Public satisfaction with the NHS and social care in 2025: Results from the British Social Attitudes survey

Also see our blog looking at what the latest results mean:
Glimmers of light but no new dawn in public satisfaction with the NHS.

Key findings

Satisfaction with the NHS

• In 2025, 26% of British adults were ‘very’ or ‘quite’ satisfied with the way in which the NHS runs – a statistically significant 6 percentage point increase from 2024.
• Around half of respondents (51%) were dissatisfied with the NHS in 2025, a statistically significant fall of 8 percentage points compared to 2024 when it was 59%.
• This is the first increase in satisfaction since 2019, and the largest fall in dissatisfaction in more than 25 years.
• People under 35 (20%), supporters of Reform (20%) and people in Wales (18%) were significantly less satisfied with the NHS than the survey average.
• Despite the increase in satisfaction only 16% of respondents thought the standard of NHS care would improve in the next 5 years compared to 53% who said they expected care to get worse.

Satisfaction with different NHS services

• Satisfaction with GP services was 35% and dissatisfaction was 45%. Neither was a statistically significant change on the previous year.
• Just over 1 in 5 respondents (22%) said they were satisfied with NHS dentistry, with 54% saying they were dissatisfied. These are similar results to the previous year.
• 22% of respondents said they were satisfied with A&E services. Dissatisfaction was 53%. In 2024, 19% said they were satisfied with A&E services, although the change is not statistically significant.
• 37% of respondents were satisfied with inpatient and outpatient hospital care, an increase of 5 percentage points since 2024, although not statistically significant. 29% were dissatisfied – no change on last year.

Attitudes to NHS standards, access and staffing

• Half of respondents (50%) were satisfied with the quality of NHS care in 2025, and 28% were dissatisfied. There was no statistically significant change since 2024.
• Only a minority of respondents were satisfied with waiting times for GP appointments (27%), hospital appointments (16%) and in A&E (14%). There were no statistically significant changes compared to last year.
• Only 12% agreed that ‘there are enough staff in the NHS these days’. 71% disagreed.
• There was no significant change compared to 2024.

Attitudes to NHS financing and efficiency

• 9% of respondents said that the government spent too much or far too much money on the NHS, 22% said that it spent about the right amount and 66% said that it spent too little or far too little. There were no statistically significant changes compared to 2024.
• Only 13% of respondents agreed that the NHS spends the money it has efficiently. 55% disagreed with this statement. There was no change compared to 2024.
• When asked about government choices on tax and spending on the NHS, the public remain closely divided between raising taxes and spending more on the NHS (45%) and keeping taxation and spending at the same level (43%). Only 8% would choose to cut taxes and spend less on the NHS. There was no statistically significant change since 2024.
• Supporters of the Green party (70%) and the Labour party (57%) were significantly more likely to support higher taxes and higher NHS spending than supporters of Reform (32%) and the Conservative party (30%).

NHS priorities and principles

• On being asked what the top three most important priorities for the NHS should be, both making it easier to get a GP appointment and improving A&E waiting times were selected as top priorities by 46% of respondents, followed by 45% for waiting times for planned operations and 43% for increasing the number of NHS staff.
• People aged 18–64 were more likely than those aged 65 and over to prioritise A&E waiting times (48% vs 38%) and increasing NHS staff (46% vs 35%) whereas those aged 65 and over prioritised prevention and staying healthy (48% vs 36%).
• As in previous years, a large majority of respondents agreed that the founding principles of the NHS should ‘definitely’ or ‘probably’ apply in 2025: that the NHS should be free of charge when you need to use it (89%), the NHS should primarily be funded through taxes (81%) and the NHS should be available to everyone (74%).
• There has been some decrease across the past five years in the proportion who think these principles should ‘definitely’ or ‘probably’ apply since the questions were first asked in 2021. The greatest decrease over time has been support for the principle that ‘the NHS should be available to everyone’.
• Support for the principle that the NHS should be available to everyone varied significantly by supporters of different political parties, with 68% of Labour supporters agreeing this principle should ‘definitely’ apply compared to 45% of Conservative supporters and 30% of Reform supporters.

Social care

• In 2025, 14% of respondents said they were satisfied with social care. 49% were dissatisfied with social care – a statistically significant decrease from 2024 when this figure was 53%.
• The top three priorities for social care were helping people stay independent at home for as long as possible (46%), making social care more affordable to those who need it (45%) and improving the quality of social care services (44%).
• When asked about government choices on tax and spending on social care, 51% said the government should keep taxes and spending on social care at the same level as now. 38% said the government should increase taxes and spend more on social care. 6% said the government should reduce taxes and spend less on social care.
• Support for increasing taxes and spending more on social care was lower than for the NHS – it was 45% for the NHS. The difference was statistically significant.

Introduction and context

Introduction

The British Social Attitudes Survey (BSA) is a ‘gold standard’, nationally representative survey that uses a robust methodology to explore public views on what it is like to live in Britain and how respondents think the country is run. Since 1983, National Centre for Social Research (NatCen), which carries out the survey, has been asking the British public their views on health and social care services. The King’s Fund and the Nuffield Trust jointly sponsor these questions to measure and track the public’s views over time.

The BSA methodology uses random probability sampling to select British households to take part. Since 2020 the BSA survey interviews have been conducted primarily online with a telephone option also available: households receive a letter inviting up to two adults to take part online, or over the phone if they prefer.

The core elements of the survey remain the same and have done since 1983. Keeping consistency over time is key to ensure comparability year on year. The main questions regarding overall satisfaction with the NHS have not changed since the survey began, but new questions have been added to reflect new areas of interest, such as views on social care.

In 2024 new questions were introduced to allow better analysis of people’s satisfaction with aspects of the NHS – including views on staffing and quality of care, and efficiency and funding. These questions were asked again in 2025. For the 2025 survey, new questions have been added on expectations for NHS care over the next five years, government priorities for social care and options for tax and spending on social care. A question on contact with NHS and social care services has also been reintroduced in a new format.

Context

The NHS in 2024 and 2025

2025 marked the first full year of a Labour government since 2009, during which the new administration sought to establish its policy priorities against a backdrop of continued economic pressure, ongoing political turbulence and uncertainty in the international environment. The most recent BSA survey was carried out between 26 August and 6 October 2025, shortly after the publication of the government’s 10 Year Health Plan and amid continued concern about waiting times for NHS care.

Public debate on the NHS during the months running up to the 2025 fieldwork was characterised by persistent pressures on health and care services, industrial action in the NHS workforce and a political drive for reform. Whereas the 2024 fieldwork took place amid ministers claiming the NHS was ‘broken’ (Streeting 2024), the 2025 fieldwork was carried out as politicians implored the NHS to ‘reform or die’ (Department of Health and Social Care 2025a).

Rhetoric around funding echoed this narrative, with the Prime Minister stating in 2024 that the NHS would not receive more funding without reform. Despite annual budget increases of £22 billion announced at the 2024 Autumn Budget and £29 billion at the June 2025 Spending Review, in 2025 NHS spending remained below its historic long-run average and large cuts were announced to NHS bodies as part of reform plans.

The government’s 10 Year Health Plan for England sought to outline a vision for the reformed NHS of the future, based on three shifts in how care is delivered and backed by significant structural changes to the organisation of the NHS. The BSA findings themselves were referenced in the plan as part of the evidence base demonstrating diminished public confidence that the plan aimed to address, and NHS England Chief Executive Jim Mackey commented on a ‘growing disconnect between the service and the population’.

The public’s view on the NHS was more nuanced: the largest public engagement exercise ever undertaken on the NHS, carried out as part of the government’s Change NHS programme, suggested that dissatisfaction with performance coexisted with strong attachment to the principles of the NHS. Participants often reported positive experiences of care once they accessed it but frustrations about a service hampered by slow processes, poor co-ordination between services and patchy communications with patients.

Staff reported similar tensions. Contributions from NHS staff to the Change NHS engagement exercise reflected commitment to the values and principles of the NHS but frustration with workload, administrative burdens and staffing levels. These issues were prominent alongside the issue of pay in the resident doctors’ dispute, which saw strikes during 2024 and into 2025.

Meanwhile, findings from the GP Patient Survey suggested improvements in patient experience with GP services (NHS England 2025), while the Adult inpatient survey showed similar improvements in people’s experience of hospital care (CQC 2025). There have been signs of increases in NHS productivity and some positive news about waits for hospital care as the number of people waiting for planned NHS treatment stabilised, albeit at a high level (Department of Health and Social Care 2025b). By the time the fieldwork was underway in September 2025, the waiting list for planned care was 7.39 million, a drop of around 200,000 on the year before.

The Scottish and Welsh governments pursued their own reform agendas but against a similar backdrop of operational pressures, long waiting times and staffing concerns. While industrial action in the devolved nations was less sustained than in England, similar concerns persisted.

Social care in 2024/25

Financial pressures and aspirations for reform were also part of the story for adult social care in the months before the survey was carried out. In England, the government announced the establishment of an independent commission on adult social care, chaired by Baroness Casey, alongside commitments to develop a fair pay agreement for the care workforce. But by the time of the 2025 fieldwork, the commission had only been announced and substantive reform had yet to begin.

In the meantime, the social care sector continued to face significant financial and operational pressures. The announcement of higher employer National Insurance Contributions at the 2024 Autumn Budget caused experts and providers to warn of real risks to the viability of social care providers.

In Scotland, proposals for a National Care Service had not yet resulted in major changes to service delivery by the time of the 2025 fieldwork, while in Wales policy attention focused on strengthening community-based care and integration with health services. Across all nations there were concerns about provider sustainability, access to services and the capacity of the care workforce to meet growing need.

About this report

This report presents findings from the 2025 British Social Attitudes survey on public attitudes to the NHS and social care. It examines satisfaction with the NHS overall and with individual services, alongside views on standards of care, access to services and staffing levels.

Subsequent chapters consider public attitudes towards NHS funding and finance, and towards priorities and principles for the future of the service. The final chapter focuses on satisfaction with social care. Together, these chapters provide insight into how the public viewed health and care services in 2025 and the issues shaping those views.

How satisfied is the British public with the NHS overall?

Overall satisfaction with the NHS

For 42 years, the BSA survey has asked a representative sample of the public how satisfied or dissatisfied they are ‘with the way in which the NHS runs nowadays’. In 2025 this question was asked to 3,464 respondents.

In 2025, 26% of the public were ‘very’ or ‘quite’ satisfied with the NHS (Figure 1), roughly equivalent to just 1 in 4 people in Britain being satisfied. Only 4% of respondents were ‘very’ satisfied. The rise in overall satisfaction represents a statistically significant increase of 6 percentage points ¹ compared to 2024, when overall satisfaction was 21%. This was the first increase in satisfaction since 2019. The recent increase in satisfaction reverses the downward trend seen between 2019 and 2024, when overall satisfaction fell by 39% points to the lowest levels of satisfaction ever recorded.

The increase in satisfaction mirrors a decline in dissatisfaction with the NHS in 2025. In 2025, 51% of respondents were ‘very’ or ‘quite’ dissatisfied. This is a statistically significant drop of 8 percentage points compared to 2024, when dissatisfaction was 59%. This is the second largest fall in dissatisfaction in the survey’s history. The largest fall in dissatisfaction was between 1997 and 1998, when dissatisfaction fell by 14 percentage points.

How does satisfaction and dissatisfaction vary by population group?

The BSA survey provides the opportunity to analyse results broken down by different population groups: age, sex, household income, country and political affiliation (see methodology for definitions). In this section we look at how satisfaction and dissatisfaction varied among these groups in 2025 and how satisfaction has changed since 2024.

In 2025, satisfaction and dissatisfaction with the NHS varied by population groups. Satisfaction was low across all population groups (Figure 2). However, there was a clear relationship between satisfaction and age. A significantly higher proportion of people aged 65 and over (35%) were satisfied. This remained statistically significant when controlling for other factors, including controlling for contact with NHS services in the past 12 months. People aged between 35 and 64 were significantly less satisfied (26%) compared to those aged 65 and over. People under 35 were significantly less satisfied (20%) compared to the survey average and compared to both older age groups.

Reform supporters (20%) were significantly less satisfied than the survey average, which remained statistically significant when controlling for other factors like age and sex. Labour (33%) and Liberal Democrat supporters (35%) were significantly more satisfied than average. Supporters of the Conservatives (30%) and Greens (25%) were not significantly different from the average.

Supporters of the governing political party have historically reported higher satisfaction than supporters of the official opposition party. This pattern was not true in 2024 but has returned in 2025 – Labour supporters were more satisfied with the NHS than Conservative supporters, although this difference was not statistically significant.

A significantly lower proportion of people in Wales (18%) were satisfied with the NHS than the survey average. This remained statistically significant when controlling for other factors. People in Scotland (33%) were significantly more satisfied than people in Wales, but not compared to people in England (26%).

Levels of dissatisfaction were similar across different population groups. Only Reform supporters (60%) and people from households with the highest income (58%) were significantly more dissatisfied compared to the average.

Changes in satisfaction from 2024 by population group

Between 2024 and 2025 satisfaction increased in almost all population groups (Figure 4), although the increase was only statistically significant for some groups. There was a significant increase in satisfaction for respondents aged 65 and over and those aged 35–64. The same was true of white respondents, both male and female respondents, respondents from the second highest household income and supporters of the Labour party and the Liberal Democrats. While satisfaction increased in Wales, Scotland and England the only one of these where the change was statistically significant was England.

Attitudes towards the standard of care in next five years

In 2025, respondents were asked ‘Thinking about the general standard of care of the NHS, over the next five years do you expect this to get better or worse?’. The majority of respondents (53%) said they expected care to get worse, including 15% saying ‘much’ worse. Only 16% said they expected care to get better, including 2% saying ‘much’ better. 29% said they expected care to be ‘about the same’.

This question had previously been asked between 2011 and 2019. The proportion of people saying better was lower in 2025 than any previous year when the question has been asked (Figure 5).

Of the respondents who said they were satisfied with the NHS, 30% still said they expected NHS care to get worse or ‘much’ worse, and 39% said it would stay ‘about the same’. Labour supporters were significantly more optimistic (28% said better or ‘much’ better) than the survey average, and Reform supporters were significantly more pessimistic (only 9% said better or ‘much’ better).

How satisfied is the British public with different NHS services?

NHS services

In addition to asking about overall satisfaction with the NHS and social care, the BSA survey also asks a smaller sample of respondents how satisfied they are with different NHS services: general practice, NHS dentistry, A&E services, and inpatient and outpatient services. In 2025 this smaller sample group was 1,460 respondents.

Figure 6 summarises the results from the 2025 survey’s questions on individual services.

In 2025, satisfaction with all four NHS services remained close to historic lows – and equally dissatisfaction remained at or close to historic highs. Each service did see overall satisfaction increase compared to 2024, but none of these changes were statistically significant, meaning that we cannot be confident that these increases represent a real change in the public’s views.

GP services

Overall satisfaction with GP services was 35% and dissatisfaction was 45%. While neither was a statistically significant change on the previous year when GP satisfaction was 31%, this does represent the highest level of GP satisfaction since 2021 and ends the downward trend of the past few years.

Analysis by age groups reveals that respondents aged 65 and over were significantly more likely (43%) to be satisfied with GP services than the 18–64 age group (33%). The least satisfied group were those under 35, with just 31% ‘very’ or ‘quite’ satisfied.

NHS dentistry

Just over 1 in 5 respondents (22%) said they were ‘very’ or ‘quite’ satisfied with NHS dentistry, with 54% saying they were ‘very’ or ‘quite’ dissatisfied. These are similar results to the previous year, meaning that satisfaction with NHS dentistry remains close to the lowest level recorded since the survey began.

While there were no significant differences between the age groups, analysis reveals that Scottish respondents are significantly more satisfied (40%) with NHS dentistry than both English (21%) and Welsh (14%) respondents. Scottish respondents were more satisfied than dissatisfied with NHS dentistry, in sharp contrast to English and Welsh respondents who were significantly more dissatisfied than satisfied.

A&E services

Satisfaction with A&E services also remained close to historic lows, with just 22% of respondents ‘very’ or ‘quite’ satisfied. Dissatisfaction was 53%. In 2024, 19% said they were satisfied and 52% said dissatisfied – neither change was statistically significant.

Respondents aged 65 and over were significantly more likely to be satisfied with A&E services than both under-65 age groups (30% of those 65 and over were satisfied, compared to 21% for those aged 35–64 and 18% for those under 35). Dissatisfaction was significantly higher in both under-65 age groups (57% for those under 35 and 55% for 35–64 compared to 42% for those over 65).

Scottish respondents were significantly more satisfied (40%) with A&E services than English (21%) and Welsh (14%) respondents.

Inpatient and outpatient services

The survey asked respondents if they were satisfied with the way both inpatient and outpatient services were run (a change implemented in 2024; previously these services were asked about separately). Satisfaction with these services was highest of all four services asked about, with 37% of respondents ‘very’ or ‘quite’ satisfied with these services. 29% were ‘very’ or ‘quite’ dissatisfied. In 2024, 32% were satisfied while 28% were dissatisfied. Neither year-on-year change was statistically significant.

There were statistically significant age differences here, with those over 65 more likely to be satisfied (50%) versus those aged 35–64 (35%) or under 35 (28%). It is too early to tell whether 2025 marked a turning point in satisfaction with individual services – and the lack of statistically significant change in satisfaction with NHS services makes it difficult to draw firm conclusions. But, as Figure 7 below shows, 2025’s findings did not see the same pattern of continued declines in service satisfaction that have been a feature of every survey since the pandemic.

Contact with NHS services

The BSA survey is not a patient experience survey – it tracks changes in public attitudes towards the NHS and social care, not how they have experienced specific services. Other surveys – like the GP Patient Survey – fulfil that role.

However, it is likely that respondents will, in many cases, be drawing on their own experiences if they have had recent contact with the NHS. People who have not had contact with the NHS will rely on more indirect information, such as media or social media coverage or anecdotal evidence from friends and family. So, does contact with the NHS affect how satisfied or not people are with it?

Between 2019 and 2023, the BSA survey asked the public whether they had used or had contact with individual NHS services in the previous 12 months, either for themselves or for someone else. In each of those four years, the service with which people had most contact was – unsurprisingly – general practice, with more than 80% of respondents reporting contact. The service where respondents reported least contact was inpatient services (just 24% in 2023). Across the surveys, this question revealed that people who had had contact tended to feel more strongly about the NHS – respondents who had contact were less likely to answer ‘neither satisfied nor dissatisfied’ with the service than those who had no contact.

In 2025, this question was simplified to ask respondents whether they had used or had contact with NHS services in the past 12 months (rather than individual services), either for themselves or someone else. The survey found that 87% of respondents reported contact with NHS services. Use of the NHS increased with age: 80% of those under 35, 88% of those aged 35–64 and 93% of those aged 65 and over said they had used or had contact with the NHS in the previous 12 months.

Figure 8 below shows that satisfaction was significantly higher among those who had contact with the NHS than those that had not, with 27% of those who had experienced the NHS, either for themselves or someone else, saying they were ‘very’ or ‘quite’ satisfied with the way the NHS runs, compared to just 16% of those who had no contact. There were no statistically significant differences in dissatisfaction between those who had and had not had contact with the NHS. Perhaps unsurprisingly, those who had not had contact with the NHS were more likely to say they were neither satisfied nor dissatisfied or did not know.

Attitudes to standards, access to services and staffing in the NHS

Since 2024 the BSA has asked respondents their attitudes to different aspects of NHS care, including quality of care, waiting times for care and the levels of staffing. There were no statistically significant differences between 2024 and 2025 across any of these aspects.

Quality

Of all the aspects of care asked about, the quality of care had the highest levels of satisfaction. Overall, 50% were satisfied with the quality of care in 2025, including 15% who were ‘very’ satisfied (Figure 9). People who have had contact with the NHS were more likely to be satisfied with the quality of care (54%) compared to people who have not had contact (30%). Overall, 28% of respondents were dissatisfied with the quality of care, including 10% who were ‘very’ dissatisfied.

Waiting times

In 2024 and 2025, respondents were asked about their satisfaction with waiting times for three aspects for care:

• the length of time it takes to get an appointment at a GP practice
• the length of time it takes to get hospital care
• the length of time it takes for someone to be seen in A&E.

Across all three, the levels of satisfaction were significantly lower than for quality of care. 27% of people were satisfied with the length of time it takes to get an appointment at a GP practice, 16% were satisfied with the length of time it takes to get hospital care and just 14% were satisfied with the length of time it takes for someone to be seen in A&E (Figure 10). More than half of respondents were dissatisfied with the length of time it takes to get an appointment at a GP practice (58%), 63% were dissatisfied with the length of time it takes to get hospital care and 66% were dissatisfied with the length of time it takes for someone to be seen in A&E.

Of the respondents who were satisfied with the NHS overall, a large proportion were still dissatisfied with waiting times for GPs (30%), hospital appointments (29%) and in A&E (40%).

Respondents aged 65 and over were more likely to be satisfied with waiting times for GP appointments (33% versus 25%) and hospital appointments (24% versus 13%), compared to those under 65.

There were no significant differences in satisfaction with waiting times by supporters of different political parties.

Staffing

In 2024 and 2025, respondents were asked whether they agreed or disagreed with the statement: ‘There are enough staff in the NHS these days’. Most respondents (71%) disagreed with the statement and only 12% agreed. This has not changed significantly since the previous year (Figure 11).

Supporters of Reform were significantly more likely to agree (22%) that there were enough staff and Green supporters were significantly less likely to agree (3%).

Attitudes to NHS financing and efficiency

In recent years, we have added questions to the BSA survey to explore public attitudes to NHS finance and funding in greater depth. We have asked for views on taxation since 2023, and on whether enough was spent, and whether it was spent efficiently, since 2024.

These questions were repeated in 2025 to examine any changes following a year of painful fiscal decisions for the UK, and a Spending Review granting extended funding increases to the health service. The results show relatively stable views on each question, with no statistically significant changes.

Government spending

The survey asked respondents whether they believed that government was spending too much or too little money on the NHS. 9% said that the government was spending ‘too much’ or ‘far too much’, 22% that it was spending about the right amount and 66% that it was spending ‘too little’ or ‘far too little’. This was not significantly different to the result the previous year, where 8% answered ‘too much’, 21% the ‘right amount’, and 69% ‘too little’ (Figure 12).

The view that the government spent too much or far too much on the NHS was significantly more likely to be held by supporters of the Reform party (21%) and Conservative party (15%), compared to supporters of the Labour party (4%).

The view that too little was spent on the NHS was significantly more likely to be held by respondents in Scotland (80%) compared to England (64%).

From 2014 to 2023 (except in 2020), the BSA survey included a question on whether the NHS was ‘facing a funding problem’. In 2014, 72% of respondents believed that the health service faced a ‘severe’ or ‘major’ funding problem: this rose to 80% the following year and remained above 80% for each subsequent year to 2023.

Efficiency

The survey asked respondents if they agree that the NHS spends the money that it does have efficiently. 55% disagreed or strongly disagreed, while 13% agreed or strongly agreed, and 30% neither agreed nor disagreed (Figure 13). These results were not significantly different to results for the same question in 2024.

Respondents aged 65 and over were significantly more likely to disagree that the NHS spends money efficiently (63%) relative to those under 65 (53%). Supporters of the Reform party were significantly more likely to disagree (72%) than supporters of Labour (50%) or the Green party (45%).

Tax

For the third consecutive year, the survey asked people whether, if they had to choose, they would rather reduce taxes and spend less on the NHS, keep taxes and spending on the NHS at the same level as now or increase taxes and spend more on the NHS. 45% said that they would choose to raise taxes and spend more, 43% would choose the same level, and 8% said that they would choose to cut both taxes and spending (Figure 14).

This picture, with most people closely divided between taxing more to spend more and the status quo, has changed little. There was no statistically significant difference to the previous year.

Supporters of the Green party (70%) and the Labour party (57%) were significantly more likely to support higher taxes and higher NHS spending than supporters of the Conservative party (30%) and Reform (32%). Conversely, support for cutting tax and NHS spend was highest among supporters of Reform, but even here support reached only 17%.

Respondents were significantly more likely to favour increasing taxes to spend more on the NHS if they were over the age of 65 (53%), rather than in working-age groups (42%).

NHS priorities and principles

NHS priorities

Since 2021, respondents have been asked to select up to three priorities for the NHS (Figure 15). In 2025, the most frequently chosen priorities were ‘making it easier to get a GP appointment’, and ‘improving waiting times in accident and emergency (A&E)’. Both priorities were selected by 46% of respondents. ‘Improving waiting times for planned operations’ (45%) and ‘increasing the number of staff in the NHS’ (43%) followed close behind. There were no significant changes year on year in the proportion choosing each priority. Furthermore, the order in which respondents ranked each priority did not change between 2024 and 2025.

In 2025, some priority choices differed significantly by age group. People aged under 65 were more likely than those aged 65 and over to select ‘improving waiting times for accident and emergency (A&E)’ (48% compared to 38%) and ‘increasing the number of staff in the NHS’ (46% compared to 35%). By contrast, people aged 65 and over were more likely to select ‘helping people stay healthy and preventing illness’ than those under 65 (48% compared to 36%). Unlike in 2024, there were no significant age differences in selecting ‘improving mental health services’ and ‘improving waiting times for planned operations’ in 2025.

There were also some significant differences by supporters of different political parties. Compared to the survey average, supporters of Labour were more likely to choose ‘improving the health of the most disadvantaged’ (25%), Liberal Democrat supporters were more likely to say ‘helping people stay healthy and preventing illnesses’ (57%), and Green supporters were more likely to say ‘increasing the number of NHS staff’ at 56% and ‘improving mental health services’ (48%).

NHS principles

In questions first introduced in 2021, people were asked about the extent to which they thought the founding principles of the NHS should still apply today. These principles are that the NHS should be:

• free of charge when you need to use it
• available to everyone
• primarily funded through taxes.

In 2025, 89% said that the NHS should ‘definitely’ (69%) or ‘probably’ (20%) be free of charge when needed. 74% said that it should ‘definitely’ (54%) or ‘probably’ (19%) be available to everyone. 81% answered that the NHS should ‘definitely’ (45%) or ‘probably’ (36%) be funded through taxes (Figure 16).

25% of respondents said that the principle of the NHS being available to everyone should ‘definitely’ or ‘probably’ not apply, and 16% of respondents believed the tax funding principle should ‘definitely’ or ‘probably’ not apply. Just 9% stated that the NHS being free of charge should ‘definitely’ or ‘probably’ not apply.

While there has been no statistically significant change since 2024 there has been a decline in the proportion who say the principles should ‘definitely apply’ since the questions were first asked in 2021.

As in previous years, there were significant differences between supporters of different political parties in 2025. Looking at differences in the number of people who said each principle should ‘definitely’ apply, most Labour supporters believed that the NHS being free at the point of use should ‘definitely’ apply (78%), while just 59% of Conservative supporters and 61% of Reform supporters agreed.

There was no significant difference in the proportion of Conservative and Labour supporters who believed NHS funding through tax should ‘definitely’ apply (43% and 56% respectively). However, compared to Labour supporters, a significantly smaller proportion of Reform supporters (36%) thought this principle should ‘definitely’ apply.

Differences between Labour, Conservative and Reform supporters for the principle ‘the NHS should be available to everyone’ were especially pronounced. 68% of Labour supporters thought this principle should ‘definitely’ apply, which was significantly higher than the proportion of Conservative supporters (45%). The proportion of Reform supporters who thought this principle should ‘definitely’ apply (30%) was significantly lower than that of both Labour and Conservative supporters.

How satisfied is the British public with social care?

Social care satisfaction

The BSA survey asks respondents about their satisfaction with social care services aimed at those who need assistance due to illness, disability or old age.

In 2025, 14% of respondents said they were ‘very’ or ‘quite’ satisfied with social care, including 2% who said they were ‘very’ satisfied (Figure 17). In 2024, 13% of respondents were ‘very’ or ‘quite’ satisfied – the change is not statistically significant.

49% said they were ‘very’ or ‘quite’ dissatisfied with social care – a statistically significant decrease from 2024 when this figure was 53%. In 2025, 17% said they were ‘very’ dissatisfied while 32% said they were ‘quite’ dissatisfied. The proportion saying neither satisfied nor dissatisfied has risen over the past few years from 27% in 2022 to 34% in 2025.

How does dissatisfaction vary by population group?

This section focuses on the respondents who said they were dissatisfied with social care. This is a much larger group of people than those who said they were satisfied, allowing for more meaningful estimates of population differences. Figure 18 shows how dissatisfaction differed among different population groups and from the average for the whole survey.

As with the overall NHS question the increased sample size for the satisfaction with social care allows a more in-depth analysis of differences between groups where these exist. The only statistically significant differences between different demographic groups this year were that black respondents were less likely to be dissatisfied (28% dissatisfied compared to the survey average of 49%) and that those in the highest weekly income group were more likely to be dissatisfied with social care (57%) compared to the average.

In line with the results from 2024 there were no significant differences between those under 65 and those aged 65 and over, nor were there any differences by gender. There were no significant differences between supporters of different political parties.

Despite a significant fall in dissatisfaction in the overall sample, there were no significant falls in dissatisfaction by population group between 2024 and 2025.

Contact

Respondents were asked whether they had contact with social care in the previous 12 months either for themselves or for someone else. 15% of respondents said they had had contact with social care in the previous 12 months. There were no differences by age on this.

Overall, respondents who had used or had contact with social care either for themselves or for someone else were, unsurprisingly, more likely to have an opinion about it than those who had not used it. Those who had contact were more likely to be satisfied. 20% of those who had contact were satisfied compared to 12% of those who had not had contact. 54% of those who had contact were dissatisfied compared to 46% of those who had not had contact (Figure 19).

Priorities

A new question was introduced in 2025 that asked people what they thought the most important priorities for social care should be. This question replaced a previous question last asked in 2023 which asked people to give reasons why they were either satisfied or dissatisfied with social care.

The top three priorities were helping people stay independent at home for as long as possible (46%), making social care more affordable to those who need it (45%) and improving the quality of social care services (44%) (Figure 20).

There were some significant differences by age. Those aged 65 and over were more likely to answer ‘helping people stay independent at home for as long as possible’ – 66% of those over 65 selected this compared to 40% of those under 65.

People under 65 were more likely to answer ‘making social care affordable to those who need it’ – 49% of those under 65 selected this compared to 34% of those aged 65 and over.

More people under 65 said ‘improving the quality of social care services’ was a priority (48%) compared to those 65 and older (34%).

Tax

A new question was introduced in 2025. Similar to the NHS question on taxes it asked respondents: ‘Suppose the government had to choose between the following three options. Which one do you think it should choose?

• Reduce taxes and spend less on social care.
• Keep taxes and spending on social care at the same level as now.
• Increase taxes and spend more on social care.’

As shown in Figure 21 most people selected ‘keep taxes and spending on social care at the same level as now’ (51%). 38% chose ‘increase taxes and spend more on social care’, while 6% chose ‘reduce taxes and spend less on social care’. Support for increasing taxes and spending more on social care was lower than for the NHS – it was 45% for the NHS. The difference was statistically significant.

Respondents aged 65 and over were significantly more likely to answer, ‘increase taxes and spend more on social care’ (52%) than those under 65 (34%). There were also differences between supporters of different political parties. Supporters of the Green Party (63%) and the Labour Party (51%) were more likely to answer ‘increase taxes and spend more on social care’. Supporters of the Reform Party were significantly less likely to select this option (26%).

Conclusion

The six-percentage point increase in satisfaction with the NHS is the first time public satisfaction has risen since 2019. Dissatisfaction has dropped 8 percentage points, the second largest drop in the survey’s history.

These are significant findings and ones that will be greeted with relief from the governing parties and those responsible for running its health service alike. While overall satisfaction is still lower than at any point in the survey’s pre-pandemic history, the relentless year-on-year falls in public satisfaction with the NHS, which have been a feature of the British Social Attitudes survey since the Covid-19 pandemic, appear to have eased.

Other sources suggest that 2025 saw improved satisfaction with GP services (NHS England 2025) and inpatient care (CQC 2025) alongside progress in stabilising long waits for elective care and A&E waiting times. Against the government’s shift in rhetoric from the NHS being ‘broken’ to the language of reform, it might be reasonable to conclude that the rise in satisfaction documented in this year’s BSA reflects improved experience of NHS care and signs of improvement.

But this year’s BSA does not offer a clear indication of whether the 6% bounce in overall NHS satisfaction marks a decisive turning point. When we asked a smaller sample of 1,460 respondents about specific NHS services, including GP, A&E, dentistry or hospital care, overall levels of satisfaction did not significantly change and remain close to historic lows.

What’s more, when asked whether they felt the standard of NHS care was likely to get better or worse, respondents were not optimistic – just over one in six (16%) said they thought it would get better, the lowest recorded. It is hard to conclude that the overall increase in satisfaction represents an unequivocal vote of confidence in the future of the NHS.

The long time-series in the BSA offers some further insight. The last time dissatisfaction with the NHS overall fell by a greater amount than in 2025 – in 1998, also the second year of a Labour government – satisfaction with GP services was 75%. In this year’s survey it is 40 percentage points lower, at 35%. Satisfaction with dentistry is nearly 20 percentage points lower than in 1998. Until satisfaction with NHS services shifts decisively, any recovery in overall NHS satisfaction will remain extremely fragile.

A striking finding is that this improvement in perceptions of the NHS seem mostly to be coming from Britain’s older adults, who have always been most likely to see the best in the health service and are those most likely to need it. As in previous years, respondents aged 65 and over report markedly higher levels of satisfaction than younger adults: 2025 saw a statistically significant year-on-year increase which was greatest among those aged 65 and over but also present in the 35–64 age group. Among those under 35, satisfaction remains far lower and largely unchanged.

The survey offers no simple explanation for this gap. Older people are more likely to use NHS services and to rely on them for managing long-term conditions, and greater exposure may shape perceptions. Yet differences by age persist even when controlling for whether respondents report recent contact with the NHS, suggesting that patterns of service use alone cannot account for the divide.

The generational divide in attitudes to the way in which the NHS runs is not new and nor is it a case of younger groups losing faith in the fundamental model of the NHS. We see no significant differences by age in how strongly people support the NHS’s founding principles – that it should be free at the point of use, available to all and funded by tax. While younger and older respondents differ markedly in how they judge the way the NHS runs, they remain united in their attachment to the model on which it is built.

Social care presents a more ambiguous picture. While satisfaction with the NHS has edged upwards, satisfaction with social care remains at 14% and shows no comparable sign of recovery. Dissatisfaction has fallen significantly, from 53% to 49%, yet this easing of negativity has not translated into any increase in positive sentiment. The result is a more muted, but no more enthusiastic, assessment of social care. As with the NHS, the signal is difficult to interpret – there is little evidence of an age divide shaping these views. The survey reflects a sector still grappling with rising demand, workforce shortages and financial strain, and in which substantive reform remains elusive.

If the NHS appears to have stepped back from the brink of ever-falling satisfaction, social care has yet to do so. The BSA survey suggests that while tentative progress may be visible in parts of the health service, the underlying signal about the direction of travel remains indistinct. Any sustained recovery in public sentiment will need to be clearly and consistently transmitted through people’s experience of accessing services – not only within the NHS, but also in social care – if it is to cut through the noise and take hold.