This exclusive polling was carried out by Ipsos MORI on behalf of NHS Providers, the Royal College of Physicians, NHS Clinical Commissioners and National Voices. The polling was first revealed at the first NHS at 70 debate on 9 May 2018.
Introduction
The NHS is at a watershed moment as it approaches its 70th anniversary on 5 July 2018.
It faces a number of severe challenges including rapidly rising demand for care from an ageing population with more complex needs, the increasing cost of new drugs and technologies, a workforce that is stretched to its limits and declining performance against key targets.
These challenges are set against the backdrop of the longest financial squeeze in the NHS’ history.
The pressure on the system as a whole was at it clearest throughout the most recent winter which is widely recognised as the worst on record for NHS performance against targets.
But have these pressures had an impact on the public’s perception of the NHS? And what the health service should be prioritising?
Polling consistently shows that there is still overwhelming public support for the NHS’ founding principles. Recent surveys show that overall the public remains satisfied with how the NHS is performing, but this has been falling. Findings from the British Social Attitudes (BSA) survey in 2017, analysed by the Nuffield Trust and The King's Fund, put public satisfaction at 57%, down 6% from the previous year. However, the number of people who say they are dissatisfied with how the NHS is performing is now at 29% - nearly double the level recorded in 2014.
We have to recognise that one of the factors behind satisfaction levels in the NHS, despite the challenges, is the dedication and commitment of NHS staff. The public remain supportive of the quality of care they receive and the attitude and behaviour of NHS staff.
However, the public are now aware of the financial pressure on the health service. The majority of the public, according to Ipsos MORI polling, believe that the NHS will face a severe funding problem in the future. It is a further indication that the public wants the government to address the widening gap between what the NHS is being asked to deliver and the resources it has available.
We have to recognise that one of the factors behind satisfaction levels in the NHS, despite the challenges, is the dedication and commitment of NHS staff.
The public have expressed their own willingness to address this. When surveyed the majority (61%) indicated they would be willing to pay more in tax if that money went towards the NHS.
This year, the prime minister, Theresa May, made a commitment to a long-term funding solution for health and social care, with the details of such an offer likely to be set out before the NHS’s 70th birthday in July and finalised in time for the 2018 Budget.
Organisations such as NHS Providers believe it is now time for a national debate about how much of our national wealth we devote to the NHS and social care to meet the needs of the public.
New public polling
Alongside a series of debates to mark the NHS' 70th anniversary, put together by NHS Providers, NHS Clinical Commissioners, the Royal College of Physicians, National Voices and Ipsos MORI, these organisations have commissioned Ipsos MORI to undertake some exclusive polling.
The objective was to assess how the public think the NHS is likely to perform in the years ahead, and what the priorities for any potential additional health and care funding should be.
Priority for the public for additional health and care funding
Q: If the government were to devote more funding to health and care services, which three if any, of the following do you think it should prioritise in terms of funding?
Figure 1
- The majority of respondents (68%) believe additional funding should be devoted to urgent and emergency care such as A&E and ambulance services. The polling follows recent winter pressures which have had a media focus on performance in A&E units
- Mental health services were the second highest scoring priority (58%) which represents a growing understanding of the importance of well resourced mental health services by the public. It comes as the government and NHS England have committed to tackling inequalities in care for those with mental health needs.
- Community and adult social care services and children’s services scored highly, and highlight a growing awareness of underfunding of community services.
Public pessimism about the future of the NHS
Q: Thinking about the NHS over the next few years do you expect it to….?
Figure 2
- Since the last survey conducted in March 2017, members of the public polled are more optimistic about the future performance of the NHS.
- The number of respondents who believe that NHS performance will get ‘much better’ or ‘better’ has increased to 21%, up from 15% the previous calendar year.
- The number of respondents who believe that the NHS will get ‘worse’ or ‘much worse’ has fallen to 46% from 62% last year.
- The polling conducted in April 2018 follows the prime minister’s commitment to a long-term funding settlement for health and social care.
Public priorities when receiving non-emergency care
Figure 3
- Quality of care is most important to people when receiving non-emergency care, with over a third of people (38 per cent) stating this.
- Waiting times are still a big issue with 21% of people saying short waiting times were most important.
- Only 11% of respondents cited ‘being treated close to my home’ as a priority when receiving non-emergency care which suggests that receiving a high quality of care is more important than the distance travelled to receive care.
Looking to the future
As we debate how the NHS can survive and thrive for another 70 years, this polling shows that the NHS remains a key issue for the public. As other recent polling from Ipsos MORIhas shown, the NHS has risen to the top of the list of public concerns, overtaking other key issues such as immigration.
As the government works to develop its plans for a long-term funding settlement for health and care, these findings provide timely insights into the priority areas that the public would like to see receive additional funding and support.
The findings show that while additional funding is important, the public continue to place most importance on the quality of care they receive.
While it may not be surprising that the public wants to see extra investment in urgent and emergency care services, particularly on the back of a very difficult winter, it is a welcome development to see more public support for investment in traditionally neglected areas such as mental health, community and adult social care services. Investment in these areas is vital if the public are to receive high quality care and if the pressures on NHS trusts is to be reduced.
The findings show that while additional funding is important, the public continue to place most importance on the quality of care they receive.
Commenting on the findings, NHS Providers deputy chief executive, Saffron Cordery, said:
"We have had a welcome commitment for more health and care funding from the prime minister as we approach the NHS’s 70th anniversary.
"Following the busiest winter on record for the NHS, it is clear that A&E and emergency services are perceived to be underfunded and overstretched by the public.
"These findings also show that properly funded mental health services are important to the public and the government must ensure its long term plan for health and care reflects this.”