Sharp drop in public satisfaction with the NHS, new analysis shows

The Nuffield Trust and The King's Fund say the results reflect the public’s growing anxieties over the funding and staffing of the NHS.

Press release

Published: 28/02/2018

Public satisfaction with the NHS has dropped 6 percentage points in a year, taking it to 57% - its lowest level since 2011[1]. Meanwhile dissatisfaction in the NHS has risen to 29% - the highest in a decade. That’s according to analysis of the National Centre for Social Research’s (NatCen) British Social Attitudes (BSA) survey, a gold standard measure of public views on the NHS, by the Nuffield Trust and The King’s Fund think tanks. [2]

The survey also revealed a significant drop in satisfaction with GP services, which slumped 7 percentage points to 65%. This is the lowest since the survey began in 1983 and the first time that general practice is not the highest rated service.

While satisfaction across the board remains significantly higher than dissatisfaction, the think tanks say the results reflect the public’s growing anxieties over the funding and staffing of the NHS. The proportion of people citing concerns over NHS staff shortages and a lack of funding as a reason for their dissatisfaction grew in 2017 compared to previous years. At the same time the proportion citing money being wasted in the NHS as a reason for dissatisfaction fell.

Key findings from the survey, which was carried out by NatCen [3] between July and October 2017, include:  

  • The proportion of people who said they were ‘very’ or ‘quite’ satisfied with the NHS fell from 63% in 2016 to 57% in 2017. Those who said they were ‘very’ or ‘quite’ dissatisfied grew from 22% in 2016 to 29% in 2017.
  • The four main reasons for satisfaction were: the quality of care, the fact the NHS was free at the point of use, the attitudes and behaviour of NHS staff and the range of services and treatments available. The four main reasons for dissatisfaction were: staff shortages, long waiting times, lack of funding and government reforms.
  • Overall satisfaction with the NHS was higher among people aged 65 years or older (63%) than among adults under 65 (55%). Between 2016 and 2017, satisfaction fell among all age groups.
  • Satisfaction with GP services fell to 65% in 2017 and inpatient services fell to 55% in 2017. Satisfaction rates in NHS dentistry, NHS outpatient services and A&E remained stable between this year and last year.
  • Satisfaction with social care services was 23% in 2017 and dissatisfaction increased by 6 percentage points in 2017 to 41%.

Professor John Appleby, Chief Economist and Director of Research at the Nuffield Trust, said:

“Despite mounting pressure on the NHS, satisfaction in the health service has remained high in recent years, with satisfaction staying above 60% for most of this decade. In the last year, however, the tide has started to turn. The drop in satisfaction and rise in dissatisfaction this year suggest that the public are worried about the NHS.

“We know that public dissatisfaction is increasingly driven by concerns over funding and staffing levels and they’re right to be anxious. As the NHS celebrates its 70th year, the government needs to put the NHS on a sustainable financial footing so it can continue to provide the same high quality, free at the point of use care that it is valued for by the general public.”

Ruth Robertson, fellow at The King’s Fund, said:

“The drop in public satisfaction with the NHS is significant, especially as it comes amid widespread political concern about the future of the service. Just as striking is that satisfaction with general practice has slumped to its lowest levels since the survey started in 1983. This reflects the huge pressure on general practices, which are struggling to meet growing demand and recruit enough GPs. Given this context, it’s not surprising that public satisfaction with general practice has been in steady decline since 2010.

“Most of the respondents or their family members will have visited the GP in the last year, so the GP satisfaction indicator offers us a rich insight into how people have found their hands-on experience with the NHS and how that compares to previous years and decades.”

Read the full analysis in detail in the report below.


Notes to Editors

  1. Satisfaction in 2017 was 57% and in 2011 it was 58%. However, as the difference between these two years is not statistically significant, we cannot say with absolute confidence that 2017’s number was, in reality, lower than 2011’s.
  2. The main question asked was ‘All in all, how satisfied or dissatisfied would you say you are with the way in which the National Health Service runs nowadays?’ and the response options were ‘very satisfied’, ‘quite satisfied’, ‘neither satisfied nor dissatisfied’, ‘quite dissatisfied’ and ‘very dissatisfied’. Satisfaction as reported here aggregates those who answer 'very' and 'quite' satisfied. It includes those who had recent contact with the NHS and those who had not. The order in which topics are covered in the survey, and the order in which questions on the NHS are asked, have not changed in recent years.
  3. Since 1983, the National Centre for Social Research’s (NatCen) British Social Attitudes (BSA) survey has asked members of the public across England, Scotland, and Wales about their views on, and feelings towards, the NHS and health and care issues generally. The latest survey was carried out between July and October 2017 and asked a nationally representative sample of 3,004 people about their satisfaction with the NHS overall, and 1,002 people about their satisfaction with individual NHS services. The Nuffield Trust and The King’s Fund sponsor the health questions and summarise the headline health results. The King’s Fund will publish further results of the health questions in March and the NatCen will publish further results from the survey in June.
  4. The analysis of the BSA health results was carried out by Ruth Robertson, John Appleby and Harry Evans. It will be published on both the Nuffield Trust and The King’s Fund websites at 0001 on 28 February 2018, with a link to the report from the NatCen website. Previous survey reports can be viewed here:
  5. The Nuffield Trust is an independent think tank aiming to improve the quality of health care in the UK by providing evidence-based research & policy analysis.
  6. The King’s Fund is an independent charity working to improve health and care in England.
  7. The National Centre for Social Research, Britain’s largest independent social research organisation, aims to promote a better-informed society through high quality social research.

For further information, or to request an interview with Prof John Appleby or Ruth Robertson, please contact Leonora Merry or Kirsty Ridyard at the Nuffield Trust on 020 7462 0555/ 020 7462 0552 or email /