Public satisfaction with the NHS has fallen to its lowest level since 2007, but overall satisfaction with the NHS was higher among people aged 65 years or older (61%) than among adults under 65 (51%).  

The figures come from the 2018 British Social Attitudes (BSA) survey published today by The King’s Fund and the Nuffield Trust. 

It finds that, following a sharp drop in 2017, public satisfaction with the health service fell by a further three percentage points in 2018 to 53%, its lowest level in over a decade and 16 percentage points below its historical peak of 70 per cent in 2010. The continued fall in satisfaction came despite Prime Minister Theresa May’s announcement last June – just before the interviews for the survey were undertaken – of a £20bn long-term funding boost for the health service.  

The think tanks’ analysis also reveals that public satisfaction with general practice has declined over the past decade. In 2018, it remained at its lowest level since the survey began in 1983 (63%), while dissatisfaction with general practice remained at its highest level since the survey began. Almost a quarter (24%) of respondents reported being dissatisfied with their GP service – double the level of dissatisfaction in 2009. 

The survey, carried out by the National Centre for Social Research (NatCen), is seen as a gold standard measure of public attitudes.

The founding principle of the NHS, that it is free at the point of use, remains one of the primary reasons people are satisfied with the NHS (selected by 62% of satisfied respondents). The survey also reported an increase over the past three years in the proportion of people who cited quality of NHS care as a reason for their satisfaction (71%).  Concerns over waiting times, NHS staff shortages and inadequate funding remained the top three reasons people gave for being dissatisfied with the NHS in 2018. 

Other key findings from the survey, which was carried out by NatCen between July and October 2018, include: 

  • Satisfaction with hospital services has fluctuated in recent years, but in 2018 an 8 percentage point increase in satisfaction with inpatient services takes it to its highest level since 1993 (63%) and a 5 percentage point increase in satisfaction with outpatient services takes it to the highest level since the survey began (70%).  
  • Satisfaction with both inpatient and outpatient hospital services was higher among those who have used those services recently or have friends or family members who have done so than among those who had no contact with inpatient services by either themselves or their friends and family.  
  • Satisfaction with NHS dentistry, accident and emergency departments and social care did not change significantly between 2017 and 2018. Satisfaction with social care provided by local authorities remains far lower than satisfaction with NHS services.   
  • There is a divergence of views between supporters of the two main political parties: 58% of supporters of the Conservative party were satisfied compared to 51% of supporters of the Labour Party.  

Ruth Robertson, Senior Fellow at The King’s Fund said: "In the short term at least, the promise of more money doesn’t appear to buy satisfaction. The public identified long-standing issues such as staff shortages and waiting times amongst the main reasons for their dissatisfaction and cash alone will not solve these."

Professor John Appleby, Director of Research and Chief Economist at The Nuffield Trust, said: "Satisfaction with general practice – historically the service people were most satisfied with – has been falling for the past decade and is now at its lowest since the BSA survey began over 30 years ago. This may reflect continued strain on general practice, with mounting workloads and staff shortages and the evidence shows that people are finding it harder to get appointments than before. The NHS long-term plan expects even more of general practice – these problems will need to be addressed quickly if that vision is to be made possible."