Record low levels of satisfaction with GP services and NHS dentistry drive dissatisfaction with the NHS to an all time nadir in 2022.
The latest British Social Attitudes Survey into public satisfaction with the NHS and social care in 2022 showed the lowest level of satisfaction in the report’s 40-year history.
The decline was evident across all parts of society causing the report’s compilers, the King’s Fund and Nuffield Trust, to call on government to prioritise shorter waiting times, recruit more staff and for the continuation of a free, accessible and tax-funded service and a functioning social care system.
It has also caused the British Medical Association (BMA) to accuse government of reducing the NHS to a “mere shadow” of what it could and should be.
Overall satisfaction
According to the report, overall satisfaction with the NHS dropped to 29% – a seven percentage point decrease from 2021, marking the lowest level of satisfaction recorded since the survey began in 1983.
More than half (51%) of respondents were dissatisfied with the NHS, the highest proportion since the survey began.
The fall in satisfaction was evident across all ages, income groups, sexes and supporters of different political parties.
The primary reason people gave for being dissatisfied with the NHS was waiting times for GP and hospital appointments (69%).
This was followed by staff shortages (55%) and a view that the government did not spend enough money on the NHS (50%).
GP services and NHS dentistry
Satisfaction with GP services declined to 35% in 2022, down from 38% in 2021- the previous record low.
The decline was less acute than that of the period between 2019 and 2021, when satisfaction fell by 30 percentage points.
Satisfaction with NHS dentistry fell to a record low of 27%, with dissatisfaction reaching a record high of 42%.
Almost a quarter (24%) of respondents said they were very dissatisfied with NHS dentistry – a higher proportion than for other health and care services asked about in the survey.
Other NHS services and social care
Satisfaction with inpatient and outpatient services fell to 35% and 45% respectively. But despite falling by four percentage points, outpatients remained the highest-rated service.
Satisfaction with A&E services also dropped eight percentage points to 30%, another record low.
Four in 10 respondents said they were dissatisfied with A&E services, an 11 percentage point increase and a new record level of dissatisfaction.
This marked the largest change in dissatisfaction in a single year since the question on A&E services was first asked in 1999.
Just 14% of respondents said they were satisfied with social care. Dissatisfaction with social care rose significantly in 2022, with 57% of respondents saying they were dissatisfied – up from 50% in 2021.
Of those who said they were satisfied with the NHS, the main reason was due to the fact NHS care is free at the point of use (74%), followed by the quality of NHS care (55%) and that it has a good range of services and treatments available (49%).
Severe funding problem
In terms of funding for the NHS, the vast majority (83%) of respondents believed that the NHS had a major or severe funding problem.
And for the first time since 2015, the most popular option when asked how more money should be raised for the NHS was that ‘the NHS needs to live within its own budget’ (chosen by 28% of respondents).
A minority (43%) of respondents chose one of the two options that meant paying more taxes.
NHS priorities
When asked what the most important priorities for the NHS should be, the top two cited by survey respondents were: increasing the number of staff in the NHS (51%) and making it easier to get a GP appointment (50%).
Improving waiting times for planned operations and in A&E were both chosen by 47% of respondents, with the latter seeing a significant increase since 2021.
But as in 2021, the vast majority of respondents agreed that the founding principles of the NHS should definitely or probably apply in 2022: that the NHS should be free of charge when you need it (93%), the NHS should primarily be funded through taxes (82%) and the NHS should be available to everyone (84%).
There were 3,362 responses to the overall NHS and social care satisfaction questions and 1,187 respondents to questions about specific NHS and social care services.
Government priorities
In terms of what government’s priorities should be to reverse NHS satisfaction levels, the report’s compilers said the message from the public could not be clearer.
“The answer may lie in understanding the factors that saw satisfaction steadily climb every year from 38% in 2001 to a high of 70% in 2010,” the authors said.
“This growth coincided with sustained investment in health services, targeted work to improve waiting times and a concerted effort to reward and retain the workforce.
“The challenges today are perhaps even greater: we are living with years of policy failure in reforming social care; the economic and fiscal outlook is bleak; and the NHS still faces a mountain to climb in recovering from the pandemic.
“But what the public want from the health service – shorter waiting times, more staff, the continuation of a free, accessible and tax-funded service and a functioning social care system – couldn’t be clearer.”
NHS ‘mere shadow’ of what it could be
BMA council chairman Professor Philip Banfield accused government of reducing the NHS to “a mere shadow of what it could, and should, be”.
“This survey makes one thing clear: patients who use the NHS can see the damage caused by that lack of investment and absence of workforce planning, uniting the public with healthcare staff who have been shouting loudly about these pressures for many years,” he said.
“As the King’s Fund itself says, these findings should be a wake-up call for the government – which continues in denial with its head sinking ever deeper into the sand.”
Professor Banfield noted the record-low public satisfaction across all parts of the health service, with huge frustrations around long waits for GP and hospital appointments, staffing shortages and underfunding.
“The public say they want services to be staffed properly, to be able to make a GP appointment more easily, and to see waiting times in A&E and for planned care slashed,” he continued.
“And even though staff are trying their absolute hardest – for example GP practices providing far more appointments than they were pre-pandemic despite plummeting GP numbers – improving patients’ experiences relies almost solely on boosting the workforce.
“And looking at the system as a whole, you cannot reduce waits in secondary care without materially increasing resource in both the front door that is general practice and the back door that is social care, as well of course, as in hospitals themselves.”