British Social Attitudes survey – The NEN

RCEM: ‘The public has recognised tackling A&E waiting times is a priority – it’s time the government did the same’

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 (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.

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: “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.

Politicians must make addressing the Emergency Care crisis a political priority as new research reveals that public satisfaction in A&E services has reached an all-time low.

That’s the call from The Royal College of Emergency Medicine (RCEM) and comes as the findings of the latest British Social Attitudes survey (BSA) Public satisfaction with the NHS and social care in 2024 have been published today (2 April 2025) showing satisfaction with A&E services has plummeted.

The survey, carried out by the National Centre for Social Research (NatCen) from 16 September to 27 October 2024 for The King’s Fund and the Nuffield Trust, asked 2,945 people across England, Scotland and Wales, for their thoughts on the NHS and adult social care services.

It also questioned 933 people about their satisfaction with specific NHS services, as well as their views on NHS priorities, principles and funding.

The research – which has been carried out every year since 1983 – found:

More than half (52%) of respondents were dissatisfied with NHS A&E services – the highest on record – up 15% from 37% in 2023. Those who were satisfied stood at 19% – a fall from 31% the previous year.
69% of people were very or quite dissatisfied with the length of time it took to be seen in A&E
The most important priorities cited by respondents for the NHS included ‘improving waiting times in A&E (49%), which was considered the second most important – behind access to GPs but ahead of elective care waiting lists.

RCEM President, Dr Adrian Boyle, said: “This annual survey is a barometer of public feeling and people – voters – have given their verdict loudly and clearly.

“The public aren’t daft and can see what is happening in our Emergency Departments. I worry that this situation stops people attending when they should.

“But it is hardly surprising when the message from the Westminster government is that the health service is broken. If that is their assessment, they must get on with the job of fixing it. And it is fixable.

“The public has stated that, behind GPs, the service they most want prioritised is A&E, but we only ever hear about what has been done to improve elective waiting times.

“The public has identified A&E as a priority. It is time the government did the same.”

The survey also revealed:

In 2024, just one in five British adults (21%) were ‘very’ or ‘quite’ satisfied with the way in which the NHS runs. This is the lowest level of satisfaction recorded since the survey began.
Only 13% of respondents said they were ‘very’ or ‘quite’ satisfied with social care (the same figure as 2023). 53% of respondents were ‘very’ or ‘quite’ dissatisfied
Satisfaction with GP services continued to fall, mirroring the trend over the last few years. 31% of respondents said they were satisfied with GP services, compared with 34% in 2023
62% were very or quite dissatisfied with the length of time it takes to get a GP appointment, and 65% for the length of time it takes to get hospital care.
Most (44%) believe the government is spending too little money on the NHS
More than 75% continue to support the founding principles of the NHS, with little sign of change compared to the previous year. However, the proportion ‘definitely’ agreeing that it should be available to everyone fell significantly from 67% to 56%.

The BSA follows a survey by Ipsos Mori conducted in February 2025 which revealed that almost 80% of people polled would avoid attending an A&E because they were worried about ending up waiting for hours on a trolley in a corridor.

Public satisfaction with the NHS and social care in 2024_WEB (4)Download

Change of public mood creates challenge for the next government

The results of the latest British Social Attitudes (BSA) survey, published yesterday by the National Centre for Social Research (NatCen), reveal that there have been significant changes in the public mood since the last election in 2019.

As a result, the next government, whatever its partisan colour, will find itself with many policy and political challenges ahead.

Much of the change in the public mood has been occasioned by the fallout from the pandemic and the Russian-Ukraine war, including the impact on inequality, the health service, Brexit, and immigration.

At the same time, the experience of the last few years has served to undermine confidence in the country’s system of government.

Inequality, cost of living, and housing

Debates about inequality during the pandemic have seemingly created a public that is now more concerned about the level of poverty. At the same time, more people say they are ‘struggling’ on their current income.

73% now believe there is ‘a great deal’ of poverty in Britain, up from 68% in 2019.
70% say that their income has failed to keep up with prices over the last twelve months.
26% say they are ‘struggling’ on their current income, compared with 17% in 2020.
However, the experience of living at home more during lockdown may explain why fewer people now support more houses being built in their neighbourhood, despite the difficulty that many currently have in finding affordable accommodation.
41% support more houses being built in their local area, down from 57% in 2018.

The NHS and tax and spend

The post-pandemic growth in NHS waiting times have resulted in record levels of dissatisfaction with the health service. The same is true of social care, which also came under great pressure during the pandemic.

The proportion dissatisfied with the NHS is, at 52%, slightly more than double what it was in 2019 (25%).
As many as 57% are dissatisfied with the provision of social care, up 20 points on 2019 (37%).
Even though taxation is now at a record high, at present, at least, many people still seem to regard the state of the NHS as a more pressing problem than the level of taxes.
46% say that, if forced to choose, the government should increase taxes and spend more on ‘health, education and social benefits’.
This is down somewhat on the 53% who expressed that view in 2019, but is still well above the 31% figure recorded in 2010 at the end of the last period of Labour government.

Brexit and immigration

Record levels of immigration since the pandemic have reversed a previous trend towards more liberal attitudes towards immigration. Together with doubts about the economic benefits of Brexit, they have also resulted in a change of attitudes to the EU.

In 2019, 47% said that migrants who come to Britain are good for the economy. This edged up further to 50% in 2021 but, in the most recent reading, this has fallen back to 39%.
45% said in 2019 that migrants enrich Britain’s cultural life, while 48% did so in 2021. Now the figure is 38%.
In 2019, 51% thought that the economy would be worse off as a result of leaving the EU. Now 71% believe the economy is worse off as a result of Brexit.
Faced with a range of options for Britain’s relationship with the EU, in 2016, 41% said that Britain should be outside the EU, as did 36% in 2019. Now the figure stands at 24%.
Supporters and opponents of Brexit continue to have different political preferences. 45% of supporters think of themselves as a Conservative, while 49% of opponents identify as a Labour supporter.

Trust and confidence in government

Between them, these policy concerns, together with the political instability of the last couple of years, have undermined levels of trust and confidence in how Britain is governed, a change that has occasioned increased support for constitutional reform.

As many as 45% ‘almost never trust governments of any particular party to place the needs of the nation above the interests of their own political party’, up from 34% in 2019 and a record high.
After falling from 79% in 2019 to 61% the following year, once again 79% believe the present system of governing Britain is in need of ‘quite a lot’ or ‘a great deal’ of improvement.
A record high of 53% now say we should change the Commons voting system ‘to allow smaller parties to get a fairer share of MPs’. 60% of Labour supporters take this view, whereas 73% of Conservative supporters believe we should keep the current system ‘to produce effective government’.
A record low of 45% believe that England should be governed as now from Westminster rather than have regional assemblies (26%) or an English Parliament (23%).

Gillian Prior, Interim Chief Executive at the National Centre for Social Research (NatCen), says: “The last four years of parliament have left their imprint on public opinion.

“From the NHS to immigration, from inequality to tax and spend, people’s attitudes have been affected by the experience of a pandemic, a cost of living crisis, and political turmoil.

“The period has left them asking themselves just how well they are being governed. Irrespective of its partisan colour, the next government will have much to do if it is to meet people’s concerns about the many difficulties they feel the country has been facing.”