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Public Satisfaction With The NHS And Social Care In 2018

7th March 2019

Photograph of Public Satisfaction With The NHS And Social Care In 2018

Public satisfaction with the NHS and social care in 2018: Results from the British Social Attitudes survey. Published today 7th March 2018 on the Kings Fund web site.

Since 1983, NatCen Social Research's British Social Attitudes (BSA) survey has asked members of the public - rather than only patients - in England, Scotland and Wales about their views on the NHS and health and care issues generally. The latest survey was carried out between July and October 2018 and asked a nationally representative sample of 2,926 people about their satisfaction with the NHS overall, and 973 people about their satisfaction with individual NHS and social care services. The 2018 BSA survey questions reported here were jointly sponsored by the Nuffield Trust and The King's Fund.

The BSA is a ‘gold standard' survey that uses a robust methodology to explore public views. The methodology is based on a randomly selected sample of the British public, and is conducted via a face-to-face interview, with multiple follow‑up requests to non-responders. The survey is conducted the same way every year and the data provides a rich time trend going back to 1983, adding a depth and context to the findings that no other measure of NHS satisfaction provides. As a result, when satisfaction changes in the BSA, we are as confident as we can be that it reflects a genuine change in public attitudes.

In the analysis below, when we say satisfaction has gone up or down, the change is statistically significant at the 5 per cent level, unless otherwise stated. If a change or difference is statistically significant, this means we can be 95 per cent confident that the survey result reflects a real change or difference in public views, rather than being down to chance. Where a change or difference is not statistically significant, we cannot be confident that it reflects a real change or difference in public views.

Satisfaction with the NHS overall in 2018

Public satisfaction with the NHS overall continued to fall in 2018. Overall satisfaction was 53 per cent - a 3 percentage point drop from the previous year and the lowest level since 2007.

Older people were more satisfied than younger people: 61 per cent of those aged 65 and over were satisfied with the NHS compared to 51 per cent of those aged 18-64.

Satisfaction levels also differed between supporters of different political parties: 58 per cent of supporters of the Conservative party were satisfied compared to 51 per cent of supporters of the Labour party.

The four main reasons people gave for being satisfied with the NHS overall were: the quality of care; the fact that the NHS is free at the point of use; the range of services and treatments available; and the attitudes and behaviour of NHS staff.

The four main reasons people gave for being dissatisfied with the NHS overall were: long waiting times; staff shortages; a lack of funding; and money being wasted.

Satisfaction with NHS and social care services in 2018

Satisfaction with inpatient services was 63 per cent. Levels have fluctuated in recent years, but the 8 percentage point increase from the previous year takes satisfaction to its highest level since 1993.

Satisfaction with outpatient services was 70 per cent. Again, levels have fluctuated in recent years, but the 5 percentage point increase from the previous year takes satisfaction to its highest level since the survey began. For the first time, outpatients was the highest-rated service in the survey.

Satisfaction with both inpatient and outpatient services was higher among those who have used those services recently or have friends and family members who have done so.

Satisfaction with accident and emergency (A&E) services was 53 per cent. The change in satisfaction from the previous year was not statistically significant.

Satisfaction with GP services was 63 per cent. The change in satisfaction from the previous year was not statistically significant, and satisfaction remains at its lowest level since the survey began in 1983.

Satisfaction with NHS dentistry services was 58 per cent. The change in satisfaction from the previous year was not statistically significant.

Satisfaction with social care services was 26 per cent. Again, the change in satisfaction from the previous year was not statistically significant.

This year, the NHS embarks on implementing a new 10-year plan, accompanied by its most generous funding settlement for almost a decade, albeit below what we think is needed to maintain and improve services (NHS England 2019; The King's Fund et al 2017). As it starts this new chapter, the NHS's report card is mixed. Although it is one of the most equitable systems in the world, it lags behind many comparable countries on key outcome measures for diseases like cancer, stroke and heart attack, as well as childhood mortality (Dayan et al 2018). So what do the British public think about the NHS and how has that changed over time?

For 36 years, the BSA survey has asked a sample of the public ‘how satisfied are you with the way the NHS runs nowadays?’ In 2018, public satisfaction with the NHS was 53 per cent; this combines people who say they are ‘very’ and ‘quite’ satisfied (Figure 1). This is a 3 percentage point drop from the previous year and continues a downward trend that takes satisfaction to its lowest level since 2007. Public dissatisfaction with the NHS was 30 per cent in 2018. The change from 2017 was not statistically significant and this is the highest level of dissatisfaction with the NHS overall since 2007.

This data gives its richest insights when viewed over decades rather than years. Taking that long-term view, Figure 1 shows that the 2000s were characterised by increasing satisfaction, up by 31 percentage points over the decade from 38 per cent (in 2001) to 70 per cent (in 2010). Conversely, the 2010s are characterised by decreasing satisfaction; although levels have fluctuated (including a 12 percentage point slump in 2011, and a 5 percentage point jump in 2014), the broad trend shows a falling level of satisfaction, which in 2018 was 16 percentage points lower than in 2010.

Read the full report at - https://www.kingsfund.org.uk/publications/public-satisfaction-nhs-social-care-2018

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