Survey shows biggest ever drop in public satisfaction with the NHS

Public satisfaction with the way the NHS runs fell from 70 per cent in 2010 to 58 per cent in 2011, according to British Social Attitudes Survey data published by The King’s Fund.

The fall is the largest since the British Social Attitudes Survey began in 1983 and follows a decade during which satisfaction with the NHS has increased almost every year. Despite the fall, NHS satisfaction remains at its third highest level since the survey began.

The King’s Fund sponsored the health questions in this year’s British Social Attitudes Survey, which has tracked public attitudes about key areas of public policy since 1983. More than 1,000 people were surveyed from July to November last year, a period that coincided with the first year in a four-year real-terms freeze in NHS spending and sustained media coverage about the government’s health reforms.

The survey data is presented in a report that explores a number of possible explanations for the fall in satisfaction. The report shows that satisfaction has fallen among supporters of all the main political parties:

• Conservatives: down 4 per cent from 70 per cent in 2010 to 66 per cent in 2011
• Labour: down 13 per cent from 74 per cent in 2010 to 61 per cent in 2011
• Liberal Democrats: down 7 per cent from 74 per cent in 2010 to 67 per cent in 2011.

Although the sharp fall in satisfaction among Labour supporters indicates an element of political partisanship at play, the report concludes that the fall in satisfaction among supporters of all the main political parties suggests other factors influenced the findings.

With the NHS performing well according to a number of key indicators and patient experience surveys, it concludes that the fall in satisfaction is unlikely to reflect a deterioration in the quality of services. Instead, the report suggests the most likely explanation is that concern about the government’s health reforms, reaction to funding pressures, and ministerial rhetoric to justify the reforms may have combined to dent public confidence in the way the NHS runs.

The survey data shows that satisfaction with individual NHS services has also fallen. Satisfaction with GP services fell for the second consecutive year, dropping by 4 per cent from 77 per cent in 2010 to 73 per cent in 2011. Satisfaction with hospital services also fell:

• inpatient services: down 4 per cent from 59 per cent in 2010 to 55 per cent in 2011
• outpatient services: down 7 per cent from 68 per cent in 2010 to 61 per cent in 2011
• A&E services: down 7 per cent from 61 per cent in 2010 to 54 per cent in 2011.

Dental services bucked this trend, with satisfaction increasing for the third successive year, up 5 per cent from 51 per cent in 2010 to 56 per cent in 2011. This is likely to reflect improved access to dentists undertaking NHS work in recent years.

John Appleby, Chief Economist at The King’s Fund said: ‘The value of this survey is that it has tracked public satisfaction over a long period, providing an important barometer of how the public view the NHS. The run of year-on-year increases in NHS satisfaction had to come to an end at some stage, and it is not surprising this has happened when the NHS is facing a well-publicised spending squeeze. Nevertheless, it is something of a shock that it has fallen so significantly. This will be a concern to the government given it appears to be closely linked with the debate on its NHS reforms.’

• See the full results of the British Social Attitudes survey
• Read John's blog: Public satisfaction with NHS plummets in 2011