Is the NHS in crisis? Public satisfaction for the health service plummets

This year marks five years since the onset of the pandemic – a time when support for the NHS was riding high.

Thursday nights were mostly spent on our doorsteps, clapping cheering and banging whatever kitchen utensil we had to hand to show our unwavering support to the hard-working nurses and doctors.

But if Harold Wilson was right and a week is a long time in politics, then five years really is an eternity and, certainly, long enough for public satisfaction with the NHS to slump to an all-time low.

According to the British Attitudes Survey 2024[1], carried out by NatCen and analysed by The Nuffield Trust and The King’s Fund, the British public are deeply unhappy with the way the NHS runs – with a mere one in five people (21%) saying they are satisfied and a sizeable 59% saying they aren’t.

Perhaps unsurprisingly, as it’s at the sharp end of the public interface with the health service, A&E tops the charts as being the service that the public is least happy about, with satisfaction levels falling from 31% in 2023 to just 19% last year. But dental surgery also performs poorly, with satisfaction levels dropping from 60% in 2019 to just 20% in 2024, and fewer than a third (31%) of adults are satisfied with GP services.

Waiting times are, of course, a particular bugbear, but there has been some progress. After reaching a record high last year, the latest figures show that the waiting list for hospital treatment in Wales has fallen slightly for the second month in a row.  Nevertheless, the Welsh Government’s target to reduce the numbers waiting longer than two years – in most specialties – still remains to be met.

Challenging situations require bold action – and that’s something that Jeremy Miles, Cabinet Secretary for Health and Social Care, has taken this month. Grasping the nettle, he’s announced an ambitious strategy to reduce the waiting list by 200,000, eliminate two-year waiting times for planned treatment and restore a maximum eight week wait for tests – all by March 2026. If achieved, that would be no mean feat.

Central to tackling this is a new ‘patient deal’ that encourages patients to play their part by making sure they are fit and well enough to benefit from the surgery and attend appointments. Those who miss two appointments, without good reason, will be sent to the back of the queue.

Despite all of the obvious frustrations that many people feel with the NHS, they still fundamentally agree with its core principles – a large majority of respondents agreed that the founding principles of the NHS should ‘definitely’ or ‘probably’ apply in 2024: that the NHS should be free of charge when you need to use it (90%); the NHS should primarily be funded through taxes (80%); and the NHS should be available to everyone (77%).

The challenge for the health service, therefore, is to preserve the highly valued principles on which it was established and to change the service so that it is fit for the health needs of people three quarters of a century after it was founded.  And that’s not easy, but it can be done.

Through our work in the healthcare sector, we come across breathtaking quality of care and the cutting-edge science that lies behind it. Just this week at Morriston Hospital, for example, they announced results of ground-breaking treatment that they are pioneering for people with heart failure that could reduce their chance of dying by 62% and their chances of rehospitalisation for heart failure by 30%.  That’s just incredible.

Jeremy Miles’ patient deal will deliver change if it is not just about treating more people faster, but also using new models of care, medicines and technology to reduce their chances of dying or needing hospital in the first place, like they are doing in Swansea.

Today is not about heroics, but the life changing, life supporting and life affirming care and treatment from those same people we cheered five years ago to help us be healthier, live better and hopefully help us to avoid hospital altogether.

This article was written by our director of healthcare, Nick Samuels and featured in the Western Mail on 21 April 2025.

[1] https://www.nuffieldtrust.org.uk/research/public-satisfaction-with-the-NHS-and-social-care-in-2024-Results-from-the-British-Social-Attitudes-survey#