Public perceptions of the NHS in 2020

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Part of Public satisfaction with the NHS

The British Social Attitudes survey has provided years of insight into public perceptions of the NHS. In 2020, in the midst of the Covid-19 pandemic, the survey asked only one question about health and care issues. Here, Dan Wellings and John Appleby share the data collected. 

Since 1983, the National Centre for Social Research’s (NatCen) British Social Attitudes (BSA) survey has asked members of the public – rather than only patients – in England, Scotland and Wales about their views on the NHS and health and care issues generally. Due to the Covid-19 pandemic, the usual methodology of the BSA was adapted and the survey was conducted online rather than face to face. Only one question was asked about overall satisfaction with the NHS. Changes in the survey method mean that comparisons over time need to be considered with caution (see box below for more details).

During October and November 2020 NatCen asked 1,275 members of the public about their satisfaction with the NHS overall.  

Overall satisfaction with the NHS in 2020

Bearing in mind the health warning about comparing the 2020 survey with previous years, when asked, ‘All in all, how satisfied or dissatisfied would you say you are with the way in which the National Health Service runs nowadays?’, 53 per cent of respondents said they were very or quite satisfied, a drop of 7 percentage points between 2019 and 2020 (a statistically significant change).  

Within this, the biggest fall was those people saying they were very satisfied (a drop from 17 per cent to 12 per cent). The percentage saying they were very or quite dissatisfied remained more or less unchanged, and those saying they were neither satisfied nor dissatisfied rose by 7 percentage points. 

BSA 2020 F1 overall trend

The survey data also allows us to look at the differences in satisfaction according to political affiliation. Satisfaction among Conservative supporters remained higher than among Labour supporters though overall satisfaction with the NHS fell for both groups – from 59 per cent satisfied in 2019 to 53 per cent in 2020 for Labour supporters (though this is not statistically significantly different) and from 68 per cent in 2019 to 57 per cent in 2020, for Conservative supporters (which is statistically significant). 

BSA 2020 F2 overall trend

As we have noted in previous BSA survey analyses, pinpointing exactly why satisfaction changes from year to year is difficult. Given the changes in methodology this year and the pace with which public opinion has been changing over the course of the pandemic, we will not be providing commentary or analysis on the 2020 results. 

The health and care system faces a hugely difficult time as it tackles a third wave of Covid-19, delivers the largest-ever vaccination programme in its history and addresses an acceleration in the backlog of people waiting for care – starkly reflected in some of the longest waiting lists and times in many years. 

The public reaction to how well the NHS (and government) manage these pressures will be revealed as the full set of health and care questions is asked in the 2021 BSA survey. The King’s Fund and the Nuffield Trust will sponsor these questions, and results will be published, with commentary, in 2022.



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