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Public dissatisfaction with the NHS grows

The latest NatCen Social Research British Social Attitudes (BSA) survey has revealed a fall in public satisfaction with the NHS and an increase in public dissatisfaction. The BSA survey has been carried out every year since 1983 and is therefore able to reveal insight into the public's view of the service not available elsewhere. 


The King's Fund and Nuffield Trust jointly sponsored the survey questions and have analysed the responses.  They report a fall in satisfaction with the NHS overall of 6% (to 57%) and at the same time a 7% increase in dissatisfaction with the NHS (to 29%), its highest level since 2007. As a result, net satisfaction (calculated as satisfaction minus dissatisfaction) is also at its lowest level since 2007.


Inpatient services and GP services both fell in the satisfaction ratings, whilst the change in satisfaction for outpatient services, A&E, dentistry services and social care services was not statistically significant.


The reasons people gave for their responses will come as a surprise to few people. Top reasons for satisfaction were the quality of care, the fact the NHS is free at the point of use, the attitudes and behaviour of NHS and the range of services and treatments available. Topping the list of reasons for being dissatisfied with the NHS overall were staff shortages, long waiting times, lack of funding and government reforms. 


This is encouraging, because dissatisfaction is driven by negative views of resourcing, not negative views of the core principles of the NHS. In fact, the polling shows that the public's support for the underlying principles of the NHS is unwavering, but its satisfaction with the service is not as constant.


The survey results also reveal negative views around how money is spent in the NHS, although on examination of the trends this perception is improving. Of those who were very or quite satisfied with the NHS overall only 4% felt that money is spent wisely. Of those stating they were very or quite dissatisfied with the NHS, 25% said they felt money is wasted in the NHS (down from 35% in 2015). The issues that have been growing in significance over the last three years of the survey are lack of funding, staff shortages and government reforms.


Stories in the media had the smallest influence on those polled - regardless of whether they were satisfied or dissatisfied.


The King's Fund and Nuffield Trust analysis concludes that the public is increasingly aware of the reality of funding pressures that the NHS has experienced over the last seven years and that with only small increases in funding planned for the next few years and performance on key headline measures worsening, it is hard to see satisfaction levels improving in the near future. 


The survey was carried out between July and October 2017 and asked a nationally representative sample of 3,004 adults in England, Scotland and Wales about their satisfaction with the NHS overall, and 1,002 people about their satisfaction with individual NHS and social care services.