low of 13%.

The BSA tells us nothing of the individual stories that sit behind these results, but everything about how the public is feeling about the NHS and social care, offering fascinating insights into their views on priorities for the NHS and the principles that underpin it. For the first time this year, we also provide insight into how the public feels about different aspects of the health service: the quality of care provided, the numbers of staff providing it, efficiency and funding, and how it communicates with patients.

This allows us to see beyond headline dismay to the complex, nuanced views that lie behind it. Deep dissatisfaction with the length of time it is taking for people to access care, and real concern about levels of funding and staffing sit alongside enduring support for the NHS and its core principles, and strong belief in the quality of care.

Our analysis reveals divergence in many areas: along party political lines, with Reform supporters least satisfied overall with the NHS; new evidence of divergent views between the under-65s and those aged 65 and over when it comes to quality of care; and clear findings that Welsh respondents held less positive views on both the NHS and social care, relative to the average across Britain.

But little divergence is found when looking at the public’s attitudes towards waiting for care: just 12% of respondents were satisfied with the length of time it takes someone to be seen in A&E and 23% of respondents were satisfied with the length of time it takes to get a GP appointment. These were similar regardless of political affiliation or country of residence. When seen alongside the clear support for prioritising improved GP and A&E access and the sharp rise in dissatisfaction with A&E services, the public is clear: deteriorating access to core services is causing sharp distress across every group in Britain.

In some ways, a consensus has grown stronger. Just weeks after the newly elected government declared that the NHS is broken, we should not be surprised that, contrary to the usual historic pattern, supporters of the governing party are no more positive about the state of the health service than supporters of the outgoing Conservatives.

Even on the question of NHS spending, where real political distinctions exist, a majority of supporters of every political party share the view that too little money is spent on the health service. At the same time, most disagree that it spends its existing budget well.

The public agrees that the NHS is broken, but in particular ways – above all because of waiting times, staffing and money. The government faces the daunting prospect of addressing these concrete concerns at a strained and unstable time if it is to reverse what we can now see has been a tectonic shift towards disillusionment with Britain's national health services.