Startling collapse in NHS satisfaction since pandemic, with just 1 in 5 satisfied - Nuffield Trust

The British public are deeply unhappy with the National Health Service – just 1 in 5 people (21%) in 2024 said they were satisfied with the way the NHS runs. That's according to analysis of the latest British Social Attitudes survey [1] (BSA) published today by the Nuffield Trust and The King's Fund. Satisfaction has plummeted by 39 percentage points since the months before the pandemic.[2] 

6 in 10 people (59%) said they were ‘very' or ‘quite' dissatisfied with the NHS in 2024, a sharp rise from 52% in 2023. This is the highest level of dissatisfaction with the health service since the survey began in 1983. The survey, carried out by the National Centre for Social Research (NatCen) in September and October 2024, is seen as a gold-standard measure of public attitudes in Britain.[3] 

The Nuffield Trust and The King's Fund say that just 12% of people were satisfied with A&E waiting times and 23% with GP waiting times. People are unhappy about waiting times even if they are satisfied with the NHS overall, regardless of age, political affiliation or nation. 

NHS staffing and spending are also worrying the public. Only 11% agreed that “there are enough staff in the NHS these days”. While a strong majority (69%) said the government spends too little or far too little on the NHS, only 14% agreed that “The NHS spends the money it has efficiently”.   

If forced to choose, the public would narrowly opt for increasing taxes and raising NHS spending (46%) over keeping them the same (41%). Only 8% would prefer tax reductions and lower NHS spending. 

Despite low satisfaction with services, there remains strong majority support for the founding principles of the NHS: that it should “definitely or probably” be free at the point of use (90%), available to everyone (77%), and funded from general taxation (80%). However, the percentage of people saying that the NHS should “definitely” be available to everyone has decreased from 67% in 2023 to 56% in 2024. 
 
Other findings from Public satisfaction with the NHS and social care in 2024 include: 

• There is a divide between generations, with satisfaction lower and falling in younger age groups. While the proportion of people who were satisfied rose slightly between 2023 and 2024 for those aged 65+ from 25% to 27%, among those under 65 it fell significantly from 24% to 19%. 

• A significantly higher proportion of people in Wales (72%) were dissatisfied with the NHS compared to 59% in England and 60% in Scotland (the difference between England and Scotland is not statistically significant). 

• Public views of A&E services have worsened dramatically, with satisfaction falling from 31% to just 19%, and dissatisfaction rising from 37% to 52%. These are the worst figures on record by a large margin and make A&E the service with the lowest satisfaction levels for the first time. 

• Satisfaction with GP services continued to fall, mirroring the trend over the last few years, with 31% of members of the British public satisfied with GP services, compared with 34% in 2023. 

• Satisfaction with NHS dentistry has continued to collapse. As recently as 2019 this was at 60%, but it has now fallen to a record low of 20%. Dissatisfaction levels (55%) are the highest for any NHS service asked about. 

• Inpatient and outpatient hospital care remains the part of the NHS with the highest levels of satisfaction, with 32% satisfied and only 28% dissatisfied. 

• Satisfaction with social care remains worryingly low. In 2024, only 13% of respondents said they were ‘very' or ‘quite' satisfied with social care. 53% of respondents were ‘very' or ‘quite' dissatisfied.   

For the first time, people who support the Reform party have been included as a separate category in the analysis instead of being part of the ‘other parties' group, to reflect the party's increased share of the election vote. Supporters of the Reform party were less likely to be satisfied with the NHS (13%) than supporters of the other main parties. They are also less likely to believe in the founding principles of the NHS.  
 
Report author Bea Taylor, Fellow at The Nuffield Trust said: 

“Just five years after the British public were called on to "Protect the NHS" at the start of the pandemic, these findings reveal just how dismayed they are about the state of the NHS today. We found that every group in Britain is dissatisfied with access to vital services such as A&E and GP appointments. 

“The government says the NHS is broken, and the public agree. But support for the core principles of the NHS – free at the point of use, available to all and funded by taxation – endures despite the collapse in satisfaction. Harnessing this support and fixing the foundations of the NHS must be central to the government's forthcoming reform programme.” 

Dan Wellings, Senior Fellow at The King's Fund said: 

“The latest results lay bare the extent of the problems faced by the NHS and the size of the challenge for the government. While the results are sobering, they should not be surprising. For too many people the NHS has become difficult to access: how can you be satisfied with a service you can't get into?   

“In 2010, seven out of ten people were satisfied with the NHS – it is now down to only one in five. The scale of the decline over the last few years has been dramatic. The results show that people do not want a different funding model, but they do want the NHS to start working for them again and they want it to have the staff and the money it needs to ensure that happens. The public are also clear that the NHS needs to get better at spending the money it does get more efficiently. 

“The government's focus on bringing down hospital waiting lists may address one area of the public's concerns, but this year's BSA shows that all areas are flashing red, particularly A&E. Voters are impatient for change, and Ministers will need to demonstrate rapid improvement, but that should not come at the cost  of the bigger, whole-system reforms that are needed to create a truly sustainable health service. These results will form the baseline from which the new Labour government's reform plans to ‘fix' the NHS will be judged.” 

In an accompanying foreword to the report, Nuffield Trust and King's Fund Chief Executives Thea Stein and Sarah Woolnough say that "The government now finds itself walking a fine line between meeting public demands for rapid improvements on waiting times and avoiding the pitfall of throwing more money - of which there is virtually none - at a system in need of deeper reform."  

The Chief Executives argue that ministers will need to meet public demand for improving A&E, GP appointments and dental care, but they should not lose sight of the much bigger prize of longer-term, sustainable reform focused around shifting care from hospital and moving the NHS from a sickness to a health service. 

Ends.

Notes to Editors

1. The most recent British Social Attitudes (BSA) survey was carried out between 16th September and 27th October 2024. It asked a nationally representative sample of 2,945 people (across England, Scotland and Wales) about their satisfaction with the National Health Service (NHS) and adult social care services overall, and 933 people about their satisfaction with specific NHS services, as well as their views on NHS priorities, principles and funding. 

2. Satisfaction with the NHS was at 60% in the 2019 BSA survey results. 

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 health and care services. The King's Fund and the Nuffield Trust sponsor the health and care questions and summarise the headline health results. NatCen will publish further results from BSA later in the year.  

4. 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', ‘very dissatisfied' and ‘don't know'. Satisfaction as reported here aggregates those who answer 'very' and 'quite' satisfied.    

5. The survey methodology is based on a randomly selected sample of the British public. It includes those who had recent contact with the NHS and those who had not. From 1983 until 2019 the survey was conducted face to face. This method was no longer possible in 2020 due to Covid-19 social distancing rules, and that year the BSA survey was conducted primarily online with a telephone option available. This method has continued since.