NHS satisfaction rises for the first time since 2019 – cause for optimism or caution?

The British Social Attitudes survey examines how the British public are feeling about their health service. Carried out every year since 1983 by the National Centre for Social Research, it provides a barometer for understanding how satisfied people are with the NHS; how they rate individual services and what they make of social care.

The 2025 survey was carried out between 26 August and 6 October 2025 with the results published on 25 March.

Chris Knights, director in Freshwater’s specialist healthcare division, takes a dive into the findings.

Public satisfaction with the NHS has fallen sharply in recent years, shaped by long waiting lists, pressure across services and the gap between expectations and experience. The latest data in the British Social Attitudes survey suggest this decline may be easing, offering some optimism for recovery, but that doesn’t mean we should assume the NHS is over the worst.

In this context, even small shifts in perception matter. They are important not only for policymakers, but for those responsible for communicating what the NHS is doing and why.

This year’s results suggest something has shifted. In 2025, 26% of British adults said they were satisfied with how the NHS runs – a significant six percentage point increase from 2024 and the first rise since 2019. At the same time, dissatisfaction fell from 59% to 51% – the largest drop in more than 25 years.

On the surface, this looks like a welcome turning point. However, the reality is more complex.

Just over one in four people say they are satisfied with the way the NHS runs. While that marks progress, it still represents one of the lowest levels recorded. Around half of respondents remain dissatisfied, underlining the scale of the challenge.

Crucially, this improvement in overall sentiment is not reflected in people’s experiences of individual services. Satisfaction with GP services, A&E and dentistry remains close to historic lows, while waiting times continue to dominate public concern. So, while the overall picture has improved, the underlying experience for many has not.

That nuance matters. Satisfaction is not evenly distributed. Older respondents are significantly more positive, with 35% of those aged 65 and over reporting satisfaction, and they are also the group most likely to have recent experience of NHS services. By contrast, younger people remain more sceptical, with just 20% of under-35s saying the same.

Geography and politics also shape perception, with lower satisfaction reported in Wales (18%) and among supporters of Reform (20%). For comms professionals working in the healthcare sector, this reinforces a simple point. There is no single public view of the NHS, and messaging that assumes otherwise risks failing to resonate.

Despite ongoing frustrations with performance, support for the NHS’s founding principles remains strong. A large majority continue to believe that the NHS should be free at the point of use (89%), funded through taxation (81%) and available to everyone (74%).

However, there are signs of gradual change beneath the surface, particularly a steady decline since 2021 in the proportion who say these principles should “definitely” apply. The public also remains divided on funding. While 45% support higher taxes and spending, 43% favour maintaining current levels. Only a small minority would opt for cuts.

Perhaps the most telling finding is not the increase in satisfaction, but the lack of optimism. Only 16% of respondents believe NHS care will improve over the next five years, while 53% expect it to get worse. Even among those who are currently satisfied, confidence is fragile. This disconnect suggests that while recent experiences may have improved slightly, confidence in long-term recovery has not.

If the NHS picture is mixed, social care is more stark. Just 14% of respondents say they are satisfied with social care, while 49% are dissatisfied. Although dissatisfaction has fallen slightly, overall confidence remains extremely low. There is also less appetite to fund social care through higher taxation, highlighting an ongoing challenge for both policymakers and communicators.

There is also an important context to these findings. The survey was conducted between late August and early October, before the NHS enters its most pressured winter period. As a result, it captures public sentiment at a particular point in the year, rather than reflecting the additional pressures that typically emerge over winter.

Through our work in the healthcare sector, we see first-hand the quality of care being delivered, alongside the innovation and scientific progress that is improving outcomes – stories that, when told well, can help rebuild public confidence.

From a PR and communications perspective, this is where careful judgement is required. There is a positive story to tell. The first meaningful uptick in satisfaction since 2019 is not insignificant and provides a platform to highlight progress and improvement. However, that story needs to be grounded in reality. Overstating progress risks undermining credibility, particularly when public expectations remain low.

There is now an opportunity for policymakers and NHS senior leaders to turn this tentative improvement in sentiment into something more meaningful. That will depend not on perception alone, but on sustained, visible improvements in people’s day-to-day experience of care. Green shoots of progress may be emerging, but until they are consistently felt by patients, any optimism is likely to be short-lived and public confidence will remain fragile.