Top three findings from the BSA survey 2023
- The 2023 survey recorded the lowest levels of satisfaction since the survey began in 1983 – only 24% of the public are satisfied with the NHS, and only 13% are satisfied with social care.
- Despite low levels of public satisfaction, a large majority of the public still support the principles of the NHS.
- 48% of the public would support the government increasing taxes and spending more on the NHS.
Why are the 2023 findings important?
The BSA survey results enable us to see long-term trends in public satisfaction with the NHS and social care services. In the current social-political-economic context, the 2023 results bring important insight.
Public satisfaction with the NHS and its services is now in uncharted territory.
- The past few years have seen unprecedented drops in overall satisfaction. Since 2020, satisfaction has fallen by 29 percentage points.
- For the first time in the survey’s history, less than a quarter of the public say they are satisfied with the NHS overall, and satisfaction with individual NHS services is at record lows.
The public largely agree on the way forward for the NHS.
- Despite the challenges the NHS is currently facing, the public are not looking for changes to the principles of the NHS. They do not want a different model – they want the one they have got to work. They are clear they want to see improvements in waiting times for services, funding and the number of NHS staff.
- Despite the current challenging economic climate, nearly half of the public (48%) support the government increasing taxes to spend more on the NHS.
Public satisfaction with the NHS and social care in 2023
Satisfaction with the NHS has dropped significantly since 2022, by 5 percentage points. Since 2020, satisfaction has seen an unprecedented drop of 29 percentage points. Dissatisfaction with the NHS is also at a record high, with 52% of respondents dissatisfied.
Satisfaction with all NHS and social care services hit record lows in 2022 and 2023, and dissatisfaction has hit record highs. Satisfaction levels were lowest for social care services, at just 13%.
The three top reasons for dissatisfaction were that there are not enough NHS staff, the government doesn’t spend enough money on the NHS, and it takes too long to get a GP or hospital appointment. These have consistently been the top reasons for dissatisfaction since the question was introduced in 2015. This mirrors what the public think should be priorities for the NHS going forward.
Public support for the principles of the NHS in 2023
Public support for the principles of the NHS in 2023
Despite the low level of satisfaction with the NHS, the public still believe in the principles of the NHS. A large majority agree that the NHS should be available to everyone (82%), free of charge (91%), and primarily funded through taxes (82%).
Public support for the government increasing taxes to pay for the NHS in 2023
Public support for the government increasing taxes to pay for the NHS in 2023
Public support for the government increasing taxes to pay for the NHS in 2023
84% of the public agree the NHS has a funding problem, and 48% would support the government choosing to increase taxes to spend more on the NHS. People with the highest income are significantly more likely to say that they would support the government increasing taxes to spend more on the NHS (62% of the highest income quartile agree).
Other key findings in 2023
Satisfaction with the NHS overall in 2023
- Satisfaction with the NHS was low across all population groups in 2023.
- In 2023, there were no statistically significant differences in satisfaction between supporters of the two main political parties.
- Of those who were satisfied with the NHS, the top reason was because NHS care is free at the point of use (66%), followed by there are a good range of services and treatments available (53%) and the quality of NHS care (52%).
Satisfaction with social care services in 2023
- 13% of respondents said they were satisfied with social care. This is the lowest level of satisfaction recorded since the survey began. 57% were dissatisfied with social care.
- The top reason for dissatisfaction with social care was pay, working conditions and training for social care workers not being adequate (57%), closely followed by people not getting all the social care they need (56%) and there not being enough support for unpaid carers (49%).
Satisfaction with different NHS services in 2023
- 34% said they were satisfied with GP services; the lowest level of satisfaction recorded since the survey began. Since 2019, satisfaction with GP services has fallen by 34 percentage points.
- Satisfaction with NHS dentistry services fell to a record low of 24% in 2023 and dissatisfaction increased to a record high of 48%.
- 35% said they were satisfied with inpatient services; no change from the previous year. 44% said they were satisfied with outpatient services, down 1 percentage point from 2022. Both services remain at record low levels of satisfaction.
- 31% said they were satisfied with A&E services, up 1 percentage point on the previous year, although this is not a statistically significant change.
- Respondents who had used or had contact with a service were more likely to have an opinion of it one way or the other, compared with those who had not had contact with the service.
Further insights and analysis
- There are interesting comparisons between the findings over the past few years and a previous period of low satisfaction.
- When satisfaction with the NHS overall fell in the mid-1990s (dropping to 34% in 1997), satisfaction with individual services remained relatively high (for example, more than 70% of respondents were satisfied with GP services during this period). In the latest results, both satisfaction with the NHS overall and satisfaction with individual services are at record lows (satisfaction with GP services is currently at 34%).
- Another difference is that in the years leading up to the election in 1997, Conservative supporters were significantly more satisfied with the NHS overall than Labour supporters. As we approach an election in 2024, low levels of satisfaction with the NHS overall are now more consistent across the political divide.
- The new government in 1997 initially boosted overall satisfaction levels but satisfaction levels then fell again. It was only when significant investment and reform were put in place in the early 2000s that satisfaction levels rose consistently year on year, reaching a high of 70% in 2010.
What is the BSA?
Other key findings in 2023
Satisfaction with the NHS overall in 2023
- Satisfaction with the NHS was low across all population groups in 2023.
- In 2023, there were no statistically significant differences in satisfaction between supporters of the two main political parties.
- Of those who were satisfied with the NHS, the top reason was because NHS care is free at the point of use (66%), followed by there are a good range of services and treatments available (53%) and the quality of NHS care (52%).
Satisfaction with social care services in 2023
- 13% of respondents said they were satisfied with social care. This is the lowest level of satisfaction recorded since the survey began. 57% were dissatisfied with social care.
- The top reason for dissatisfaction with social care was pay, working conditions and training for social care workers not being adequate (57%), closely followed by people not getting all the social care they need (56%) and there not being enough support for unpaid carers (49%).
Satisfaction with different NHS services in 2023
- 34% said they were satisfied with GP services; the lowest level of satisfaction recorded since the survey began. Since 2019, satisfaction with GP services has fallen by 34 percentage points.
- Satisfaction with NHS dentistry services fell to a record low of 24% in 2023 and dissatisfaction increased to a record high of 48%.
- 35% said they were satisfied with inpatient services; no change from the previous year. 44% said they were satisfied with outpatient services, down 1 percentage point from 2022. Both services remain at record low levels of satisfaction.
- 31% said they were satisfied with A&E services, up 1 percentage point on the previous year, although this is not a statistically significant change.
- Respondents who had used or had contact with a service were more likely to have an opinion of it one way or the other, compared with those who had not had contact with the service.
Further insights and analysis
- There are interesting comparisons between the findings over the past few years and a previous period of low satisfaction.
- When satisfaction with the NHS overall fell in the mid-1990s (dropping to 34% in 1997), satisfaction with individual services remained relatively high (for example, more than 70% of respondents were satisfied with GP services during this period). In the latest results, both satisfaction with the NHS overall and satisfaction with individual services are at record lows (satisfaction with GP services is currently at 34%).
- Another difference is that in the years leading up to the election in 1997, Conservative supporters were significantly more satisfied with the NHS overall than Labour supporters. As we approach an election in 2024, low levels of satisfaction with the NHS overall are now more consistent across the political divide.
- The new government in 1997 initially boosted overall satisfaction levels but satisfaction levels then fell again. It was only when significant investment and reform were put in place in the early 2000s that satisfaction levels rose consistently year on year, reaching a high of 70% in 2010.
What is the BSA?
The British Social Attitudes (BSA) survey is a ‘gold standard’ nationally representative survey that uses a robust methodology to explore public views on a wide range of issues. The King’s Fund and the Nuffield Trust jointly sponsored the 2023 BSA survey attitudes to health and care questions reported here.
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