“Public satisfaction with the NHS is rising, but will care experiences follow suit?”
Chris Graham; Director of Research & Policy, responds to the publication of the British Social Attitudes Survey, and discusses what it really tells us about people’s experiences of the NHS.
Public satisfaction with the NHS is rising and is at its second highest recorded level, according to new analysis of the British Social Attitudes survey published today by the King’s Fund. But despite recent improvements, results have still not returned to the historic high point set in 2010.
On the face of it, today’s results suggest strong NHS performance in spite of well documented financial pressures and high demand. It is important to note, though, the survey asks about public satisfaction rather than the specific experiences of recent users of healthcare services. It is likely that public support for the NHS is a contributing factor to the reported levels of satisfaction: as the King’s Fund have suggested, respondents may have wished to give “a vote of support for the NHS as an institution in difficult times.” (www.kingsfund.org.uk/projects/bsa-survey-2014/conclusion). Tellingly, the majority of the improvement in results from 2013 to 2014 is attributable to people who have not used services recently. Although there are improvements recent patients, they are much smaller: in the order of three percentage points compared to 10-12 points for those who have no first-hand experience of services.
There are also more challenging findings in the longer term trends. Overall satisfaction with the NHS has improved five points from 2013 (the proportion who were ‘quite’ or ‘very satisfied’ has risen from 60% to 65%) but remains five points behind the 2010 position, when satisfaction was at an all-time high (70% ‘quite’ or ‘very’ satisfied). In that context, this year’s improvement looks like a partial recovery after a marked drop in satisfaction in 2011, coinciding with a change of government and the passage of the controversial Health and Social Care Act. An alternative reading is that satisfaction, which had improved sizably every year since 2004, has stalled over the last five years. This might be understandable in a time of austerity: indeed, given the financial pressures on the service, it’s commendable that satisfaction does remain high. But with an election less than 100 days away, we can be sure that major parties will be carefully scrutinising these trends.
There are some more worrying results too, particularly around primary care: satisfaction with both GP and dental services have fallen by three points in the last year.
The importance of the NHS as an electoral issue cannot be overstated. Regular polling from Ipsos MORI (https://www.ipsos-mori.com/researchpublications/researcharchive/2905/Issues-Index-2007-onwards.aspx?view=wide), quoted by the King’s Fund, shows the proportion of people rating the NHS as “one of the most importance issues facing Britain today” increasing by a half from 22% in May 2010 to 33% in December 2014. Even more strikingly, recent polling by ComRes for ITV, showed a dramatic jump in the proportion rating the NHS as one of the top three election issues: leaping 11 points from 39% in December 2014 to 50% in January 2015, overtaking immigration as the top ranking issue. And as today’s results show, voters from all sections of the political spectrum are less satisfied with the NHS today than they were in 2010.
NHS performance and its public perception is therefore going to remain top of the agenda right up to May 7th. Meanwhile, Picker are currently beginning to collate data from the 2014 NHS inpatient survey, one of the largest systematic sources of data on the experiences of NHS patients: we look forward to seeing whether the improvement in general satisfaction reported today is matched by the experiences of those recently discharged from hospital.